1. Charlotte-Anne Wells Senior Occupational Therapist Craigavon Area Hospital Fatigue Management in Phase III Cardiac Rehabilitation

3. Fatigue Frequent & distressing symptom (Brink et al, 2002) Reported to be the most frequent symptom before Acute MI (McSweeney et al, 2003) ‘Vital Exhaustion’: unusual fatigue, increased irritability, feelings of demoralisation (Appels and Mulder, 1988; Shuitemaker et al 2004)

4. Fatigue Living with Incomprehensible Fatigue after Recent MI (Alsen et al, 2008. Advanced Journal of Nursing) Description: ‘‘A different kind of tiredness’ ‘Incomprehensible’ ‘Unpredictable’ ‘Not related to effort’ Effects: Daily functioning Ability to work Physical functioning Intellectual and emotional function Social activity

5. Fatigue Management & Energy Conservation (Craigavon Area Hospital) Fatigue in relation to Activities of Daily Living, Work & Leisure Activity Analysis Use of METS Activity Grading Use of Borg Scale in relation to Daily Activities Advice on Energy Conservation/Fatigue Management Psychological effect of Fatigue and MI

6. Audit Aims To ascertain the proportion of programme attendees who felt that fatigue was a major symptom of their condition To establish how those individuals felt fatigue impacted upon their daily functional ability To examine how useful individuals found the advice given To establish what, if any, aspects of the session they incorporated into daily life To identify areas for improvement and development

7. Methodology Study Design Recruitment of Research Team Sampling Size Timescale Data Collection Demographics

8. Results

9. Percentage of patients who felt that Fatigue was a major symptom of their condition

10. Areas of Daily Life affected by Fatigue N=20N=23N=17N=21N=10N=19

11. Topics within the session which participants found useful N=25N=30 N=18 N=21 N=25 N=19 N=25N=27

12. How participants rated the session on Fatigue Management N=22N=12 N=3N=0

13. Topics within the session which participants introduced into daily life N=15N=21N=5N=7N=14N=3N=15N=17

14. Qualitative Feedback ‘Relevant’‘Interesting’ ‘It increased my confidence to complete my daily activities’ ‘It enabled me to manage my condition with confidence’ ‘My family was able to relate to the information provided’ ‘It increased my confidence to complete my daily activities’

15. Study Limitations Study is based on patient reporting alone – no objective measurement Timeframe Retrospective

16. Recommendations Further study Larger sample size The use of an objective measurement tool Administer questionnaire or assessment tool within a set timeframe pre or post Phase III

17. …. and finally

18. Thank You