The relationships between fatigue, depression, and sleep disturbance after myocardial infarction

Recovery following myocardial infarction (MI) is associated with physiological and psychological symptoms. Knowledge about recovery symptoms during the first six weeks after MI is insufficient, particularly our understanding of fatigue, depression, and sleep disturbance. Thus, the purpose of this study was to examine the relationships between fatigue, depression, and sleep disturbance in MI patients during the first six weeks of recovery. Also, the changes in fatigue, depression, and sleep disturbance over time and whether or not physiological, psychological, and situational variables contribute to changes in these symptoms was determined.; A prospective, descriptive repeated measures design was used. A convenience sample of 51 individuals (mean age 54 years) with first time MI had face-to-face interviews three times: 3rd day of admission and two and six weeks after discharged from the hospital.; Findings showed strong relationships between fatigue, depression, and sleep disturbance in MI patients at each measurement point. Analysis of variance over time showed that levels of fatigue and sleep disturbance significantly decreased over time, although this decrease did not remain when controlling for the physiological variables of LVF, cardiac functional status, and beta-blocker dose; psychological variables of patients' perception of CAD and anxiety; and situational variables of age, gender, and marital status. Thus, these findings indicate that these covariates influence the changes in the recovery symptoms. There was no statistically significant change in depression over time, although the reduction in depression scores over time was clinically significant.; Nurses can use the study findings to develop guidelines and home going discharge protocols to help MI patients to manage these symptoms. The study findings reveled that the recovery symptoms are related, suggesting that intervention to mange one symptom could improve other symptoms. Future studies should be designed to develop interventions that address these symptoms as a group and include contextual confounding variables.