Running head: ACKNOWLEDGING FATIGUE OF TIRED WOMEN
Acknowledging Unexplained Fatigue of Tired Women
The title “Acknowledging Unexplained Fatigue of Tired Women” indicates a qualitative study. This study is applicable to women (aged 18 years or more) with the symptoms of fatigue, depression, sense of powerless, and body aches.
The problem is stated clearly throughout the introduction. The background information illustrates that fatigue is not well understood. If the patterns associated with fatigue were better understood, diagnosis, treatment, and management of symptoms would be attainable. Justification for this study is based on the principle that no previous research has taken place focusing on the patterns of fatigue. These must be understood in order to treat accurately. The specific significance of the problem to the nursing practice is not stated within the text. One can deduce that fatigue is multi-dimensional syndrome that requires care from all members of the interdisciplinary team, which includes nurses. The problem can be researched using objective measures to find correlations of fatigue and related symptoms.
The literature review precedes the explanation of the study. In this section, there is examination of treatment studies that have proven therapeutic for fatigue symptoms, including thyroid hormones and antidepressants. The review of the literature demonstrates that the best approach of care has not been found and there is a need to clearly define the patterns of fatigue. Classic research cited was Aaronson et. al (1999), which examined “fatigue physiological, intrapersonal, and psychosocial patterns related” (Dzurec, 42). Current research included in the literature review included Dzurec et al. (2000), in which the results show that anti-depressants are inadequate for long-term fatigue (Dzurec, 42). Supporting studies showed need for research in this area and opposing studies were those of pharmacological treatment. The literature review is logically organized by first stating the drug research, why it is ineffective, the need to redefine patterns to find a cause and therefore find the treatment that works. A primary resource included is Aaronson et. al (1999) and a secondary source was the American Associations of Clinical Endocrinologist website. There is no summary of the literature review, but there is an appropriate statement of purpose and research cues.
The purpose is clearly stated. The statement is appropriate for a qualitative study as it emphasizes verbal description and meaning of experiences.
The research method used is a quasi-experimental design with descriptive and comparative techniques. The rational for use of this design was absent from the text. Given the purpose of the study, the design deems appropriate based on the need for indicators of the symptoms. The issues of rigor are addressed by measuring questions objectively as well as subjectively.
The sample was selected by convenience using snowball techniques to recruit women. Sample size was determined by alpha set of .05 with anticipation of an large effect size. This is appropriate for a general study. There were four criteria for inclusion: the participant must be generally healthy, non-pregnant, pre-menopausal, and aged 18 years or greater. General health was measured by regular participation in daily activities and school, work, or home and normal CBC, non-fasting blood glucose level test, BUN, serum creatnine, and iron tests. The tests were administered to rule out abnormalities that may cause fatigue.
The steps in the data collection process were cleared stated in the text The instruments utilized was pen and paper tests including a demographic form, the MFSC, the CES-D, and the PKPCT. Appropriateness of instruments was measured by a panel, which supported the validity of the test for the specific uses of this study.
All participants signed the informed consent and the procedures were approved by the International Review Board. There is no mention of anonymity or confidentiality of participants within the study.
The data was analyzed using 1-tailed t tests and adjusted by a Bonferroni significance test. For significance of the symptomatic group, a Pearson correlation was administered. There is no mention of who analyzed the research or the data program used. Based on the noted tests used, one can deduce that the software used was Statview, as a Pearson correlation was used.
The findings presented were that the differences between all four instruments were found statistically significant. Researchers note that the differences were expected, as well as, the directions were expected. The direction of the differences is not noted in the text, as well as the expected direction is not noted. This leads to unclear descriptions of the results. It is however, made clear that depression and fatigue are positively correlated, and depression and sense of power are negatively correlated. There is no use of tables or graphs to illustrate the results, a visual aid may have furthered the understanding of the results, especially in the area of correlation direction.
The significant findings related to the purpose of the study in that the research objectively described the symptoms associated with fatigue, which is the goal of the study. Knowledge taken from previous studies indicted that unexplained fatigue is very complex. The lack of knowledge of this complexity facilitated the further exploration of the subject. New knowledge is gained in the current study by objectively finding biochemically normal women with symptoms of the hypothyroid-like nature. Conclusions are appropriately documented in that there is a complex interplay of these symptoms. This can further complicate effective diagnosis, treatment, and management of symptoms. It is now known that there are differences between women who experience fatigue and women who do not. Now the direction of further research is known; what could be the causes of these symptoms? The future research suggested to develop the answer to this question includes: more quantitative studies and sampling, increase the size and diversity of the sample, and look at exogenous issues that may contribute to the cause, such as marital status, employment status, and number of children. The limitations of this study noted in the discussion included a small sample size resulting in inadequate power of the study. The groups were not demographically identical, the asymptomatic group was significantly younger than the symptomatic group. As well as limitations of variability due to snowball sampling procedures. There was no note in the text of the relevance of this study to clinical nursing practice.
One strength of this research study was that the study had explicit rationale. The reasoning of the study was clearly stated that the patterns associated with fatigue are vaguely understood. If better understood, then care that is more effective could be administered to the women that experience these symptoms. Another strength of the study is that there is a logical progression of arguments. The lack of research in the specific area of symptoms of fatigue leads to a clear need for this study. The methods are specific to each symptom. The results showed that there is a difference in women complaining of these symptoms. Finally, there are many ways to apply this to new research and clinical practice. A weakness of the study includes poor documentation. A number of facts were absent from the text, such as the reasoning for the specific research design, anonymity or confidentiality discusses with participants, and use of tables and graphs to illustrate the results. The literature review is the second weakness, as it does not provide a solid background of the past research and framework for research design. All but one of the articles cited in the literature review are past studies of the author of this study. This is a conflict of interest. If they only reviewed and analyzed their own work, the literature review most likely does not reflect the ideas of the profession as a whole. Other citations and reviews are needed.
An appropriate nursing diagnosis would be Fatigue.
Carpenito, L. J. (2002). Handbook of Nursing Diagnosis: Ninth Edition. J. B. Lippincott Company; Philadelphia, PA.
Dzurec, L.C., Hoover, P. M. & Fields, J. (2002). Acknowledging unexplained fatigue of tired women . Journal of Nursing Scholarship, 34, 41-46.
Fain, J. A. (2004). Reading, Understanding, and Applying Nursing Research; Second Edition. F. A. Davis Company; Philadelphia, PA.