No gender differences in fatigue and functional limitations due to fatigue among patients with COPD

TLDR: In this paper, the authors examined gender differences in experiences of fatigue and functional limitations due to fatigue in patients with chronic obstructive pulmonary disease and a comparison group and found that female patients with COPD experience more fatigue than men.

Abstract: Aims and objectives.  To examine gender differences in experiences of fatigue and functional limitations due to fatigue in patients with chronic obstructive pulmonary disease and a comparison group. Background.  Fatigue is a major problem for patients with chronic obstructive pulmonary disease. The prevalence rate of chronic obstructive pulmonary disease in females is increasing and to our knowledge there are few studies reporting gender differences in one of their worst symptoms, fatigue and functional limitations due to fatigue. Design.  This study has a descriptive cross-sectional design. Methods.  Patients with chronic obstructive pulmonary disease (n = 345) and a comparison group of the same gender and age from the same region as the patients (n = 245) answered mailed questions about the frequency, duration and severity of fatigue and the fatigue impact scale. Results.  High frequency (≥20 days/month), long duration (≥6 hours/day) and great severity (one of my worst symptoms) of fatigue were experienced by 51%, 54% and 44% of the male patients with chronic obstructive pulmonary disease, respectively and 60%, 55% and 51% of the female patients with chronic obstructive pulmonary disease, respectively. The figures for the males from the comparison group were 14%, 24% and 17% and for the females 30%, 42% and 32%, respectively. There were no gender differences regarding fatigue (frequency, duration and severity) or functional limitations due to fatigue in the chronic obstructive pulmonary disease patients, while the differences between males and females from the comparison group were statistically significant for frequency and severity of fatigue as well as functional limitation due to fatigue. Conclusion.  In the comparison group, there were gender differences regarding fatigue, as well as functional limitations due to fatigue. This was not observed in the chronic obstructive pulmonary disease group. Relevance to clinical practice.  The results of this study suggest that nurses should not take for granted that female patients with chronic obstructive pulmonary disease experience more fatigue than men.

Figures

Table 2 Frequency, duration and severity of fatigue among male and female patients with COPD and a comparison group

Table 1 Demographics and social data for male and female patients with COPD and a comparison group

Table 3 Functional limitations due to fatigue among male and female patients with COPD and a comparison group

Full text

Linköping University Post Print
No gender differences in fatigue and functional
limitations due to fatigue among patiens with
COPD
Kersti Theander and Mitra Unosson
N.B.: When citing this work, cite the original article.
This is the authors’ version of the following article:
Kersti Theander and Mitra Unosson, No gender differences in fatigue and functional
limitations due to fatigue among patiens with COPD, 2011, Journal of Clinical Nursing, (20),
9-10, 1303-1310.
which has been published in final form at:
http://dx.doi.org/10.1111/j.1365-2702.2010.03625.x
Copyright: Blackwell Publishing Ltd
http://eu.wiley.com/WileyCDA/Brand/id-35.html
Postprint available at: Linköping University Electronic Press
http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-67756

Gender, fatigue and COPD
1
NO GENDER DIFFERENCES IN FATIGUE AND FUNCTIONAL LIMITATIONS
DUE TO FATIGUE AMONG PATIENTS WITH CHRONIC OBSTRUCTIVE
PULMONARY DISEASE

Gender, fatigue and COPD
2
ABSTRACT
Aims and objectives. To examine gender differences in experiences of fatigue and
functional limitations due to fatigue in patients with chronic obstructive pulmonary disease
and a comparison group.
Background. Fatigue is a major problem for patients with chronic obstructive pulmonary
disease. The prevalence rate of chronic obstructive pulmonary disease in females is
increasing and to our knowledge there are few studies reporting gender differences in one of
their worst symptoms, fatigue and functional limitations due to fatigue.
Design. This study has a descriptive cross-sectional design.
Methods. Patients with chronic obstructive pulmonary disease (n =345) and a comparison
group of the same gender and age from the same region as the patients (n = 245) answered
mailed questions about the frequency, duration and severity of fatigue and the Fatigue impact
Scale.
Results. High frequency ( 20 days/month), long duration ( 6 hours/day) and great severity
(one of my worst symptoms) of fatigue were experienced by 51%, 54% and 44% of the male
patients with COPD, respectively, and 60%, 55% and 51% of the female patients with
chronic obstructive pulmonary disease, respectively. The figures for the males from the
comparison group were 14%, 24% and 17% and for the females 30%, 42% and 32%,
respectively. There were no gender differences regarding fatigue (frequency, duration and
severity) or functional limitations due to fatigue in the chronic obstructive pulmonary disease
patients, while the differences between males and females from the comparison group were

Gender, fatigue and COPD
3
statistically significant for frequency and severity of fatigue as well as functional limitation
due to fatigue.
Conclusion. In the comparison group there were gender differences regarding fatigue, as
well as functional limitations due to fatigue. This was not observed in the chronic obstructive
pulmonary disease group.
Relevance to clinical practice. The results of this study suggest that nurses should not take
for granted that female patients with chronic obstructive pulmonary disease experience more
fatigue than men.
Key words: chronic obstructive pulmonary disease, fatigue, fatigue impact scale, gender,
general population

Gender, fatigue and COPD
4
INTRODUCTION
Traditionally, chronic obstructive pulmonary disease (COPD) has been a male disease. Its
prevalence in females is increasing, however, and will continue to increase as more females
started smoking after World War II (Mannino 2002). Since the year 2000 more females than
males are dying in COPD (Mannino 2002), but seem to have better survival than males (de
Torres et al. 2009). Several studies have reported gender differences in health status (de
Torres et al. 2006, Di Marco et al. 2006, Laurin C 2007, Martinez et al. 2007). For patients
with COPD, symptoms like dyspnea and fatigue are the most prominent symptoms
influencing their health (Arnold et al. 2005, Belza et al. 2001, Yeh et al. 2004). Little
attention has been paid to how gender differs in symptom experience, especially fatigue, and
functional status for this group of patients. Also, in the light of the change in gender
prevalence it might be important to consider gender-specific interventions for relieving
symptoms and improving functional status.
Fatigue is one of the most common symptoms experienced by patients with COPD
(Blinderman et al. 2009, Gift & Shepard 1999, Graydon & Ross 1995). In contrast to
tiredness, fatigue is described as a subjective, abnormal or unusual experience often with
no relation to activity or exertion (Piper 2003, Ream & Richardson 1996). When fatigue
lasts for a month or more, it is considered to be chronic fatigue (Piper 2003). Patients
experiencing fatigue have reported “feelings of abnormal tiredness, decreased physical
performance, weakness and unusual need for rest, which was distinctly different from
healthy persons” (p. 82) (Glaus et al. 1996).

Frequently asked questions

Q1. What are the contributions in "No gender differences in fatigue and functional limitations due to fatigue among patiens with copd" ?

For example, this paper found that women with COPD report more dyspnoea than males, in both primary care and pulmonary outpatient settings, measured using the Medical Research Council ( MRC ) dyspnea scale ( Dales et al. 2007 ). 

Q2. What future works have the authors mentioned in the paper "No gender differences in fatigue and functional limitations due to fatigue among patiens with copd" ?

As results still are contradictory, future research is required to further examine gender differences in fatigue and functional limitations. Further research on general population groups including relevant characteristics for gender differences such as education, social class, working and home management is needed. Therefore in future research an exclusion criterion of age is not necessary. In further research, severity of COPD and other sociodemographic and environmental factors should be included to obtain a better understanding of the differences among male and female patients with COPD who experience fatigue. 

Q3. What is the importance of age in the evaluation of COPD?

When planning for interventions in patients with COPD, however age is of subordinate importance; more important is how they experience fatigue and how fatigue limits their functioning. 

Q4. What factors are to be considered in the assessment when planning for reducing the experience of fatigue?

In the symptom management of fatigue in male and female patients with COPD, factors such as social, environmental, cultural and individual are to be considered in the assessment when planning for reducing the experience of fatigue. 

Q5. What was the age of the male patients with COPD?

Male patients with COPD were two years older and had a higher frequency of being married or cohabiting than female patients with COPD. 

Q6. What is the prevalence of COPD in females?

Its prevalence in females is increasing, however, and will continue to increase as more females started smoking after World War II (Mannino 2002).