A Concept Analysis of Prodromal Myocardial Infarction Fatigue

Currently our featured ANS article is titled “Prodromal Myocardial Infarction Fatigue: A Concept Analysis” by John R. Blakeman, MSN, RN, PCCN-K.  Please download the article at no cost while it is featured, and return here to share your comments and feedback!  Here is John’s message about his work, including a presentation that he prepared featuring this work:

Symptom research is complicated. Because symptoms are, at their core, a human experience, each individual may perceive, attribute, and react to them in different ways. Because of the unique context in which they occur, symptoms cannot reliably be reduced to single, simple, objective pieces of data. Prodromal myocardial infarction (MI) fatigue is no different.

About six years ago, I began my adventure into the world of MI symptoms, especially MI symptoms experienced by women. I had heard about symptom differences between men and women, but, up to that point, I had not closely examined these symptoms in any comprehensive, systematic way. As I dove into the literature, one of the major themes that I identified was that fatigue was a particularly prevalent symptom experienced by women before an MI. However, fatigue was conceptualized in a variety of ways.

Symptom research is a messy business, partly because this research necessarily involves a considerable amount of self-report data. It is not uncommon to see multiple different descriptions of a given symptom. In the case of prodromal MI fatigue, I read a number of descriptions. Some research participants across studies had described this fatigue as “tiredness,” while others might have opted for the term “weakness.” Still others simply used the term “fatigue.” Study participants also provided an array of descriptions regarding the severity and intensity of this symptom. I recognized that this central, latent construct of prodromal MI fatigue was really made up of a number of other constructs, and I wanted to comprehensively review the literature to identify what exactly this latent construct of prodromal MI fatigue “looked like.” Out of this desire came the present concept analysis.

I learned that there was not a simple, neat definition that could be created, though I was able to identify several general commonalities across the many documents that I reviewed. I also recognized the need to further investigate prodromal MI fatigue, and I am now completing a qualitative study focused on women’s experiences of prodromal MI fatigue. This concept analysis helped frame my understanding of the symptom and guided me as I designed my study. Is there more work to do? Absolutely. I expect, and would hope, that this concept will be further refined and that researchers will be able to use this increased knowledge to improve care and patient outcomes. Indeed, if prodromal MI fatigue can be recognized early, morbidity and mortality can likely be reduced due to early intervention, prior to MI.