By Apinya Kochamat, Promjit Hornboonherm, Apinya Wongpiriyayothar, Wichai Eungpinithpong

While majority of stress afflicted people turn to smoking for relief, prevalence of COPD inches its way among the top causes of mortality worldwide. Managing symptoms of COPD is already winning half the battle. With the success of a recent study on an assessment tool for COPD , more COPD patients will finally take a breather.

The sixth leading cause of death worldwide is Chronic Obstructive Pulmonary Disease or COPD, according to a finding from the 1990 Global Burden of Disease Study which gauges health loss from identifies diseases, injuries and risk factors. The progression of COPD incidence is remarkable that by the year 2020, and by then placing COPD in the third rank (Calverley and Walker, 2003).
In Thailand, around ten million people smoke cigarettes – a fact which accounts for the 15 to 30 % of its population inflicted with COPD. Worse, at least 1.5 to 3 Million of its population are projected to have COPD ,as well (Boonsawat, 2005).

When Fatigue Strikes
While dyspnea is the most threatening symptom, fatigue (or tiredness) follows suit. In one study on COPD, it is revealed that about 68 to 80% show the symptoms of fatigue (Solona and Gomes, 2006). Both dyspnea and fatigue are apparent in patients. The patients who suffer from dyspnea likewise suffer from fatigue (Woo, 2000). A previous study of Theander and Unosson (2004), showed that almost a half of all patients are also down with fatigue. Moreover, these patients suffered from this symptom for 6 hours daily.

Fatigue has significant impact on the daily routine of COPD (Theander and Unosson, 2004). The effect of fatigue involved both the physical and emotional well-being of the patient. Consequently, patients who are faced with severe fatigue experience a state of hopelessness, low self-esteem due to resulting disability and dependency on others, and concern about uncertainty and dying (Teeranoot, 1999). The quality of life of COPD patients are greatly at stake.

The Silent Symptom
Along with symptoms such as dyspnea and chronic cough ( with or without secretion ), difficulty to speak is another predicament for COPD patients. Their situation hinders effective treatment as doctors would have no way to find out the extent of their malaise.
COPD is a chronic disease that is irreversible (Boonsawat , 2005). The goal of treatment in COPD patients is to abate symptoms and not for curative outcome. All symptoms progress from mild to severe (Udompanich, 2003).

Analysing Fatigue: The Trendall Fatigue Tool
Because of variation in the definition of fatigue, assessing this particular symptom was investigated in previous researches (Small & Lamb, 2000; Trendall & Esmond, 2007). In the study of Trendall & Esmond (2007), the fatigue tool was developed specifically for assessing fatigue in COPD patients.
After two stages of analysis, the researchers proposed a fatigue tool for COPD patients in clinical setting that will be utilized by nurses. The outcome and suggestions resulting from the research, which was studied in the Western culture, roused the authors’ interest to apply the fatigue tool in a different culture.

To help COPD patients cope with symptoms, especially evaluate fatigue, the Trendall Fatigue Tool was developed by experts Judith Trendall and Glenda Esmond (2007). This tool has since been utilized by nurses in evaluating COPD symptoms in their patients and aid in managing the condition to reduce or prevent symptoms of fatigue.

Read more of this article

• Study Abstract
• Methodology
• Research Instruments
• Translating the Study
• Discussion and Conclusion

to Malaysian Journal of Nursing