Exploring the patient perspective of fatigue in adults with visual impairment: A qualitative study

Wouter Schakel, Christina Bode, Hilde P.A. Van Der Aa, Carel T.J. Hulshof, Judith E. Bosmans, Gerardus H.M.B. Van Rens, Ruth M.A. Van Nispen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss.

Original languageEnglish
Article numbere015023
JournalBMJ Open
Volume7
Issue number8
DOIs
Publication statusPublished - 1 Aug 2017

Cite this

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title = "Exploring the patient perspective of fatigue in adults with visual impairment: A qualitative study",
abstract = "Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss.",
keywords = "fatigue, low vision, patient's perspective, qualitative research, quality of life",
author = "Wouter Schakel and Christina Bode and {Van Der Aa}, {Hilde P.A.} and Hulshof, {Carel T.J.} and Bosmans, {Judith E.} and {Van Rens}, {Gerardus H.M.B.} and {Van Nispen}, {Ruth M.A.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1136/bmjopen-2016-015023",
language = "English",
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Exploring the patient perspective of fatigue in adults with visual impairment : A qualitative study. / Schakel, Wouter; Bode, Christina; Van Der Aa, Hilde P.A.; Hulshof, Carel T.J.; Bosmans, Judith E.; Van Rens, Gerardus H.M.B.; Van Nispen, Ruth M.A.

In: BMJ Open, Vol. 7, No. 8, e015023, 01.08.2017.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Exploring the patient perspective of fatigue in adults with visual impairment

T2 - A qualitative study

AU - Schakel, Wouter

AU - Bode, Christina

AU - Van Der Aa, Hilde P.A.

AU - Hulshof, Carel T.J.

AU - Bosmans, Judith E.

AU - Van Rens, Gerardus H.M.B.

AU - Van Nispen, Ruth M.A.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss.

AB - Objectives Fatigue is an often mentioned symptom by patients with irreversible visual impairment. This study explored the patient perspective of fatigue in visually impaired adults with a focus on symptoms of fatigue, causes, consequences and coping strategies. Setting Two large Dutch low vision multidisciplinary rehabilitation organisations. Participants 16 visually impaired adults with severe symptoms of fatigue selected by purposive sampling. Methods A qualitative study involving semistructured interviews. A total of four first-level codes were top-down predetermined in correspondence with the topics of the research question. Verbatim transcribed interviews were analysed with a combination of a deductive and inductive approach using open and axial coding. Results Participants often described the symptoms of fatigue as a mental, daily and physical experience. The most often mentioned causes of fatigue were a high cognitive load, the intensity and amount of activities, the high effort necessary to establish visual perception, difficulty with light intensity and negative cognitions. Fatigue had the greatest impact on the ability to carry out social roles and participation, emotional functioning and cognitive functioning. The most common coping strategies were relaxation, external support, socialising and physical exercise and the acceptance of fatigue. Conclusions Our results indicate that low vision-related fatigue is mainly caused by population specific determinants that seem different from the fatigue experience described in studies with other patient populations. Fatigue may be central to the way patients react, adapt and compensate to the consequences of vision loss. These findings indicate a need for future research aimed at interventions specifically tailored to the unique aspects of fatigue related to vision loss.

KW - fatigue

KW - low vision

KW - patient's perspective

KW - qualitative research

KW - quality of life

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U2 - 10.1136/bmjopen-2016-015023

DO - 10.1136/bmjopen-2016-015023

M3 - Article

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 8

M1 - e015023

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