Replication Data for: Fatigue trajectory and its associated factors in patients after cardiac surgery: A longitudinal study

Background: Fatigue is associated with multidimensional factors in heart failure patients. Investigating longitudinal changes in fatigue and its association in patients undergoing cardiac surgery is needed to create interventions for improving fatigue during recovery. Aims: This study examined the trajectory of fatigue and its associated factors over time in patients undergoing cardiac surgery. Methods: This longitudinal study enrolled 125 patients undergoing cardiac surgery in northern Taiwan. Patients completed questionnaires before surgery, at discharge, and at 1, 3 and 6 months post-discharge. Fatigue was measured using the General Fatigue Scale. Generalised estimating equation models were fitted to identify variables associated with fatigue over time. This study complied with the STROBE checklist. Results: The sample (mean age = 60.70 ± 10.42) was mostly male (68%). High fatigue was found in 73.6% of patients before cardiac surgery and significantly decreased over the six months after discharge. NYHA III/IV, lower haemoglobin level, more symptom distress, poor sleep quality, higher anxiety and depression and lower social and family support were significantly associated with an increase in fatigue levels over time. Compared with before discharge, decreases in sleep quality at 1, 3 and 6 months were significantly associated with an increase in fatigue levels (p < .001). The increases in social support (B = 0.20, p = .016) and family support (B = 0.37, p = .002) at 6 months were significantly associated with an increase in the fatigue scores. Conclusion: Fatigue was common and associated with symptoms, sleep quality, emotion and social support in patients undergoing cardiac surgery. In addition to symptom management, improving sleep quality and social support are important to manage fatigue for the long-term care of patients undergoing cardiac surgery. Relevance to clinical practice: Patient education on symptom management, sleep hygiene and family support is suggested to improve fatigue in patients recovering from cardiac surgery.

背景：心力衰竭患者的疲劳与多维度因素相关。为制定康复期改善疲劳的干预方案，亟需探究心脏手术患者疲劳的纵向变化及其关联因素。
研究目的：本研究旨在明确心脏手术患者疲劳随时间变化的轨迹及其相关影响因素。
研究方法：本项纵向研究纳入中国台湾北部地区125例行心脏手术的患者。分别于术前、出院时以及出院后1、3、6个月对患者开展问卷调查。采用通用疲劳量表（General Fatigue Scale）评估疲劳程度。通过构建广义估计方程（Generalised Estimating Equation, GEE）模型，识别随时间变化与疲劳水平相关的变量。本研究严格遵循STROBE声明（STROBE Checklist）的规范进行报告。
研究结果：本研究样本的平均年龄为60.70±10.42岁，其中男性占比68%。术前73.6%的患者存在重度疲劳，且该比例在出院后6个月内显著下降。纽约心脏协会（New York Heart Association, NYHA）心功能分级III/IV级、较低的血红蛋白水平、更严重的症状困扰、较差的睡眠质量、较高的焦虑与抑郁水平以及较低的社会与家庭支持，均与随时间推移的疲劳水平升高显著相关。与出院前相比，出院后1、3、6个月时睡眠质量的下降均与疲劳水平升高显著相关（p < 0.001）。出院后6个月时，社会支持（B=0.20，p=0.016）与家庭支持（B=0.37，p=0.002）的提升，均与疲劳评分升高显著相关。
研究结论：心脏手术患者的疲劳发生率较高，且其与症状表现、睡眠质量、情绪状态及社会支持密切相关。除症状管理外，改善睡眠质量与社会支持对于心脏手术患者术后长期康复中的疲劳管理至关重要。
临床实践启示：建议对心脏手术康复期患者开展症状管理、睡眠卫生及家庭支持相关的患者教育，以改善其疲劳症状。