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Development of a Tool for Assessment of Post-Myocardial Infarction Fatigue

Even in cases of successful medical treatment for myocardial infarction (MI), quite a few persons will experience different symptoms, including fatigue, during the recovery phase. Such symptoms can negatively affect well-being and daily life functioning, with the risk of deleterious effects on cardiovascular prognosis. Several inventories have been developed to measure fatigue in different groups of persons with chronic conditions, mostly related to cancer diagnoses, but there are almost none targeting coronary heart diseases. The aim of the present study was to construct the multidimensional Post-Myocardial Infarction Fatigue (PMIF) scale, based on empirical data gathered in coronary heart disease contexts. 

The construction of the post-MI fatigue scale was conducted in seven steps, ending in a psychometric evaluation of the internal structure of the scale. Besides, the Multi-Dimensional Fatigue Inventory (MFI-20) was used to complement the PMIF scale and the Cardiac Self-Efficacy (CSE) Scale was used to test discriminant validity. Confirmatory factor analysis (CFA) was performed to examine the extent to which the factor structure replicated the hypothesized hierarchical models. Model fit was estimated by: 1) χ2 goodness-of-fit, χ2/df, 2) the Root Mean Square Error of Approximation (RMSEA), 3) the Standardized Root Mean Square Residual (SRMR), 4) the Comparative Fit Index (CFI). Mean summed scores for each scale were assessed, and then convergent and discriminant validity were considered based on calculations of Pearson’s correlations.

The study comprised 141 persons, ≤75 of age, diagnosed with MI two months earlier. The MI diagnosis was based on electrocardiographic data, symptoms and enzymatic criteria. Respondents were consecutively recruited to participate in a longitudinal follow-up of recovery after MI. The results showed that the PMIF scale represented three dimensions: physical, cognitive and emotional fatigue. It was also found that the scale was suitable for summing the items to obtain a total score representing a post-MI global fatigue dimension. 

In conclusion, the PMIF scale—a brief and easily completed scale—may be useful for identifying persons experiencing post-MI fatigue. And early identification of fatigue, together with health behavior support, might be useful in promoting fatigue relief.


Article by Eva Brink, et al, from Sweden.

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