Home Health Care Management & Practice

Because of the widespread nature of chronic fatigue, health care providers need a common understanding of chronic fatigue to enable effective communication. To aid this understanding a concept analysis was undertaken using a modified version of Rodger’s evolutionary method of concept analysis. The literature review yielded many resources focused on defining fatigue and relating it to many diverse chronic conditions. This article also discusses the differences between chronic fatigue and acute episodes of fatigue. Chronic fatigue is a subjective, unpleasant, changeable, and exhausting experience that adversely affects quality of life. Whereas rest or sleep often relieves acute fatigue, chronic fatigue is unrelenting. Chronic fatigue has multiple antecedents and is a component of a diverse array of chronic diseases.

When fatigue is not addressed, there is a high probability that it will negatively affect the patient’s participation in healthy behaviors. It is well known that a patient’s active participation can improve recovery from any injury or illness. The first step is the assessment of a patient’s fatigue, with a follow up focus on fatigue management strategies. The clinical guidelines for cancer-related fatigue recommend fatigue assessment as the sixth vital sign. This recommendation is a good guideline for all provider/patient interactions and provides an overall picture of the patient’s health. While fatigue is often an expected symptom of chronic illness or cancer therapy, few patients are given a proactive approach to fatigue management. When fatigue is left untreated, the patient is set up for failure in all self-management behaviors. Fatigue is a manageable condition but requires the active and well-informed patient and a supportive, well-informed health care team.

Managing fatigue can be supported by incorporating energy conservation and work simplification strategies into daily routines. Fatigue is a common symptom experienced by people with various chronic diseases, such as, but not exclusively, arthritis, cancer, diabetes, multiple sclerosis, or fibromyalgia. This type fatigue is not linked to activity level or rest patterns. It can have an effect on a person’s ability to complete the various daily tasks to maintain their lifestyle. This article addresses approaches and tips for integrating energy conservation and work simplification into daily activities.

Fatigue is a debilitating symptom of many chronic illnesses. Because of pain, discomfort, and chronic fatigue, people with chronic illnesses often decrease their activity levels. There is often a vicious cycle that can prevent a person from participating in a regular exercise program. A person will avoid exercise because of pain, discomfort, or fatigue. However, a review of research by this author has shown that mild to moderate exercise, for as little as 10 to 15 minutes a day, can improve a person’s activity level and reduce fatigue and some pain.

Whether trying to minimize symptoms of fatigue or eat to decrease disease risks, a basic approach using regular foods is usually going to meet needs. Media “sells” quick fix products that may accomplish the task, but the media does not teach lifestyle changes that we can live with long-term. This article provides simple steps to show patients about their diet intake and where they are in their nutritional intake. The steps on how to change to a healthier eating style and habits are introduced.

The traditional acute health care model works well for acute injuries and illnesses but is unlikely to achieve good outcomes in managing chronic health care conditions. Positive outcomes in chronic illness management requires multiple referrals from the primary care provider for a multidisciplinary team, relinquished control by the health care providers as they coach the patient into the active role of self-care life skills and daily management of their health, and active learning, participation, and accountability of the patient.

This article addresses the issues of organizational culture and the mitigating forces that affect and drive the development of compliance plans. It also offers insight into the potential benefits of developing a healthy compliance culture in an organization. The article discusses the major topics of understanding the culture that exists in an agency, core values for compliance, external mitigating factors, internal mitigating factors, and the benefits an agency can accrue by creating a healthy compliance culture.