Fatigue in patients with chronic heart failure - a burden associated with emotional and symptom distress. 
The relationship between experience of fatigue and emotional and symptom distress in chronic heart failure (CHF) needs to be thoroughly explored, because fatigue has major impact on daily activities in life.  The purpose was to examine the association between fatigue, as a multidimensional experience and anxiety, depression and symptom distress, and to explore the relationships between individual symptoms and the dimensions of fatigue in patients with CHF.  A consecutive sample of 112 patients with exacerbation of symptoms of CHF answered the Multidimensional Fatigue Inventory (MFI-20), the Hospital Depression and Anxiety (HAD) Scale and the Symptom Distress Scale (SDS).  Anxiety was associated with mental fatigue, whereas depression was associated with reduction of activity, low motivation and decreased functioning.  Physical fatigue was affected by symptom distress, with women reporting more distress than men.  With exception of breathlessness, poor agreement was found between fatigue and the most intensive reported symptoms.  The relationship between emotional distress and the experience of fatigue in patients with CHF may have a devastating affect on the patient's ability to cope and manage daily activities, including self-care and adherence to recommended treatment.