CLINICAL ISSUES
The Fatigue Experience for Women With Human Immunodeficiency Virus

https://doi.org/10.1111/j.1552-6909.1999.tb01984.xGet rights and content

Purpose

To examine fatigue as a symptom experienced by women with human immunodeficiency virus (HIV).

Sample

A convenience sample of 100 women with HIV.

Analysis

Independent sample f-tests were used to test for mean differences in fatigue related to variables in the women's sociocultural and home environment (ethnicity, employment, marital status, and parenting). Pearson product moment correlations were used to examine significant relationships between fatigue and physiologic variables (age, CD4 cell count, and sleep).

Findings

Lower CD4 cell counts were related to more daytime sleep, higher evening fatigue, and higher morning fatigue. Morning fatigue was related to duration of wake episodes during the night, napping, and perception of sleep disturbance during the past week. The number of awakenings during the first night predicted the severity of fatigue the next evening.

Conclusion

To understand the fatigue experienced by women with HIV, researchers and clinicians must focus on the relative contributions of sociocultural, home, and physiologic environments within which these women live. Additional research is ongoing to identify the strategies these women use to manage daily activities such that gender-relevant and culturally relevant interventions for alleviating fatigue can be tested in women with a variety of chronic illnesses, including HIV and acquired immune deficiency syndrome.

Section snippets

Conceptual Framework

The proposed study was guided by Lee, Lentz, Taylor, Mitchell, and Woods’ (1994) conceptual model of the demands and resources that influence fatigue placed within the context of McBride and McBride’s (1981) theoretical framework for women’s health. Within this model and framework, a woman’s fatigue experience is influenced by her contextual environment, and her health problems cannot be examined without consideration of that context. For the purpose of this study, a woman’s health is

Sample

A cross-sectional, descriptive design was used to describe the multifaceted environment of a convenience sample of 100 ethnically diverse women with HIV. Women were recruited from four agencies that primarily provide care for Medi-Cal/Medicaid clients in northern California. To be included in the study, women had to be: 1) 18 years of age or older, 2) able to understand and sign an English consent form, and 3) seropositive for HIV. For the purpose of this study, women were excluded if there

Sociocultural Environment

The convenience sample of 100 women in this study reflects the ethnic makeup of those with HIV in the San Francisco Bay area. There were 59 African American women, 27 European American women, and 14 English-speaking Hispanic American women. Most were unemployed (82%) but reported doing some volunteer work. Most (60%) were high school educated; eight women had completed college, and five women had not completed grade school. Most (73%) reported a net family annual income of less than $10,000;

Conclusions

This sample of women with HIV reflects the demographic profile of women with HIV in California. The range of infection severity, as assessed by CD4 cell count, is representative of the population of persons with HIV in the United States. None of these women were taking protease inhibitors when the study was conducted. Whether this was because of a lack of resources or lack of information from their health care provider remains unknown. As a group, these women perceived high levels of fatigue

Implications for Women’s Health Care Providers

Nurses care for people with HIV at many points in the health care system (Bradley-Springer, Schwanberg, & Frank, 1994). The current and future health problems for someone with HIV primarily involve fever, anemia, pain, infection, depression, and disturbed sleep cycles associated with immune dysfunction. In addition, medications used in the treatment of HIV often produce adverse side effects, such as nausea, vomiting, and diarrhea. These side effects also can exacerbate a patient’s experience of

Acknowledgment

This research was supported by The National Institute of Nursing Research (NINR) R01 NR03969.

REFERENCES (43)

  • T.V. Ellerbrock et al.

    Epidemiology of women with AIDS in the United States, 1981 through 1990

    JAMA

    (1991)
  • R.L. Harris et al.

    The timing of psychosocial transitions and changes in women’s lives: An examination of women aged 45 to 60

    Journal of Personality and Social Psychology

    (1986)
  • P.J. Hauri et al.

    Wrist actigraphy in insomnia

    Sleep

    (1992)
  • K.A. Lee

    Self-reported sleep disturbances in employed women

    Sleep

    (1992)
  • Κ. Lee et al.

    Fatigue as a response to environmental demands in women’s lives

    Image: Journal of Nursing Scholarship

    (1994)
  • A.B. McBride et al.

    Theoretical underpinnings for women’s health

    Women & Health

    (1981)
  • A.I. Meleis et al.

    Role integration and health among female clerical workers

    Research in Nursing and Health

    (1989)
  • R.G. Miller et al.

    Fatigue and myalgia in AIDS patients

    Neurology

    (1991)
  • A.M. Morris et al.

    The p300 event-related potential

    Journal of Occupational Medicine

    (1992)
  • C. Muller

    Health and health care of employed women and homemakers: Family factors

    Women & Health

    (1986)
  • C.A. Nathanson

    Social roles and health status among women: The significance of employment

    Social Science and Medicine

    (1980)
  • Cited by (0)

    View full text