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. Author manuscript; available in PMC: 2020 Jun 1.
Published in final edited form as: J Pain Symptom Manage. 2019 Dec 20;59(6):1320–1343. doi: 10.1016/j.jpainsymman.2019.12.358

Table 2.

Study Characteristics

Studies by Chronic Condition
  • Purpose Statement

  • Methods (Design; Sampling; Data Collection; Analysis; Theoretical Framework)

  • CASP Score

  • Study Location—Setting

  • Sample Size (N)

  • Age

HF
 Dickson et al.17
  • To explore the meaning of depression and how depressive symptoms affect self-care in an ethnic minority black population with HF

  • Mixed-method concurrent nested design; purposive homogeneous sampling; semistructured interviews; thematic content analysis; situation-specific theory of HF self-care

  • CASP score: 17

  • U.S.—HF clinic and inpatient units at a large urban medical center

  • N = 30 (40% females, 60% males)

  • Mean age 59.63

 Gwaltney et al.18
  • To identify relevant and important concepts to patients with chronic HF and to understand broadly the language that they use to describe their experiences

  • Design not named; secondary analysis of interviews from three separate studies; semistructured interview; content analysis; no theoretical framework specified

  • CASP score: 10

  • U.S.—setting unclear

  • N = 63 (40% females, 60% males)

  • Mean age 68.9, age range 38–90

 Hagglund et al.15
  • To illuminate the lived experience of fatigue among elderly women with chronic HF

  • Explorative and descriptive design; convenience sampling; one-hour interviews; qualitative content analysis; no theoretical framework specified

  • CASP score: 20

  • Sweden—home setting

  • N = 10 (all females)

  • Mean age 83, age range 73–89

 Holden et al.20
  • To apply a systems model to investigate patient work performance to understand the nature and prevalence of barriers to self-care

  • Mixed methods; convenience sampling; semistructured interviews; iterative analysis; patient work system model

  • CASP score: 16

  • U.S.—home setting (surveys), clinic setting (interviews)

  • N = 30 (43% females, 57% males)

  • Mean age 74, age range 65–86

 Jones et al.23
  • To explore the perceptions, experience, and meaning of fatigue as a distressing symptom of chronic HF

  • Interpretive study design; purposive sampling; semistructured interviews; interpretive analysis; no theoretical framework specified

  • CASP score: 15

  • U.S.—outpatient cardiology and geriatric clinics

  • N = 26 (31% females, 69% males)

  • Median age 61, age range 50–71

 Jurgens et al.19
  • To describe contextual factors related to symptom recognition and response among elders hospitalized with decompensated HF

  • Mixed methods; convenience sample; open-ended questions; content analysis; self-regulation model of illness

  • CASP score: 18

  • U.S.—hospital setting

  • N = 77 (48% females, 52% males)

  • Mean age 75.9

 Norberg et al.21
  • To describe clients and occupational therapists’ experiences of a home-based program focusing energy conservation strategies for clients with chronic HF

  • Single descriptive case study (qualitative and quantitative); consecutive sample; semistructured interviews; thematic analysis; energy conservation

  • CASP score: 19

  • Sweden—home setting

  • N = 52 (40% females, 60% males)

  • Mean age 80, age range 56–92

 Walsh et al.22
  • To investigate the experiences of younger persons living with HF

  • Descriptive qualitative approach; purposive sampling; participants recruited from hospitals and HF clinics; semistructured interviews; qualitative(descriptive) thematic analysis; no theoretical framework specified

  • CASP score: 20

  • U.S.—private hospital room or home setting

  • N = 18 (56% females, 44% males)

  • Mean age 48, age range 38–53

MS
 Al-Sharman et al.24
  • To explore the lived experiences of Jordanian people with MS and the impact of the disease on their daily lives

  • Phenomenology; convenience sample; patients recruited from a research database; focus groups; content analysis; no theoretical framework specified

  • CASP score: 17

  • Jordan—Jordan University of Science and Technology

  • N = 16 (50% females, 50% males)

  • Mean age 36, age range 29–57

 Kayes et al.12
  • To explore the barriers and facilitators to engagement in physical activity from the perspective of people with MS

  • Qualitative descriptive; purposive sample; Setting—face-to-face interviews in the participant’s home; modified grounded theory; no theoretical framework reported

  • CASP score: 19

  • New Zealand—home setting

  • N = 10 (70% females, 30% males)

  • Mean age 44, age range 34–53

 Lohne et al.11
  • To explore how persons suffering from MS experience whether health care personnel maintain and respect these patients’ human dignity

  • Descriptive and exploratory design; convenience sample; semistructured interviews; hermeneutic analysis; phenomenological—hermeneutic approach

  • CASP score: 11

  • Norway—two rehabilitation institutions’ patient rooms

  • N = 14 (57% females, 43% males)

  • Age range 39–66

 Moriya and Kutsumi25
  • To obtain descriptions of the experiences of fatigue of people with MS, including experiences related to their social life and interpersonal relations

  • Qualitative, exploratory, descriptive, and contextual design; purposeful sampling; semistructured interviews; data analysis not stated; no theoretical framework reported

  • CASP score: 18

  • Japan—setting not given/described

  • N = 9 (66% females, 34% males)

  • Mean age 42, age range 31–57

 Newland et al.26
  • To characterize symptoms experienced by people with relapsing-remitting MS in patients’ own words

  • Research design not stated; convenience sample; audiotaped focus groups; Krippendorff data analysis method; no theoretical framework reported

  • CASP score: 17

  • U.S.—medical center familiar to participants

  • N = 16 (75% females, 25% males)

  • Age range 18–70

 Barlow et al.27
  • The perceived value and experience of the chronic disease self-management course for people with MS

  • Qualitative study nested in a randomized controlled trial; purposive sampling; telephone interviews; framework analysis

  • Self-efficacy theory

  • CASP score: 10

  • U.K.—telephone

  • N = 10 (70% females, 30% males)

  • Age range 30–60

 Turpin et al.28
  • To further our understanding of the experience of living with MS fatigue by exploring how people became aware of and understood their MS fatigue and how they accommodate it in their daily lives

  • Qualitative thematic analysis; purposive sampling; 13 in-depth semistructured interviews; thematic analysis

  • CASP score: 18

  • Australia—setting not given/described

  • N = 13 (85% females, 15% males)

  • Mean age 46, age range 24–67

RA
 Connolly et al.29
  • To explore people with rheumatic diseases’ experiences of fatigue in work

  • A qualitative descriptive design was used with semistructured interviews; purposive sampling; constant comparative method of data analysis; no framework specified

  • CASP score: 18

  • Ireland—private room university setting

  • N = 18 (67% females, 33% males)

  • Mean age 36, age range 31–40

 Feldthusen et al.30
  • To describe how persons with RA of working age experience fatigue

  • Descriptive qualitative; purposive sampling; focus group methodology using semistructured interview schedule; qualitative content analysis; no theoretical framework specified

  • CASP score: 18

  • Sweden—hospital setting

  • N = 25 (76% females, 24% males)

  • Mean age 46, age range 20–60

 Minnock et al.31
  • To explore the patient’s experiences and perceptions of fatigue after treatment with TNFi

  • Descriptive, qualitative; purposive sampling; semistructured interviews with open-ended questions; content analysis using qualitative inductive logic; pragmatism as theoretical lens

  • CASP score: 19

  • Ireland—setting not given/described

  • N = 10 (60% females, 40% males)

  • Mean age 59, age range 44–75

 Mortada et al.32
  • To describe fatigue experience among Egyptian Muslim patients with rheumatic disease

  • Prospective, monocentric, qualitative study; purposive sampling; semistructured interviews; conventional content analysis, inductive reasoning; grounded theory

  • CASP score: 20

  • Egypt—hospital setting

  • N = 20 (80% females, 20% males)

  • Mean age 40, age range 32–60

 Nikolaus et al.33
  • To explore the experience of fatigue in persons with RA

  • Descriptive qualitative design using framework approach; purposive sampling; hierarchical interview scheme, analysis combined inductive and deductive elements; grounded in literature

  • CASP score: 16

  • The Netherlands—hospital setting

  • N = 31 (74% females, 26% males)

  • Mean age 58, age range 32–83

 Repping-Wuts et al.34
  • To explore the experience of fatigue from the patient’s perspective

  • Design not specified; semistructured interviews in clinic; purposive sampling; analysis in The Observer software and consensus-based review; framework based on the literature

  • CASP score: 18

  • The Netherlands—telephone

  • N = 29 (59% females, 41% males)

  • Mean age 59, age range 36–80

 Thomsen et al.4
  • To describe how patients with RA describe daily sedentary behavior

  • Qualitative, explorative, descriptive design; purposive sampling; content analysis of semistructured interviews; hermeneutical reflection

  • CASP score: 17

  • Denmark—home setting,8 office,5 rheumatology outpatient clinic2

  • N = 15 (67% females, 33% males)

  • Age range 23–73

CKD
 Cox et al.36
  • To describe the process and preliminary qualitative development of a new symptom-based patient-reported outcome measure intended to assess hemodialysis treatment-related physical symptoms

  • Qualitative study design; purposeful sampling; concept elicitation interviews/semistructured interviews; method of qualitative interpretive description

  • CASP score: 17

  • U.S.—five dialysis clinics

  • N = 50 (48% females, 52% males)

  • Mean age 54.6, age range 20–75

 Kazemi et al.37
  • Investigate the experiences of the social interaction of Iranian persons who are receiving hemodialysis

  • Descriptive exploratory study; purposive sampling; semistructured interviews; thematic analysis; no theoretical framework specified

  • CASP score: 18

  • Iran–three hemodialysis centers

  • N = 21 (57% females, 43% males)

  • Mean age 42.2, age range 24–74

 Monaro et al.38
  • To describe the essence of the lived experience of patients and families in the early phase of long-term hemodialysis therapy

  • Heideggerian hermeneutic phenomenology approach; nonprobability purposive sampling; semistructured interviews; Halling (2008) phenomenological analysis as a three stage

  • CASP score: 17

  • Australia—dialysis unit, in-center dialysis, or telephone

  • N = 16 (63% females, 37% males)

  • Mean age 40.5, age range 33–84

 Picariello et al.41
  • To explore renal patients’ experience of fatigue across the full spectrum of ESRD

  • Qualitative—pluralist methodological approach; purposive sampling; semistructured interviews; inductive thematic analysis; critical realist approach—combination of realist ontology and interpretivist epistemology

  • CASP score: 18

  • Englandd17 phone interviews and eight face-to-face interviews (home or private room at the university)

  • N = 25 (40% females, 60% males)

  • Mean age 60.84, age range 33–83

 Pugh-Clarke et al.42
  • To explore the patient symptom experience in non-dialysis-dependent CKD Stages 4 and 5 as the bases for the development of a symptom assessment instrument

  • Qualitative; × sampling, semistructured interviews; thematic analysis; multiphasic inductive process

  • CASP score: 18

  • U.K.—setting not described

  • N = 18 (50% females, 50% males)

  • Mean age 65.08

 Schipper et al.39
  • Describe the experiences and needs of patients with moderate-to-severe kidney damage

  • Qualitative study; purposeful sampling; 31 semistructured interviews followed by two focus groups; thematic analysis; no theoretical framework specified

  • CASP score: 19

  • The Netherlands—setting not given/described

  • N = 41 (59% females, 41% males)

  • Age range 18–65

 Yngman-Uhlin et al.40
  • Examine the experience of tiredness linked to poor sleep in patients on peritoneal dialysis

  • Phenomenology; purposeful sample of patients on home dialysis; face-to-face interviews; thematic analysis; phenomenological research design was developed for systematic investigation in psychology by Giorgi (1985)

  • CASP score: 16

  • Sweden—outpatient visit11 or home setting3

  • N = 14 (57% females, 43% males)

  • Mean age 59, age range 36–82

COPD
 Kouijzer et al.43
  • To explore the patient’s perspective on the impact of fatigue on their daily lives and on treatment opportunities to tackle the burden of fatigue

  • Design not named; purposive sampling; inpatient and outpatient; in-depth, semistructured, face-to-face interviews conducted either in a private hospital room or in the participant’s home; thematic analysis; no theoretical framework specified

  • CASP score: 20

  • The Netherlands—private hospital room (inpatient) or home setting (outpatient)

  • N = 20 (70% females, 30% males)

  • Median age 72 (inpatient), 63 (outpatient)

 Paap et al.44
  • To identify which domains of HRQOL are most important from the COPD patient’s perspective and why

  • Exploratory study; purposive sampling—recruited from two pulmonary clinics; semistructured interviews; method of data analysis not named; no theoretical framework specified

  • CASP score: 19

  • The Netherlands—private hospital room

  • N = 21 (38% females, 62% males)

  • Age range 52–84

 Stridsman et al.45
  • To describe people’s experience of fatigue in daily life when living with moderate-to-very severe COPD

  • Qualitative research design; purposive sampling from obstructive lung disease in Northern Sweden; semistructured interviews; qualitative content analysis; no theoretical framework specified

  • CASP score: 19

  • Sweden—home setting or medical facility

  • N = 20 participants

  • Median age 73

 Wortz et al.46
  • To address gaps in the literature on self-management support by examining patients’ responses to questions about goals, needs, and expectations regarding self-management using qualitative methods

  • Design not named; sampling strategy—recruited from a self-care management intervention study; in-depth interviews; inductive approach using grounded theory methods; the chronic care model

  • CASP score: 19

  • U.S.—outpatient setting

  • N = 47 (47% females, 53% males)

  • Mean age 62.4

 Shalit et al.47
  • To identify factors that influence dietary intake patterns in a stable COPD population attending pulmonary rehabilitation programs

  • Qualitative methods approach; sampling not specified—recruited from outpatient/community pulmonary rehabilitation programs; semistructured interviews; thematic analysis; no theoretical framework specified

  • CASP score: 18

  • Australia—setting not given/described

  • N = 30 (50% females, 50% males)

  • Age range 45–87

CASP = Critical Appraisal Skills Program; HF = heart failure; MS = multiple sclerosis; RA = rheumatoid arthritis; TNFi = tumor necrosis factor inhibitor; CKD = chronic kidney disease; ESRD = end-stage renal disease; COPD = chronic = obstructive pulmonary disease; HRQOL = health-related quality of life.