Having spent the last two decades working within inflammatory bowel disease, I still sit in awe of the challenges of living with inflammatory bowel disease, and how individuals adapt to living with a chronic disease. In my early days as a specialist nurse, the way I was trained and educated led me to consider the physical symptoms of the disease and I will openly admit that very little time was spent assessing fatigue and the psychological impact of diagnosis.
I do worry whether the conversion to telephone clinics from conventional face-to-face clinics due to the covid pandemic will ultimately impact the psychological care we provide to patients. Within my own practice, a significant number of times I have identified depression or fatigue has been based on visual cues noted during assessment. The themes identified in this study potentially provide a framework for assessment and interventions of fatigue which could be applied in a non-face-to-face setting.
This qualitative study is important as it informs practice well. It provides nurses with a framework for discussion, exploring how individuals live with fatigue, the impact upon relationships and how they alter everyday processes to cope with fatigue and recognise their own limitations. Finally, it recognises the role of good health, exercise and nutrition which all have a great evidence base and an opportunity for nurses to provide.
As I read through the thematic analysis, unpicking the impact of fatigue upon daily life, relationships, work life. I deliberated if I spent enough time exploring them with patients and whether I avoided raising them for discussion because they often require considerable time to work through or was it because I didn’t feel confident in understanding the underlying issues or having the knowledge to address them competently. This is a significant admission as a Consultant Nurse, but ultimately why research in this area is so vital.
Biography
Cath Stansfield is a Consultant Nurse in gastroenterology at the Salford Royal NHS Trust, having worked in gastroenterology and intestinal failure for 20 years. Her current interests include service redesign for patients with complex Crohn’s disease.