Fatigue is a common and debilitating symptom for adult patients with end-stage renal disease on hemodialysis and has been associated with decreased survival and quality of life. Patients on hemodialysis must find ways to manage their fatigue and mitigate its effects on their lives. Currently, there is no description of the experience of fatigue for American hemodialysis patients, nor is there any description of the ways in which they manage their fatigue. The purpose of this qualitative descriptive work was to describe the experience and self-management of fatigue as well as how fatigue changes over time from one dialysis session to the next. Several themes were identified which included: the nature of fatigue, cycles of fatigue, management of fatigue, consequences of fatigue, and correlates of fatigue. Further, hemodialysis patients experience two types of fatigue, post-dialysis fatigue, fatigue that occurs acutely after the dialysis session and resolves after sleep or rest, and constant fatigue, a persistent, underlying fatigue that patients experience at all times and worsens after the dialysis session usually requiring a prolonged period of recovery.

Background: Family caregivers for a parent with dementia often experience negative emotional consequences. These caregivers may also be at risk for compassion fatigue, a concept that was introduced to the health care community as feelings of anger, inefficacy, apathy, and depression resulting from a caregiver's inability to cope with devastating stress. Compassion fatigue was first observed in nurses and later in other caring professionals such as social workers and psychologists and the definition was adapted to focus on prolonged exposure to suffering as one of the primary causes.

Although compassion fatigue has not been studied in family caregivers providing care at home, their experiences, particularly those of adult daughter caregivers for parents with dementia, appear to create a foundation for developing compassion fatigue. For this reason, it was important to investigate compassion fatigue in this growing population of caregivers and this dissertation explored compassion fatigue in daughter caregivers for parents with dementia. The dissertation aims were to 1) identify common themes across the literature on compassion fatigue and to apply these themes and the existing model of compassion fatigue to informal caregivers for family members with dementia...