The measurement of fatigue in chronic illness: a systematic review of unidimensional and multidimensional fatigue measures.
ABSTRACT Fatigue is a common symptom associated with a wide range of chronic diseases. A large number of instruments have been developed to measure fatigue. An assessment regarding the reliability, validity, and utility of fatigue measures is time-consuming for the clinician and researcher, and few reviews exist on which to draw such information. The aim of this article is to present a critical review of fatigue measures, the populations in which the scales have been used, and the extent to which the psychometric properties of each instrument have been evaluated to provide clinicians and researchers with information on which to base decisions. Seven databases were searched for all articles that measured fatigue and offered an insight into the psychometric properties of the scales used over the period 1980-2007. Criteria for judging the "ideal" measure were developed to encompass scale usability, clinical/research utility, and the robustness of psychometric properties. Twenty-two fatigue measures met the inclusion criteria and were evaluated. A further 17 measures met some of the criteria, but have not been tested beyond initial development, and are reviewed briefly at the end of the article. The review did not identify any instrument that met all the criteria of an ideal instrument. However, a small number of short instruments demonstrated good psychometric properties (Fatigue Severity Scale [FSS], Fatigue Impact Scale [FIS], and Brief Fatigue Inventory [BFI]), and three comprehensive instruments demonstrated the same (Fatigue Symptom Inventory [FSI], Multidimensional Assessment of Fatigue [MAF], and Multidimensional Fatigue Symptom Inventory [MFSI]). Only four measures (BFI, FSS, FSI, and MAF) demonstrated the ability to detect change over time. The clinician and researcher also should consider the populations in which the scale has been used previously to assess its validity with their own patient group, and assess the content of a scale to ensure that the key qualitative aspects of fatigue of the population of interest are covered.
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ABSTRACT: The population of cancer survivors has grown steadily over the past several decades. Surviving cancer, however, is not synonymous with a life free of problems related to the disease and its treatment. In this paper we provide a brief overview of selected physical and psychosocial health problems prevalent among cancer survivors, namely pain, fatigue, psychological distress and work participation. We also address issues surrounding self-management and e-Health interventions for cancer survivors, and programmes to encourage survivors to adopt healthier lifestyles. Finally, we discuss approaches to assessing health-related quality of life in cancer survivors, and the use of cancer registries in conducting psychosocial survivorship research. We highlight research and practice priorities in each of these areas. While the priorities vary per topic, common themes that emerged included: (1) Symptoms should not be viewed in isolation, but rather as part of a cluster of interrelated symptoms. This has implications for both understanding the aetiology of symptoms and for their treatment; (2) Psychosocial interventions need to be evidence-based, and where possible should be tailored to the needs of the individual cancer survivor. Relatively low cost interventions with self-management and e-Health elements may be appropriate for the majority of survivors, with resource intensive interventions being reserved for those most in need; (3) More effort should be devoted to disseminating and implementing interventions in practice, and to evaluating their cost-effectiveness; and (4) Greater attention should be paid to the needs of vulnerable and high-risk populations of survivors, including the socioeconomically disadvantaged and the elderly.EJC Supplements 06/2014; 12(1). DOI:10.1016/j.ejcsup.2014.03.005 · 9.39 Impact Factor
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ABSTRACT: Teachers and parents have long believed that children with hearing loss (CHL) are at increased risk for fatigue. CHL may be physically and mentally " worn out " as a result of focusing so intently on a teacher's speech and on conversations with other students. Moreover, increased listening effort, stress, and subsequent fatigue could compromise a child's ability to learn in a noisy classroom environment. Only recently, however, have we begun to see empirical studies supporting the notion that some CHL experience more fatigue than children with normal hearing (CNH). The purpose of this paper is to enhance the awareness of fatigue in school-age CHL among educational audiologists. To this end, an overview on the topic of fatigue in CHL is provided including its importance, definitions, consequences, and preliminary findings from a large-scale study at Vanderbilt University. In addition, we discuss the role of the educational audiologist in the identification and management of CHL who are fatigued. Research on fatigue in CHL is lacking and the importance of, and need for, scientific exploration in this area is emphasized.
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ABSTRACT: AIMS AND OBJECTIVES: To assess the profile, evaluation criteria and fatigue treatment. BACKGROUND: Fatigue, characterised by tiredness, weakness or lack of energy, involves physical, cognitive and emotional aspects. Its aetiology is not well defined and the prevalence ranges from 30-70% in women with breast cancer, reaching up to 80% when they are undergoing radiotherapy. This is one of the most frequent side effects of radiotherapy, and it may interfere with self-esteem, social activities and quality of life. DESIGN: Literature systematic review. METHODS: A search for studies published from 2000-2010 was carried out in Pubmed, Scielo and Bireme databases, using the descriptors fatigue and radiotherapy and their correlates in Portuguese. RESULTS: We selected 12 articles of 1085 found. The number of studies involving breast cancer was higher than those related to gynaecological cancer. Functional Assessment of Cancer Therapy-Fatigue was the most used scale specifically for the evaluation of fatigue. Pretreatment fatigue level may be an important risk factor to aggravate it during radiotherapy and decrease the quality of life. Five studies proposed interventions, all of them involving non-pharmacological therapies: cognitive-behavioural therapy associated with hypnosis, moderate-intensity physical exercises, stretching programmes, yoga and polarity therapy. The studies showed good results in relation to fatigue, physical and psychological aspects, and quality of life. CONCLUSION: Early detection of fatigue, using appropriate scales, is relevant to propose suitable treatments and achieve better clinical conditions, adherence and continuity of radiotherapy treatment, aiming to ensure more effective responses. RELEVANCE TO CLINICAL PRACTICE: Fatigue is a frequent symptom in patients undergoing radiotherapy. It may become a factor that limits or prevents the continuity of radiotherapy and therefore should be diagnosed in the initial appointments, so that it can be properly treated.Journal of Clinical Nursing 05/2013; 22(19-20). DOI:10.1111/jocn.12236 · 1.23 Impact Factor