To explore the relationship between fatigue, sociodemographic and clinical variables in a population of patients with multiple sclerosis (MS).
There is a need to identify empirical relationships with possible antecedents of fatigue among patients with MS.
A mailed questionnaire designed to survey sociodemographic variables and the Fatigue Severity Scale (FSS) was mailed to 502 individuals from the population of patients with definite MS in the city of Oslo. A total of 368 (73%) responded. Clinical data were collected from the Oslo City MS-Registry.
The prevalence of fatigue in this population was 60.1%. The FSS score showed a negative correlation with education (r = -0.15, P < 0.01) and a positive correlation with age (r = 0.20, P < 0.001) and time since disease onset (r = 0.11, P < 0.05). When controlled for gender, level of education and time since disease onset, the data showed a positive relationship between fatigue and age (P < 0.001) among patients with primary progressive (PP) disease. This relationship between age and fatigue was not found among patients with relapsing-remitting/secondary progressive (RR/SP) disease.
The negative relationship between level of formal education (FE) and fatigue among individuals with RR/SP disease suggests that behavioral factors may be among the antecedents of fatigue in this patient group. In contrast to normative data from the general population, our findings revealed no differences in fatigue related to gender Thus, this study supports the hypothesis that there are disease-specific antecedents of fatigue among patients with MS.
" Gender differences in fatigue frequency appear not to be large.  Fatigue exacts a tremendous toll in individuals with MS as it can influence all aspects of daily functioning and markedly compromise quality of life.   Studies have linked fatigue to both unemployment and early retirement. "
[Show abstract][Hide abstract] ABSTRACT: Background: Fatigue is the most commonly reported symptom in multiple sclerosis (MS). Purpose: This brief narrative review addresses the clinical features, pathophysiology, and management of MS fatigue, as well as the varied approaches to its definition and measurement. Methods: A literature search was conducted through Medline of studies published since 1984, with a focus on findings reported since 2008. Results: Studies of MS fatigue have primarily relied on the definition of fatigue as a subjective sense of tiredness measured through self-report. Additional studies have measured fatigability in MS, as demonstrated by a decline in cognitive or motor performance over time. The pathogenesis of fatigue remains poorly understood but disease characteristics, including structural and physiologic cerebral alterations as well as immune, endocrine, and psychological factors, may all contribute to its expression. Fatigue therapy has included pharmacologic approaches which have had either methodological limitations (e.g., small sample sizes) or inconclusive results and non-pharmacologic interventions, some of which have been effective in reducing fatigue. Conclusions: Fatigue remains a challenging symptom in MS. The most effective measurement approaches will likely be multidimensional and include both subjective and objective indicators, whereas therapy will likely require more than one type of intervention.
"It has good internal consistency, stability, and sensitivity to change over time and is frequently used to assess fatigue in MS populations  . A mean score ≥ 4 has been suggested as a cutoff to indicate clinically significant fatigue and has been used in several other studies   . "
[Show abstract][Hide abstract] ABSTRACT: . Despite evidence of the potential importance of the role of health and lifestyle behaviours in multiple sclerosis (MS) outcomes, there has not been a significant focus on this area of research.
. We aimed to recruit an international sample of people with MS at baseline and over a five-year timeframe, examine their health and lifestyle behaviours, and determine the relationship of these behaviours to self-reported disability, disease activity, and quality of life.
. People with MS were recruited through web 2.0 platforms including interactive websites, social media, blogs, and forums and completed a comprehensive, multifaceted online questionnaire incorporating validated and researcher-derived tools.
. 2519 participants met inclusion criteria for this study. This paper describes the study methodology in detail and provides an overview of baseline participant demographics, clinical characteristics, summary outcome variables, and health and lifestyle behaviours. The sample described is unique due to the nature of recruitment through online media and due to the engagement of the group, which appears to be well informed and proactive in lifestyle modification.
. This sample provides a sound platform to undertake novel exploratory analyses of the association between a variety of lifestyle factors and MS outcomes.
Erratum to “Methodology of an International Study of People with Multiple Sclerosis Recruited through Web 2.0 Platforms: Demographics, Lifestyle, and Disease Characteristics”
Neurology Research International 04/2013; 2013(2):580596. DOI:10.1155/2013/580596
"Level of energy was evaluated using a single item asking the respondents to rate their perceived level of energy during the last two weeks on a visual analogue scale (VAS) ranging from 0 (total lack of energy/total fatigue) to 10 (full of energy/energy surplus). The item was developed and used in an MS study (Lerdal et al., 2003). "
[Show abstract][Hide abstract] ABSTRACT: Four dimensions of inner strength were previously identified in a meta-theoretical analysis: firmness, creativity, connectedness, and flexibility.
The aim of this study was to develop an Inner Strength Scale (ISS) based on those four dimensions and to evaluate its psychometric properties.
An initial version of ISS was distributed for validation purpose with the Rosenberg Self-Esteem Scale, the resilience scale, and the sense of Coherence Scale. A convenience sample of 391 adults, aged 19-90 years participated. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used in the process of exploring, evaluating, and reducing the 63-item ISS to the 20-item ISS. Cronbach's alpha and test-retest were used to measure reliability.
CFA showed satisfactory goodness-of-fit for the 20-item ISS. The analysis supported a fourfactor solution explaining 51% of the variance. Cronbach's alpha on the 20-item ISS was 0.86, and the test-retest showed stability over time (r=0.79).
The ISS was found to be a valid and reliable instrument for capturing a multifaceted understanding of inner strength. Further tests of psychometric properties of the ISS will be performed in forthcoming studies.
International journal of nursing studies 04/2011; 48(10):1266-74. DOI:10.1016/j.ijnurstu.2011.03.006 · 2.90 Impact Factor
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