The psychology of fatigue in patients with multiple sclerosis: A review (original) (raw)
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Multiple sclerosis-related fatigue
Physical medicine and rehabilitation clinics of North America, 2005
Fatigue is a significant factor in the lives of many MS patients and the most commonly reported symptom in many studies. Fatigue is an important symptom to consider because it affects patients' social lives, occupations, and activities of daily living. Efforts to predict fatigue have been mixed, but it appears to be related to overall quality of life and mood. From a pathophysiologic perspective, fatigue in MS is multifactorial and complex,involving dysregulation of the immune system, changes in the nervous system related to the disease process, neuroendocrine and neurotransmitter changes, and other factors such as physical deconditioning, sleep disturbance, pain, and medication side effects. Various attempts to assess fatigue have been made, and many measures are now available for use in clinical practice and research. In clinical practice, these measures help guide treatment considerations. Recent research has provided valuable strategies to ameliorate fatigue in MS, and altho...
Fatigue in multiple sclerosis 1
mechanisms have been proposed, but none of them fully explains the fatigue occurrence, underlying its complexity (Iriarte et al 2000). Recent studies highlight the role of axonal damage in the pathogenesis of cerebral atrophy and fatigue (Boërio et al 2006; Induruwa et al 2012). The relationship between depression and fatigue has been also postulated (Pittion-Vouyovitch et al, 2000; Motl et al 2012). Fatigue represents a major disabling symptom, affecting the quality of life of MS patients (Pittion-Vouyovitch et al 2000). It is defined as a decrease in physical and /or psychological energy, perceived by the patient as interfering with his normal activities (Mills et al 2011). Being a subjective symptom, its evaluation is difficult and variable interpreted (Flachenecker et al 2002; Chahin et al 2015). There are several rating scales that quantify the severity and impact of fatigue on daily physical, cognitive and psychosocial activities (Krupp et al 1989; Fisk et al 1994; Iriarte et al 1999), mostly being self-assessment questionnaires.
Fatigue in multiple sclerosis patients
Journal of Clinical Nursing, 2009
Aim. This study aimed to describe fatigue and the factors that affect fatigue in people with multiple sclerosis. Background. Fatigue is the most common symptom and has the greatest effect on multiple sclerosis patients' activities of daily living. There is limited understanding of the level of fatigue experienced by people with multiple sclerosis, with research currently limited to other symptoms and problems related to multiple sclerosis. Design. This research was conducted as a descriptive survey. Methods. The study involved 120 people with multiple sclerosis. The data were collected with a Patient Questionnaire and a Visual Analogue Scale for Fatigue (VAS-F). Variance analysis, Mann-Whitney U-test and Kruskal-Wallis test were used in the data analysis. Results. All of the individuals in the sample experienced fatigue. Their fatigue was also affected by factors such as age, gender, education, marital status, number of children, occupation and duration of illness. In addition, the situations with the greatest effect on their fatigue were taking a hot bath/shower, hot/humid weather, stress, infection and other illnesses causing fever, disturbance in sleep pattern, increase in daily activities and exercise. Conclusions. Fatigue is a symptom that has a significant effect on the daily lives of people with multiple sclerosis. Accordingly, it is recommended that factors affecting fatigue in people with multiple sclerosis be evaluated and that education programmes directed at how to control these factors. Relevance to clinical practice. The determination of factors affecting fatigue is important for multiple sclerosis individuals' ability to cope with fatigue and keep it under control. To be able to accomplish this it is necessary for health care personnel, the family and friends to work together.
Assessment of Fatigue in Multiple Sclerosis
Neurology International Open
One of the most frequent symptoms in multiple sclerosis (MS) is fatigue. It has a major impact on quality of life as well as on professional activity. Even nowadays it is still unclear what constitutes an adequate assessment of the perceived fatigue.The following overview will discuss different possibilities to assess fatigue with the help of questionnaires, clinical interviews or the objective measurement of cognitive performance. Furthermore, a structured guideline for the assessment of fatigue will be proposed. Clinical criteria for MS related fatigue include the main symptoms, their everyday relevance, the possible causal relation with the cause of disease (the underlying MS), as well as an exclusion of other possible somatic or psychological reasons. It is recommended to use the “Würzburger Erschöpfungs-Inventar bei Multipler Sklerose (WEIMUS)” (English: Würzburg Fatigue Inventory for Multiple Sclerosis) and especially the “Fatigue Scale for Motor and Cognitive Functions” (FSMC...
Journal of Psychosomatic Research, 2002
Objective: To explore relations of fatigue, physical disabilities, and depression in patients with multiple sclerosis (MS) cross-sectionally and over time. Methods: Ninety-eight MS patients were interviewed twice at an interval of a year. Relationships of physical and mental fatigue, and reduced activity and motivation with depression and physical disabilities were established cross-sectionally by regression analyses and longitudinally by structural equation modelling. Results: Crosssectionally, physical fatigue was related with physical disabilities, and mental fatigue was associated with depression. Prospectively, physical fatigue was a predictor of the physical disabilities of a year later. The reverse relationship of physical disabilities predicting the physical fatigue of one year later was, however, not significant, while depression predicted this physical fatigue and reduced activity of a year later. Depression did not predict the later mental fatigue nor was depression predicted by preceding fatigue experiences. Conclusions: Fatigue in MS should be studied over time as relationships of fatigue with physical and mental health change during the course of a year. Moreover, differentiating in fatigue experiences sheds light on the relationship of fatigue with physical and mental health.