A medical definition of fatigue in multiple sclerosis

Mills, Roger; Young, Carolyn A

doi:10.1093/qjmed/hcm122

Cited by 145 publications

(114 citation statements)

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“…Clear overlaps in findings were also evident with regard to the description of fatigue through its impact on functioning (Magnusson et al ., 1999; Scott et al ., 2011), the distinction between tiredness caused by activity versus tiredness disproportionate to or unrelated to activity or exertion (Adamsen et al ., 2004; Glaus, Crow, & Hammond, 1996), the role of motivation in the experience of fatigue (Bennett, Goldstein, Friedlander, Hickie, & Lloyd, 2007; Hewlett et al ., 2005; Lee et al ., 2007; Mills & Young, 2008; Yngman‐Uhlin et al ., 2010), and the contribution of social comparisons to fatigue (Repping‐Wuts, Uitterhoeve, van Riel, & van Achterberg, 2008; Tack, 1990). …”

Section: Discussionmentioning

confidence: 99%

“…Different attitudes towards management of fatigue were evident across the interviews, as has been previously identified in the literature, such as avoidance and accommodation of activity according to fatigue (Graydon, Bubela, Irvine, & Vincent, 1995; Heiwe & Dahlgren, 2004; Horigan et al ., 2013; Johnson et al ., 2004; Magnusson et al ., 1999; Mills & Young, 2008; Rhodes, Watson, & Hanson, 1988; Scott et al ., 2011; Stuifbergen & Rogers, 1997; Yngman‐Uhlin et al ., 2010), or restoring to various activities to cope with fatigue (Magnusson et al ., 1999; Mills & Young, 2008; Scott et al ., 2011; Wu & McSweeney, 2007; Yngman‐Uhlin et al ., 2010). According to a quantitative study, avoidance coping was an independent predictor of greater fatigue over time in RA (Scharloo et al ., 1999).…”

Section: Discussionmentioning

confidence: 99%

“…According to a quantitative study, avoidance coping was an independent predictor of greater fatigue over time in RA (Scharloo et al ., 1999). However, the notion of self‐compassion was acknowledged by participants here and in other qualitative studies (Hewlett et al ., 2005; Mills & Young, 2008; Repping‐Wuts et al ., 2008; Scott et al ., 2011; Wu & McSweeney, 2007). …”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

Picariello

Moss‐Morris

Macdougall

et al. 2017

British J Health Psychol

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BackgroundFatigue is commonly experienced in end‐stage kidney disease (ESKD) patients. In order to develop patient‐centred psychosocial interventions to help patients manage fatigue symptoms, a more in‐depth understanding regarding the experience of fatigue is needed.ObjectiveThe objective of this study was to explore renal patients’ experiences of fatigue, across renal replacement therapy (RRT) modalities.MethodsTwenty‐five in‐depth semi‐structured interviews were conducted. Interviews were audio‐taped, transcribed, and analysed using inductive thematic analysis.ResultsMain themes included the strong role of the illness and treatment in the aetiology of fatigue. Two contrasting streams of illness–fatigue interpretations emerged: catastrophizing versus normalizing. Participants emphasized the importance of having a sense of purpose in facilitating active management of fatigue. Many participants described the consequences of fatigue on their functioning. Low mood, frustration, and anger were common emotional consequences of fatigue. Three dominant fatigue management strategies emerged: one related to accommodation of activities around fatigue, another on increasing activities to counteract fatigue, and the third one revolved around self‐compassion. Social support emerged as an important aspect of the fatigue experience, serving as a source of motivation, yet participants were wary of becoming a burden to others.ConclusionFindings identify casual attributions, behavioural and emotional reactions, management strategies, and facilitators of active management of fatigue in ESKD. Untying fatigue from the illness and treatment may help patients to develop alternative less catastrophic perceptions of fatigue, increase their perception of control over fatigue, and facilitate active fatigue management. Statement of contribution What is already known on this subject? Fatigue is persistent and debilitating in end‐stage kidney disease (ESKD), with no consistent treatment model.Promising evidence is available for psychological fatigue interventions in other chronic conditions.There is a gap in studies looking at the fatigue experiences of patients with ESKD across renal replacement therapies. What does this study add? Fatigue is not inherently negative, but shaped by patients’ beliefs and behaviours.Findings provide novel insights, for example, on the important role social support seems to play in fatigue.An in‐depth understanding of fatigue may help to inform a future patient‐centred intervention in ESKD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

Picariello

Moss‐Morris

Macdougall

et al. 2017

British J Health Psychol

View full text Add to dashboard Cite

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“…5,6 Fatigue can be triggered by mental or physical exertion, but it can also occur without a trigger. 7 Although there are several theories of fatigue in MS, the causes of fatigue are still poorly understood. It has been postulated that there are primary and secondary mechanisms that lead to fatigue.…”

Section: Patient Interviews/focus Groupmentioning

confidence: 99%

Development and Feasibility of an Evidence-Based Patient Education Program for Managing Fatigue in Multiple Sclerosis

Wendebourg¹,

Feddersen²,

Lau³

et al. 2016

International Journal of MS Care

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Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system. Fatigue is a common and disabling symptom, often causing decreased quality of life, social withdrawal, and unemployment. We developed and studied the feasibility of a cognitive-behavioral group intervention to manage fatigue in MS. We aimed to integrate the concepts of cognitive-behavioral therapy and evidence-based patient information.

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“…However, the aetiology of MS-related fatigue is uncertain, and primary disease-related mechanisms as well as secondary mechanisms have been proposed (for reviews, see Induruwa, Constantinescu, & Gran, 2012;Kos, Kerckhofs, Nagels, D'hooghe, & Ilsbroukx, 2008;Krupp, et al, 2010). MS-related fatigue is mostfrequently defined as "a subjective lack of physical and/or mental energy that is perceived by the individual or caregiver to interfere with usual and desired activities" (Multiple Sclerosis Council for Clinical Practice Guidelines, 1998, p.2); however, multiple definitions exist (e.g., Comi, Leocani, Rossi, & Colombo, 2001;Mills & Young, 2008). Measuring fatigue is equally complex, and multiple self-report tools -of varying psychometric quality -are available to quantify subjective fatigue retrospectively in chronic illness (Whitehead, 2009).…”

Section: Ms-related Fatiguementioning

confidence: 99%

Ambulatory Assessment in Neuropsychology

Schlotz

Powell

2014

Zeitschrift für Neuropsychologie

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Zusammenfassung AbstractNeuropsychological disorders involve a variety of symptoms that often lead to substantial functional impairments in daily life. Research, assessment, and treatment should include a reference to daily life, considering symptoms, personality, and life circumstances of the individual patient. Ambulatory assessment methodology provides progress by avoiding retrospective memory-based bias, increasing ecological validity, and by generating individual time series that permit idiographic analysis. Using multiple sclerosis as an example, we illustrate new findings generated by ambulatory assessment studies in the areas of fatigue, stress and cognitive functions, and we demonstrate future opportunities presented by ambulatory assessment methodology to research and clinical practice with multiple sclerosis patients.

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A medical definition of fatigue in multiple sclerosis

Abstract: A framework, not only derived from patient experience but also meaningful in a medical context, was shown to be capable of describing fatigue in a large cross-section of MS patients. The definition may facilitate inter-disease comparison of fatigue as well as physiological enquiry.

Cited by 145 publications

References 15 publications

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

‘It's when you're not doing too much you feel tired’: A qualitative exploration of fatigue in end‐stage kidney disease

Development and Feasibility of an Evidence-Based Patient Education Program for Managing Fatigue in Multiple Sclerosis

Ambulatory Assessment in Neuropsychology

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