Theories of Fatigue: Application in HIV/AIDS

Abstract

A number of theoretical fatigue frameworks have been developed by nurse scientists with the intention of guiding research, practice, and education in fatigue. However, there is a significant gap between theory development and research utilization of fatigue frameworks in clinical and intervention trials. The purpose of this report is to assess an example of an inductive fatigue framework and a deductive symptom management model: The Integrated Fatigue Model (IFM) and the revised University of California, San Francisco, Symptom Management Model (UCSF-SMM), to investigate their potential to guide future nursing research projects on fatigue. The IFM is a fatigue-specific comprehensive framework of 14 biological and psychosocial patterns that influence signs and symptoms of fatigue and trigger six fatigue dimensions. The developers emphasized that patterns could be interrelated and influence the dimensionality of fatigue. The UCSF-SMM is a multidimensional symptom management model embedded within the three nursing domains: person, environment, and health and illness. The model places symptom perceptions, symptom management strategies, and outcomes within these nursing domains to be the key components of a highly complex symptom management process. The IFM is an important development in the understanding and conceptualization of fatigue in cancer and in HIV/AIDS. However, it does not reach the level of integration of the UCSF-SMM in taking fatigue research a significant step forward by integrating symptom impact, symptom management, and symptom outcomes. Both models have significant weaknesses because of their complexity.

Identification of Fatigue Biomarkers in Treated and Treatment-Naive HIV Patients

“…In a recent study, both treated and treatment-naive PLWH had significant decreases in adipose-tissue mtDNA content and citrate synthase function compared to the uninfected control group (100% mtDNA; Garrabou et al, 2011). The results did not indicate a significant difference between mtDNA content in adipose tissue of treatment-naive (62% remaining mtDNA) and treated PLWH (69% remaining mtDNA), suggesting that the mtDNA damage was independent of ART use (Garrabou et al, 2011; Voss, Dodd, Portillo, & Holzemer, 2006). This finding contradicts previous work that links mitochondrial dysfunction to ART.…”

A 7-item version of the fatigue severity scale has better psychometric properties among HIV-infected adults: an application of a Rasch model

“…Several other studies have tested the unidimentionallity of the FSS-9 and concluded that it is a unidimensional scale [23,46]. Since fatigue is theoretically understood as a multi-dimensional concept [47,48], including dimensions such as distress, and mental and physical fatigue [47,49], future studies of fatigue associated with HIV infection should use different measures in order to capture its different dimensions (Whitehead 2009). Like the FSS-9, the explained variance of the latent variable in the FSS-7 was satisfactory, although for both the FSS-7 and the FSS-9, the proportion of variance explained by the second dimension was above the expected 5%.…”

Association between Mitochondrial Bioenergetics and Radiation- Related Fatigue: A Possible Mechanism and Novel Target

“…The interactions of several mechanisms have been proposed to influence the individual fatigue experience, including genetic factors, energy expenditure, metabolism, aerobic capacity, and the patients' immune response to inflammation [29,31].…”