Assessment Of Fatigue In Patients Research Articles

The reliability and validity of The Turkish version of Multidimensional Fatigue Inventory-20 for the evaluation of different dimensions of fatigue in patients with fibromyalgia.

Objectives In this study, we aimed to evaluate the validity and reliability of the Multidimensional Fatigue Inventory-20 (MFI-20) for Turkish patients with fibromyalgia (FM). Patients and methods Between February 2011 and September 2011, a total of 120 female patients (mean age 45±9.1 years; range, 20 to 60 years) admitted to our outpatient clinic with extensive pain and fatigue and diagnosed with FM according to 1990 and 2010 American College of Rheumatology criteria were included in this study. The MFI-20 was translated according to forward-backward translation procedure. For the test-retest reliability, the patients re-filled out the scale 48 hours after the first application. Structural validity was evaluated with confirmatory factor analysis (CFA). Reliability was assessed by internal consistency with Cronbach alpha and test-retest reliability was assessed by intra-class correlation coefficient (ICC). For convergent validity, Spearman rho correlation coefficient was used for relevance analysis with the Fatigue Impact Scale (FIS), visual analog scale (VAS)-pain, VAS-fatigue, and Short Form-36 (SF-36) questionnaires. Results The total Cronbach alpha coefficient was found to be 0.92 (range, 0.78 to 0.93). The CFA showed good structural validity and revealed five dimensions. The ICC coefficient was found to be 0.934. All correlation coefficients between the MFI and FIS were calculated as above 0.80, indicating a strong relationship. Conclusion The results of this study show that the Turkish version of the MFI-20 has a high internal consistency and reasonable construct validity. It is a valid and reliable measurement of the assessment of fatigue in patients with FM multidimensionality.

Evaluation of different fatigue scales in assessment of fatigue in patients with multiple sclerosis (P1.417)

Evaluation of different fatigue scales in assessment of fatigue in patients with multiple sclerosis (P1.417)

Assessment of fatigue in patients with a permanent cardiac pacemaker: prevalence and associated factors.

IntroductionFatigue is a debilitating symptom of subjective nature which lacks effective therapy. The aim of the study was to assess levels of fatigue and the associated factors among patients with permanent cardiac pacemaker (PCM).Material and methodsThis was a cross-sectional study carried out in Athens. The study sample consisted of 250 patients with a PCM.ResultsData indicated moderate to low levels of fatigue. Furthermore, women (median: 24, p = 0.001), those with primary school education (median: 21, p = 0.001), those who were “a little-not at all” informed about PCM (median: 31, p = 0.001), those who had someone to help them in daily activities (median: 23, p = 0.001), those who did not believe that PCM solved their cardiac problem (median: 36, p = 0.001), and those who did not believe that their quality of life was improved (median: 35, p = 0.001) had high levels of fatigue. Moreover, high levels of fatigue were felt by those who characterized themselves as anxious and those who reported to be very anxious about their heart rate and the proper function of PCM (medians: 21.5, 25 and 25 respectively). Additionally, more fatigue was felt by participants who did not smoke after implantation and did not exercise at all (medians: 20 and 24 respectively). Finally, older patients felt more fatigue (rho = 0.248) while the later the implantation device was inserted the more fatigue the patients felt (rho = 0.274).ConclusionsThe present results will help clinicians to acquire an in-depth knowledge of factors associated with fatigue after implantation.

Plantar flexor muscle weakness and fatigue in spastic cerebral palsy patients

BackgroundPatients with cerebral palsy develop an important muscle weakness which might affect the aetiology and extent of exercise-induced neuromuscular fatigue. AimThis study evaluated the aetiology and extent of plantar flexor neuromuscular fatigue in patients with cerebral palsy. MethodsTen patients with cerebral palsy and 10 age- and sex-matched healthy individuals (∼20 years old, 6 females) performed four 30-s maximal isometric plantar flexions interspaced by a resting period of 2–3s to elicit a resting twitch. Maximal voluntary contraction force, voluntary activation level and peak twitch were quantified before and immediately after the fatiguing task. ResultsBefore fatigue, patients with cerebral palsy were weaker than healthy individuals (341±134N vs. 858±151N, p<0.05) and presented lower voluntary activation (73±19% vs. 90±9%, p<0.05) and peak twitch (100±28N vs. 199±33N, p<0.05). Maximal voluntary contraction force was not significantly reduced in patients with cerebral palsy following the fatiguing task (−10±23%, p>0.05), whereas it decreased by 30±12% (p<0.05) in healthy individuals. ConclusionsPlantar flexor muscles of patients with cerebral palsy were weaker than their healthy peers but showed greater fatigue resistance. What this paper addsCerebral palsy is a widely defined pathology that is known to result in muscle weakness. The extent and origin of muscle weakness were the topic of several previous investigations; however some discrepant results were reported in the literature regarding how it might affect the development of exercise-induced neuromuscular fatigue. Importantly, most of the studies interested in the assessment of fatigue in patients with cerebral palsy did so with general questionnaires and reported increased levels of fatigue. Yet, exercise-induced neuromuscular fatigue was quantified in just a few studies and it was found that young patients with cerebral palsy might be more fatigue resistant that their peers. Thus, it appears that (i) conflicting results exist regarding objectively-evaluated fatigue in patients with cerebral palsy and (ii) the mechanisms underlying this muscle fatigue − in comparison to those of healthy peers − remain poorly understood. The present study adds important knowledge to the field as it shows that when young adults with cerebral palsy perform sustained maximal isometric plantar flexions, they appear less fatigable than healthy peers. This difference can be ascribed to a better preservation of the neural drive to the muscle. We suggest that the inability to drive their muscles maximally accounts for the lower extent of exercise-induced neuromuscular fatigue in patients with cerebral palsy.

Real-Time Assessment of Fatigue in Patients With Multiple Sclerosis: How Does It Relate to Commonly Used Self-Report Fatigue Questionnaires?

Objectives(1) To assess real-time patterns of fatigue; (2) to assess the association between a real-time fatigue score and 3 commonly used questionnaires (Checklist Individual Strength [CIS] fatigue subscale, Modified Fatigue Impact Scale (MFIS), and Fatigue Severity Scale [FSS]); and (3) to establish factors that confound the association between the real-time fatigue score and the conventional fatigue questionnaires in patients with multiple sclerosis (MS). DesignCross-sectional study. SettingMS-specialized outpatient facility. ParticipantsAmbulant patients with MS (N=165) experiencing severe self-reported fatigue. InterventionsNot applicable. Main Outcome MeasuresA real-time fatigue score was assessed by sending participants 4 text messages on a particular day (How fatigued do you feel at this moment?; score range, 0–10). Latent class growth mixed modeling was used to determine diurnal patterns of fatigue. Regression analyses were used to assess the association between the mean real-time fatigue score and the CIS fatigue subscale, MFIS, and FSS. Significant associations were tested for candidate confounders (eg, disease severity, work status, sleepiness). ResultsFour significantly different fatigue profiles were identified by the real-time fatigue score, namely a stable high (n=79), increasing (n=57), stable low (n=16), and decreasing (n=13). The conventional questionnaires correlated poorly (r<.300) with the real-time fatigue score. The Epworth Sleepiness Scale significantly reduced the regression coefficient between the real-time fatigue score and conventional questionnaires, ranging from 15.4% to 35%. ConclusionsPerceived fatigue showed 4 different diurnal patterns in patients with MS. Severity of sleepiness is an important confounder to take into account in the assessment of fatigue.

Assessment of fatigue in rheumatoid arthritis and its relation to pain and disease activity measures

Fatigue is a serious outcome of rheumatoid arthritis (RA). Inflammatory synovitis is potentially an important causal factor for RA fatigue. Other factors include psychosocial factors, health beliefs, illness perceptions, and poor social support. Fatigue also has strong relationships to pain and depression. The aim of the study was to define the amount of fatigue experienced by RA patients, and determine the relative contribution of RA disease activity to fatigue in comparison with factors such as pain and treatment in established RA cases using different instruments to assess fatigue [visual analog scale (VAS) fatigue and the vitality subscale of the Medical Outcomes Study Short Form 36 (SF-36) questionnaire]. A total of 50 adult patients diagnosed with RA according to the 1987 Revised American College of Rheumatology – 42 of them being female and the remaining eight being male, with a mean age of 45.36 ± 9.6 years and a mean disease duration of 7.78 ± 4.1 years – were included in the study. Fatigue was measured using a 100 mm VAS and the SF-36 vitality scores. We measured pain using 100 mm VAS, Disease Activity Score for 28 joint counts (DAS28), early morning stiffness, the modified Health Assessment Questionnaire score, and the physician global assessment score. Fatigue was common in RA patients. Out of 50 patients, 42 patients had fatigue (VAS ≥ 20 mm), and at the same time 26 had high fatigue scores (VAS350 mm). The mean SF-36 energy and vitality score was 60.5 ± 23.1. The VAS fatigue scores and the SF-36 vitality scores were significantly correlated with disease activity measures, including duration of morning stiffness (P = 0.001), articular index (P < 0.0001), VAS pain (P < 0.0001), DAS28 (P < 0.0001), C reactive protein (CRP) (P = 0.04 and 0.001, respectively), erythrocyte sedimentation rate (ESR) (P = 0.04), and rheumatoid factor positivity (P = 0.04 and 0.01, respectively). Pain had the strongest association with fatigue, followed by articular index, duration of morning stiffness, ESR, DAS28, and finally CRP in that order. High fatigue levels are common in RA and are mainly linked to pain. VAS fatigue scores are simple measurements that can be used for assessment of fatigue in patients with RA.

Long-term Assessment of Fatigue in Patients with Culture-confirmed Lyme Disease

BackgroundFatigue is a common symptom with numerous causes. Severe fatigue is thought to be an important manifestation of post-treatment Lyme disease syndrome. The frequency with which severe fatigue occurs as a long-term sequela in prospectively followed patients with Lyme disease is unknown. MethodsPatients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fatigue using an 11-item Fatigue Severity Scale (FSS-11) that has been used in studies of post-treatment Lyme disease syndrome. An FSS-11 score of ≥4.0 is indicative of severe fatigue. ResultsA total of 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (range, 42-86 years). The mean duration of follow-up was 15.4 years (range, 11-20 years). Nine subjects had severe fatigue but in none as a consequence of Lyme disease. Only 3 subjects were thought to possibly have persistent fatigue from Lyme disease. The FSS-11 value for these 3 individuals was less than 4, averaging 2.27, and none had functional impairment. ConclusionsSevere fatigue was found in 9 patients (9%) with culture-confirmed early Lyme disease at 11 to 20 years after presentation, but was due to causes other than Lyme disease. Fatigue of lesser severity was possibly due to Lyme disease, but was found in only 3% of 100 patients, and therefore is rarely a long-term complication of this infection.

PedsQL™ multidimensional fatigue scale in sickle cell disease: Feasibility, reliability, and validity

Sickle cell disease (SCD) is an inherited blood disorder characterized by a chronic hemolytic anemia that can contribute to fatigue and global cognitive impairment in patients. The study objective was to report on the feasibility, reliability, and validity of the PedsQL™ Multidimensional Fatigue Scale in SCD for pediatric patient self-report ages 5-18 years and parent proxy-report for ages 2-18 years. This was a cross-sectional multi-site study whereby 240 pediatric patients with SCD and 303 parents completed the 18-item PedsQL™ Multidimensional Fatigue Scale. Participants also completed the PedsQL™ 4.0 Generic Core Scales. The PedsQL™ Multidimensional Fatigue Scale evidenced excellent feasibility, excellent reliability for the Total Scale Scores (patient self-report α = 0.90; parent proxy-report α = 0.95), and acceptable reliability for the three individual scales (patient self-report α = 0.77-0.84; parent proxy-report α = 0.90-0.97). Intercorrelations of the PedsQL™ Multidimensional Fatigue Scale with the PedsQL™ Generic Core Scales were predominantly in the large (≥0.50) range, supporting construct validity. PedsQL™ Multidimensional Fatigue Scale Scores were significantly worse with large effects sizes (≥0.80) for patients with SCD than for a comparison sample of healthy children, supporting known-groups discriminant validity. Confirmatory factor analysis demonstrated an acceptable to excellent model fit in SCD. The PedsQL™ Multidimensional Fatigue Scale demonstrated acceptable to excellent measurement properties in SCD. The results demonstrate the relative severity of fatigue symptoms in pediatric patients with SCD, indicating the potential clinical utility of multidimensional assessment of fatigue in patients with SCD in clinical research and practice.

Correlação de fadiga com dor e incapacidade na artrite reumatoide e na osteoartrite, respectivamente

To investigate the correlation of fatigue with pain in rheumatoid arthritis patients and with disability in osteoarthritis patients. Twenty patients with rheumatoid arthritis and 20 patients with osteoarthritis were evaluated. The degree of fatigue was evaluated with a visual analogue scale and the Multidimensional Assessment of Fatigue. Pain was evaluated with a visual analogue scale as well as Patient Global Assessment. For disability evaluation, the Health Assessment Questionnaire was performed. Age, gender, disease duration, education, income, antirheumatic drugs used and comorbidity were also obtained. Statistical analysis included Fisher exact, Shapiro-Wilk, Kruskal-Wallis and Spearman tests. The significance level was 0.05. Fatigue was more significantly increased in patients with osteoarthritis than in patients with rheumatoid arthritis when evaluated with Multidimensional Assessment of Fatigue (P < 0.05). Pain was found to correlate with fatigue evaluated with visual analogue scale or Multidimensional Assessment of Fatigue in patients with rheumatoid arthritis (r = 0.46; P < 0.05). Health Assessment Questionnaire was associated with fatigue visual analogue scale in patients with osteoarthritis (r = 0.54; P < 0.05). Patient Global Assessment correlates with fatigue visual analogue scale (r = 0.44; P < 0.003). Patients were similar in both groups: all females, similar mean age, with long disease duration and low income. Our results corroborate that fatigue in rheumatoid arthritis patients correlates with the degree of pain, while in osteoarthritis patients it is associated with disability. Therefore, we found that fatigue has different correlates in osteoarthritis and rheumatoid arthritis, and we suggest that disability, not pain, is a correlate of fatigue in osteoarthritis patients.

An assessment of cancer-related fatigue in patients (pts) with chemotherapy-induced anaemia (CIA) treated with darbepoetin alfa (DA): Comparison of two quality of life (QoL) questionnaires

19654 Background: CIA is often associated with debilitating fatigue and reduced QoL. DA can effectively treat CIA when administered once every 3 weeks (Q3W).This study aims to compare the psychometrics of the Functional Assessment of Cancer Therapy Fatigue Subscale (FACT-F) and The Fatigue Symptom Inventory (FSI) in CIA pts treated with DA Q3W. Methods: Longitudinal single- centre prospective study in adult pts with solid tumours undergoing chemotherapy (CT) and with mild to moderate cancer-related fatigue (CRF) (Visual Analogue Scale (VAS) =30 mm). Pts with haemoglobin (HB) levels &lt;11 g/dL were treated with DA 500 mcg Q3W. Key clinical parameters, FACT-F, and FSI measurements were collected at the beginning and end of the CT treatment period. Psychometric indicators for reliability and validity were calculated. Results: A preliminary analysis was conducted in 58 pts: mean age, 61.3 years (SD 12.3), 51.7% women, 25.9% with breast cancer, 91.4% ECOG 0–1, 69.0% IV stage, 63% had no prior CT. At baseline, the mean CRF score by VAS was 58.8 mm (SD 19.4) and the mean Hb was 10.2 g/dL (SD 0.7). Median CT duration was 15.1 weeks (range, 3.3 - 25.7) and all pts received DA treatment during CT (median duration of CT, 6.6 wks [range, 0 - 19]). The median number of DA doses administered was 3 (range, 1–7). The rate of hematopoietic response (Hb ≥ 12 g/dL or Hb rise from baseline ≥ 2 g/dL) was 69.0%. FACT-F and FIS scores improved by 5.6 and 13.0 points respectively during CT. Consistency (Cronbach alpha coefficient - CA) was high and similar for both questionnaires (FACT-F=0.98; FSI=0.97). Conclusions: Both the FACT-F and FIS QoL questionnaires measured a change in fatigue during the study with high and similar consistency. DA administered at a fixed dose of 500 mcg Q3W seems to be effective in clinical practice. No significant financial relationships to disclose.

Ecological Momentary Assessment of Fatigue in Patients Receiving Intensive Cancer Therapy

The ability to accurately assess the incidence, intensity, and timing of cancer-related fatigue is important for clinicians attempting to manage this symptom and for researchers evaluating interventions to reduce or alleviate fatigue. This methodological report describes our experiences with ecological momentary assessment (EMA) and discusses its applicability for capturing real-time, real-world assessments of fatigue in patients receiving intensive cancer therapy. This methodological report is part of a larger study examining fatigue and physical activity before and after hematopoietic stem cell transplantation (HSCT). A prospective, repeated measures design was used to assess changes in fatigue three days before and three days after intensive cancer therapy and HSCT. A convenience sample ( n = 20 before HSCT, and n = 17 after HSCT) was drawn from two Midwestern academic medical centers. Real-time fatigue was measured with a single-item, global, fatigue intensity scale. Multiple fatigue assessments were conducted throughout each study day. Data were collected electronically, facilitating examination of compliance. Subjects responded to fatigue intensity queries 87% of the time before HSCT and 86% after HSCT. Response rates were not unduly influenced by level of fatigue, time of day, or gender. The study findings demonstrate that it is feasible to use computerized EMA to collect self-report fatigue data in acutely ill oncology patients. Most HSCT patients were able to provide real-time fatigue data even when experiencing multiple side effects from the preparatory regimen. EMA is a novel approach that holds substantial promise for investigating fatigue and other cancer symptoms.

Assessment of fatigue in patients with ankylosing spondylitis

In this study, we evaluated fatigue by using the multidimensional assessment of fatigue (MAF) index in 68 ankylosing spondylitis (AS) patients. To determine the disease activity, functional status and quality of life, bath ankylosing spondylitis disease activity index (BASDAI), bath ankylosing spondylitis functional index (BASFI) and Short Form 36 (SF36) were used respectively. Mander enthesis index (MEI) was used for evaluation of enthesitis. The mean age of the patients was 37.7 (11.1) years. The prevalence of fatigue was 76.5%. There were significant correlations between MAF and BASDAI (P < 0.001), BASFI (P < 0.001), MEI (P = 0.048), pain (P = 0.001), hemoglobin (P = 0.001), ESR (P = 0.035), dorsal Schober's (P = 0.009), occiput-wall distance (P = 0.048). Also MAF was correlated with all dimensions of SF36 except for social function and emotional role. BASFI was found to be the most significant correlated (P = 0.002) parameter with MAF. This study suggests that fatigue is an important symptom in AS and it seemed to occur in severe AS patients. It should appropriately be measured with respect to its intensity with appropriate measures, such as MAF. Moreover, fatigue may increase functional disability, which is already present as a feature of the disease.

Assessment of fatigue in patients with fibromyalgia and chronic widespread pain. Reliability and validity of the Swedish version of the MFI-20

Objectives. Fibromyalgia (FM) and Chronic Widespread Pain (CWP) are common diseases in primary care and, in addition to the pain they cause, fatigue is a major problem. Fatigue is regarded as a multidimensional concept and instruments assessing fatigue should therefore cover several different dimensions. The Multidimensional Fatigue Inventory (MFI-20) measures five different dimensions of fatigue. The aim of the study was to investigate the test-retest reliability and convergent construct validity of the Swedish version of the MFI-20 in female patients with FM or CWP.Methods. To investigate the convergent construct validity, 166 female patients with FM or CWP completed the Swedish version of the MFI-20 and a Visual Analogue Scale (VAS) measuring global fatigue. Thirty-six of the 166 patients completed the Swedish version of the MFI-20 on two occasions, one day apart to evaluate the test-retest reliability.Results. Spearman's correlation coefficient revealed a significant association between each of the five subscales of the MFI-20 and the VAS for global fatigue. General Fatigue had the highest correlation with the VAS (rs = 0.62, p<0.001), while Reduced Motivation had the lowest (rs = 0.32, p<0.001). The intra-class correlation coefficients (ICC) were satisfactory for all the five subscales of the MFI-20.Conclusion. The results of this study indicate that the Swedish version of the MFI-20 is a reliable tool for assessing the degree of fatigue in patients with FM or CWP. This study also supports the theory that fatigue is a multidimensional concept and different aspects of fatigue should be measured separately.

A Comparison of Fatigue Scales in Postpoliomyelitis Syndrome

Vasconcelos Jr OM, Prokhorenko OA, Kelley KF, Vo AH, Olsen CH, Dalakas MC, Halstead LS, Jabbari B, Campbell WW. A comparison of fatigue scales in postpoliomyelitis syndrome. Objective To examine the applicability and validity of traditional fatigue questionnaires in postpoliomyelitis syndrome (PPS) patients with disabling fatigue. Design Cross-sectional study. PPS and disabling fatigue were ascertained according to published criteria. Descriptiveness was determined using the McNemar test, and interscale z-score agreement was estimated with Pearson’s coefficients. Setting PPS clinic. Participants Fifty-six survivors of poliomyelitis: 39 met criteria for PPS, 25 of whom met criteria for disabling fatigue. Interventions Not applicable. Main Outcome Measures The Fatigue Severity Scale (FSS), visual analog scale (VAS) for fatigue, and Fatigue Impact Scale (FIS). Results Twenty-four patients scored 50% or higher on the scale range for FSS, compared with 19 patients for VAS for fatigue ( P=.042), and 7 patients for FIS ( P<.001). Scores for patients with disabling fatigue averaged 81.5%, 62%, and 40.9% of the scale range for FSS, VAS for fatigue, and FIS, respectively. Agreement was moderate between the FSS and VAS for fatigue ( r=.45, P=.02), but low between FSS and FIS ( r=.29, P=.15), and FIS and VAS for fatigue ( r=.20, P=.33). Two sample t tests showed significant differences between those with disabling fatigue and those without, based on FSS scores ( t=3.8, P<.001), but not for VAS for fatigue or FIS scores. Conclusions FSS was the most descriptive of the instruments tested. Scores generated by the scales were not interchangeable. Of the 3 scales, FFS seemed to be the most informative for the clinical assessment of fatigue in patients with PPS.

Assessment of fatigue in patients with ankylosing spondylitis: A psychometric analysis

To investigate whether the single-item fatigue question of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Multidimensional Fatigue Inventory (MFI) are appropriate instruments to measure fatigue in ankylosing spondylitis (AS); to identify factors that influence fatigue in AS; and to assess how fatigue in all its aspects is associated with quality of life in AS. A total of 812 patients with AS were included. Patients completed questionnaires on disease activity (BASDAI), functional ability (Bath Ankylosing Spondylitis Functional Index [BASFI]), global well-being (Bath Ankylosing Spondylitis Global Score [BAS-G]), overall perceived health (EuroQoL visual analog scale), and quality of life (Ankylosing Spondylitis Quality of Life questionnaire, and Short Form 36 [SF-36]). Patients were dichotomized into a F+ group (fatigue = major symptom) if the BASDAI fatigue score was > 5.0 and a F- group (fatigue = minor symptom) if the fatigue score was < 5.0. Reproducibility was assessed with intraclass correlation coefficients, and responsiveness was calculated according to 3 different methods. Logistic regression analysis was used to determine which factors were associated with fatigue. Multiple regression analysis was used to investigate whether fatigue contributes in explaining quality of life. Fifty-three percent of the patients were assigned to the F+ group. They scored significantly worse compared with the F- group with respect to each dimension of the MFI and to all other questionnaires studied (all P < 0.001). The BASDAI fatigue question, as well as each separate dimension of the MFI, showed moderate to good reproducibility (0.57-0.75) and responsiveness (0.23-0.96). Fatigue was, in the opinion of the patients, highly associated with pain (70% of patients) and stiffness (54% of patients). Logistic regression analysis showed that scores on BASDAI, BASFI, BAS-G, and mental health status (SF-36) were independently associated with fatigue (R(2) = 0.52). Multiple regression analysis showed that scores on the BASDAI fatigue question were significantly associated with quality of life. With the 5 MFI dimensions as explanatory variables, different aspects of fatigue were associated with different domains of quality of life. Fatigue as a major symptom of AS can effectively be measured with either a single-item question on the intensity of fatigue or with the MFI. The MFI, however, provides more insight into specific dimensions of fatigue. Fatigue appears to be associated with the level of disease activity, functional ability, global well-being, and mental health status. In addition, fatigue negatively influences different aspects of quality of life.

Assessment of fatigue in patients with chronic hepatitis C using the Fatigue Impact Scale.

The aim of this study was to assess the impact of fatigue on the quality of life of patients with chronic hepatitis C (CHC) and to examine its relationship with various parameters of the disease, including viral load. The Fatigue Impact Scale (FIS), a self-report questionnaire, was applied to 92 patients with CHC, and the results were compared to those of an age-matched cohort of 213 healthy blood donors. Fatigue was frequent and disabling, being present in 67% of CHC patients, and the FIS was significantly increased in CHC patients compared to the healthy controls. Fatigue severity was not correlated with the activity of the disease or with the level of viremia. The FIS proved to be a valuable tool to assess this symptom. It should be of help for better evaluation of the clinical spectrum of the disease and should be included in trials assessing the efficacy of therapeutic interventions.