Fatigue Assessment Instrument Research Articles

The mediating effect of psychological flexibility on fatigue and depressive symptoms among nursing staff.

To explore the relationship between depressive symptoms, fatigue and psychological flexibility, as well as their interactions on depression in Chinese nurses. Using convenience sampling, a cross-sectional survey of 796 nurses in municipal hospitals of Zhengzhou, Henan Province, China, was conducted. The questionnaires of Work-related Acceptance and Action Questionnaire, Center for Epidemiological Studies Depression Scale and Fatigue Assessment Instrument were used. Hierarchical regression and bootstrap methods were used to examine the mediating effect of psychological flexibility between fatigue and depression. More than 51.8% of the nurses were at risk of depression and 62.3% were at risk of fatigue. There was a significantly positive and moderate correlation between depression and fatigue severity, situation specificity, and consequences (r = 0.43, r = 0.24 and r = 0.31, respectively, p < 0.01). Depression was negatively correlated with psychological flexibility (r = -0.28, p < 0.01). Psychological flexibility had a negative impact on depression with the explained variance increased by 4.2% (β = -0.211, p < 0.001). The bootstrap method showed that the mediating effect of psychological flexibility accounting for 8.5% and 12.3% on fatigue and depressive symptoms, respectively. Psychological flexibility plays a partial mediating role between the fatigue severity, consequences of fatigue and depressive symptoms of nurses. Hospital managers should improve medical staff work acceptance to alleviate their depressive symptoms. Int J Occup Med Environ Health. 2023;36(4):563-74.

Ginseng and Ginseng Herbal Formulas for Symptomatic Management of Fatigue: A Systematic Review and Meta-Analysis.

Objectives: Ginseng has been widely used in fatigue management. However, its efficacy on fatigue remains unclear. This study aimed to assess the efficacy and safety of ginseng and ginseng herbal formulas for fatigue in randomized clinical trials (RCTs). Methods: The authors searched PubMed, Embase, Cochrane, Web of Science, and Allied and Complementary Medicine Database (AMED) databases from inception to July 6, 2022. Outcomes included fatigue severity, quality of life (QoL), and adverse events (AEs). Quality of evidence was assessed using the Cochrane Risk of Bias Tool. They pooled all included data and performed subgroup analysis by fatigue type, assessment instrument, and ginseng type. Results: The authors included 19 RCTs. Pooled analyses found no significant reduction in fatigue severity with ginseng versus controls (standardized mean difference [SMD]: -0.36, 95% confidence interval [CI]: -0.82 to 0.11, p = 0.13). In subgroup analysis, there was significant fatigue reduction with the ginseng herbal formula (SMD: -0.39, 95% CI: -0.66 to -0.13, p = 0.004) and chronic fatigue (CF) (SMD: -0.30, 95% CI: -0.56 to -0.03, p = 0.03) compared to controls. Ginseng produced significant reductions in general (i.e., non-disease-specific) fatigue compared to controls (SMD: -0.48, 95% CI: -0.71 to -0.25, p < 0.0001). Ginseng was associated with a trend toward QoL improvement (p = 0.05) and did not increase AEs compared with controls. Effect sizes were small. Conclusion: Ginseng herbal formulas improved fatigue severity compared to controls, especially among patients with CF, but with a small effect size. Rigorous RCTs as well as guidelines for standard ginseng usage are needed to further evaluate the effects of ginseng for fatigue and ensure proper use.

Validation of the Indonesian translated Zoom Exhaustion and Fatigue (ZEF-I) scale: a RASCH Model and Factor Analysis

ABSTRACT Background The Coronavirus Disease pandemic has led to exponentially greater screen time and technology utilization. The Zoom Exhaustion and Fatigue (ZEF) scale is a diagnostic measure developed to identify zoom fatigue arising from excessive screen time. The language barrier, however, has prevented its implementation in Indonesia. This paper thus investigated the validity and reliability of a Bahasa Indonesia diagnostic instrument, ZEF-I. Methods This study generated a ZEF-I translation through the World Health Organization (WHO)-Euro-Reves technique. RASCH and confirmatory factor analysis (CFA) of the scale based on data from 300 participants were undertaken. The reliability and validity of the ZEF-I were specifically assessed with the separation index, Cronbach’s alpha, content validation index as well as Pearson and corrected-item correlations. Results The model showed adequate reliability and validity of the ZEF-I as well as favorable goodness-of-fit indexes and fit indices. The fit-misfit statistics also preserved all 15 items on the translated instrument. Among fatigued students, the blurred vision item was the most frequently endorsed, while the need for self-time was the least endorsed item. Conclusion This study developed and validated an Indonesian translation of the zoom fatigue questionnaire. ZEF-I is an appropriate zoom fatigue assessment instrument for Indonesian university students.

The mediating role of anxiety and depression for family members of ICU patients in perceived social support and fatigue

To analyze the mediating role of anxiety and depression in perceived social support and fatigue in ICU patients' families, and to provide a theoretical evidence for alleviating their fatigue status. A total of 223 family members of ICU patients who received treatment at the Affiliated Hospital of Jiangnan University from October 2020 to April 2021 were selected as the study subjects. The general data questionnaire, perceived social support scale (PSSS), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9) and fatigue assessment instrument (FAI) were used to conduct a survey. Among 223 family members of ICU patients, 155(69.51%) had fatigue problems. There were statistically significant differences in total fatigue scores of ICU patients' family members in terms of gender, age, education level, relationship with patients, residence, payment method and per capita monthly income (P<0.05). Anxiety, depression and fatigue were negatively correlated with perceived social support (r are -0.353, -0.276 and -0.416, respectively, all P<0.01). Depression and fatigue were positively correlated with anxiety (r are 0.808 and 0.703, respectively, all P<0.01), and fatigue was also positively correlated with depression (r= 0.665, P<0.01). Anxiety and depression had a partial mediating effect on perceived social support and fatigue, and the total indirect effect size was 52.64%. Comprehensive intervention on the level of social support, anxiety and depression is helpful to improve the fatigue status of ICU patients' family members.

Efficacy and safety of Ma's Bamboo-based medicinal moxibustion therapy for chronic fatigue syndrome

Abstract Background: Chronic fatigue syndrome (CFS) is a recurrent functional disease with an unknown pathogenesis. Modern treatment mainly focuses on symptomatic and supportive care, but no specific treatment has emerged. Ma's Bamboo-based Medicinal Moxibustion therapy is a folk traditional Chinese medicine developed in Jinsha County, Guizhou Province. Over a long period of practice in the primary health care setting, it has been confirmed in folk medicine that the therapy can significantly improve the symptoms of patients with CFS, but there is no sufficient and scientific clinical evidence. Therefore, this randomised controlled pilot study was designed to preliminarily evaluate the efficacy and safety of Ma's Bamboo-based Medicinal Moxibustion therapy. Methods/design: This is a parallel, randomized, controlled, and exploratory study. Sixty patients with CFS admitted to the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine will be randomly assigned to the experimental or control group. The experimental group will receive Ma's Bamboo-based Medicinal Moxibustion therapy, whereas the control group will undergo conventional acupuncture. Both groups will be treated once daily for 6 consecutive days as a course of treatment, and two courses separated by 1 day will be completed (12 total treatments). All patients will undergo follow-up after the end of treatment. The baseline period is 2 days. The Fatigue Assessment Instrument score as the primary efficacy measure and secondary efficacy measures, including the Clinical Symptom Score and Fatigue Scale-14, will be evaluated at baseline, after one and two courses of treatment, and during follow-up. Serum T lymphocyte subset counts (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +) and safety measures ((blood routine test, liver and kidney function and electrocardiogram) will be evaluated at baseline and after two courses of treatment. All adverse events occurring between baseline and the end of follow-up will be summarised at the end of the follow-up. Discussion: The results of this trial will clarify whether Ma's Bamboo-based Medicinal Moxibustion therapy can improve the symptoms of patients with CFS and provide preliminary evidence for the effectiveness and safety of Ma's Bamboo-based Medicinal Moxibustion therapy for this indication. Ethics approval: This study has been approved by the Ethics Review Committee of the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine (No.K2020–038). Trial Registration: Chinese Clinical Trial Registry, ChiCTR2000038860. Registered on 7 October 2020.

Moxibustion for Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis

Objective This review aimed at systematically evaluating the efficacy and safety of moxibustion for chronic fatigue syndrome (CFS). Methods Relevant trials were searched in seven digital databases up to January 2021. After literature screening, data extraction, and literature quality evaluation, the included studies were meta-analyzed using RevMan 5.4 software. The evidence level was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Results Fifteen studies involving 1030 CFS participants were included. Meta-analyses showed a favorable effect of moxibustion on the total effective rate compared with acupuncture (OR = 4.58, 95%CI = [2.85, 7.35], P < 0.00001) and drugs (OR = 6.36, 95%CI = [3.48, 11.59], P < 0.00001). Moxibustion also appeared to significantly reduce fatigue severity measured by fatigue scale-14 (FS-14) (WMD = −2.20, 95% CI = [−3.16, −1.24], P < 0.00001) and fatigue assessment instrument (FAI) (WMD = −16.36, 95% CI = [−26.58, −6.14], P=0.002) compared with the control group. In addition, among the 15 included studies, only two studies reported adverse events related to moxibustion, and the symptoms were relatively mild. The quality of evidence based on the 15 included trials was assessed as moderate to very low. Conclusions Based on limited evidence, moxibustion might be an effective and safe complementary therapy for CFS, which can be recommended to manage CFS. Because of the limited level of evidence in this review, further high-quality trials are still needed to confirm these findings.

The efficacy and safety of moxibustion for chronic fatigue syndrome: A protocol for systematic review and meta-analysis.

Background:The pathogenesis of chronic fatigue syndrome (CFS) is not clear. The main purpose of treatment is to improve autoimmune function and relieve fatigue symptoms. Moxibustion is often used to treat diseases caused by low autoimmunity, especially in relieving fatigue symptoms. It is a superior therapy for CFS in traditional Chinese medicine. At present, there is a lack of the high level clinical evidence to support the moxibustion in the treatment of CFS, so this study will systematically review and analyze the currently available randomized controlled trials to evaluate the efficacy and safety of moxibustion in the treatment of CFS.Methods:We will systematically search PubMed, EMBASE, Cochrane library, Sinomed, CNKI, VIP, and Wanfang Database, ClinicalTrials.gov and Chinese Clinical Trial Registry will also be searched. The time range for the search will be from database activation to March 31, 2021. The randomized controlled trials (RCTs) associated with moxibustion for CFS will be included, regardless of language.We will use the standard proposed in Cochrane Handbook 5.1.0 to assess the bias risk of a single RCT. The main outcome index of the study is Fatigue Assessment Instrument (FAI), secondary outcome indexes will include Fatigue Scale -14 (FS-14), Fatigue Severity Scale (FSS), Pittsburgh sleep quality index (PSQI), natural killer (NK) cells, interleukin- 2 (IL-2), T lymphocyte subsets (CD4+, CD8+), cure rate, total efficiency and adverse reactions. The random effect model meta was used to analyze the effect data of a single RCT. Heterogeneity will be measured by Cochran Q test and I-squared statistics. We will use 2 subgroup analyses to explore the source of heterogeneity. RCTs with high bias risk was excluded and adjustment effect model was used for sensitivity analysis to test the robustness of the meta-analysis results. The publication bias included in RCTs will be assessed by funnel plot and Egger test.Results:This study will objectively and comprehensively evaluate the efficacy and safety of randomized controlled trials of moxibustion in the treatment of chronic fatigue syndrome, and the results will be submitted to peer-reviewed journals for publication.Conclusion:This systematic review will provide clinicians with the latest high-quality evidence for the use of moxibustion in the treatment of chronic fatigue syndrome.INPLASY registration number:INPLASY202140063.

The effectiveness of cupping therapy on chronic fatigue syndrome: A single-blind randomized controlled trial

Backgroundand purpose: We investigated the effectiveness of cupping therapy with three different pressures in patients with chronic fatigue syndrome (CFS). Materials and methodsThe participants were randomly assigned to three groups, as follows: cupping pressure of −0.02 mpa (n = 38), −0.03 mpa (n = 38), or −0.05 mpa (n = 36). Each group received cupping treatment that consisted of 10 sessions over 5 weeks (2 sessions per week). The primary outcomes were Fatigue Scale (FS-14) score and Fatigue Assessment Instrument (FAI) score after 5 and 10 sessions. The secondary outcomes were the Self-Rating Anxiety Scale (SAS) score, the Self-Rating Depression Scale (SDS) score, and the Pittsburgh Sleep Quality Index (PSQI) score. ResultsThere were 91 participants who completed the trial. After five sessions of treatment, the primary outcome of FS-14 score decreased by 3.20 (2.19, 4.21) in the −0.02 mpa group, by 2.39 (1.51, 3.27) in the −0.03 mpa group, and by 3.40 (2.28, 4.52) in the −0.05 mpa group (P = 0.667). After 10 sessions of treatment, the outcome of FS-14 score decreased by 5.00 (3.79, 6.21) in the −0.02 mpa group, by 4.06 (3.07, 5.05) in the −0.03 mpa group, and by 4.77 (3.52, 5.94) in the −0.05 mpa group (P = 0.929). And, the results were statistically different between 5 sessions and 10 sessions of treatment (P < 0.01). However, there were no statistical differences in FAI, SAS, SDS, and PSQI scores between the three groups after 5 sessions and 10 sessions of treatment. ConclusionsIn conclusion, cupping therapy has significantly relieved fatigue symptoms and improved emotion and sleep condition of CFS patients, and 10 sessions of treatment had superior results compared with 5 sessions in each group. Moreover, in 5 sessions of treatment, cupping with high pressure showed better improvement in fatigue syndromes and sleep condition according to effective rates. Trial registrationChinese clinical trial registry (ChiCTR1800017590); Ethical approval number: ChiECRCT-20180085.

The Effects of Auricular Acupressure Therapy on Sleep Disorder and Fatigue in Menopausal Women

Purpose: The purpose of this study was to identify the effects of auricular acupressure therapy on sleep disorder and fatigue in menopausal women. Methods: The study design was a non-equivalent control group pretest-posttest design. The participants were 40~60 years old women, assigned to the experimental group (n=25) or the control group (n=27). Auricular acupressure using vaccaria seeds was administered to the experimental group. The sessions continued for 6 weeks. Outcome measures included Pittsburgh sleep quality index, sleep meter, sleep diary, fatigue assessment instrument, serum cortisol, and serum serotonin. Results: Menopausal women in the experimental group showed significant increases in deep sleep, light sleep, serotonin level and sleep duration compared with the control group. Also, the experimental group reported decreases in PSQI, sleep latency, awakening time, fatigue and cortisol level compared with the control group. Conclusion: Results show that auricular acupressure using vaccaria seeds is considered as an effective treatment for sleep disorder and fatigue in menopausal women. We conclude that it can be used as a nursing intervention method proven to reduce sleep disorder and fatigue in menopausal women.

Effect of solution focused approach-based nursing care on the oriented main caregivers fatigue and caring burden of patients with urinary stoma

Objective To explore the effect of solution focused approach-based nursing care on the oriented main caregivers fatigue and caring burden of patients with urinary stoma. Methods A total of 100 urinary stoma patients who treated in the Yuechi county people′s hospital from July 2016 to December 2018 were enrolled in the present study, patients were randomly divided into intervention group 50 cases and control group 50 cases according to the random number table method. In the control group, patients received continuous nursing, meanwhile, solution focused approach-based nursing care was carried out in the intervention group. The scores of main caregivers fatigue, caring burden in two groups was determined by fatigue assessment instrument and Zarit caregiver burden interview, respectively. Results Before intervention, the scores of FAI and caring burden in intervention group were (5.23±0.72) and (43.15±3.87), after solution focused approach-based nursing intervention, FAI and caring burden scores in the intervention group were (4.21±0.74) and (27.99±2.36). Meanwhile, those index were (5.31±0.58), (42.75±4.35) and (4.57±0.65), (33.42±3.29) in the control group, respectively. Before intervention, the main caregivers fatigue, caring burden between two groups had no statistical difference (P>0.05). After intervention, the main caregivers fatigue and caring burden was significantly decreased in the intervention group compared to the control group (t=2.606, 9.476, P<0.05). Intra-group comparison showed significnat difference between before and after intervention for both groups, the intervention group: t=7.032, 23.62, P<0.01; the control group: 6.013, 12.105, P<0.01. Conclusions Solution focused approach-based nursing care can alliviate their main caregivers fatigue and caring burden. Key words: Solution focused approach; Urinary stoma; Fatigue; Caring burden

Perceived fatigue and cognitive performance change in multiple sclerosis: Uncovering predictors beyond baseline fatigue

BackgroundFatigue is a common and disabling symptom in multiple sclerosis (MS) with a variety of direct and indirect influences, but remains poorly understood. Perceived fatigue and cognitive performance fatigability may only be weakly correlated and may have independent predictors. We adopted a multifactorial approach, utilising a measure of concurrent cognitive performance change in order to examine the clinical, psychological, and cognitive factors influencing perceived and cognitive performance fatigability in MS. MethodsIndividuals with adult-onset MS were identified from a regional patient database and invited to complete an assessment battery during a home visit. Baseline perceived fatigue was measured using the Modified Fatigue Impact Scale, Fatigue Assessment Instrument, and a Visual Analogue Scale (VAS). The Conners Continuous Performance Test 3 (CCPT3) and VAS were administered before and after our intervention of roughly 2.5 hours of assessment, which represented a period of cognitive effort. The differences in scores formed measures of cognitive performance fatigability and perceived fatigue change, respectively. We examined differences across baseline fatigue, fatigue change and performance change classifications, using regression analysis to uncover predictors of perceived fatigue and performance change. ResultsThe sample comprised 61 participants who were recruited from an existing cohort of MS patients. Positive relationships with depression and emotion-focused coping, and a negative one with sleep, each predicted baseline perceived fatigue with the model explaining 53.5% of variance. Increased perceived fatigue change was not associated with baseline fatigue, cognitive impairment, disease variables or levels of disability, but was linked with higher anxiety, lower self-efficacy and gender. Most CCPT3 performance change variables did not show significant correlations with baseline clinical, psychological, or fatigue variables. However, two variables were predicted by positive relationships with estimated intelligence, whilst a negative relationship with self-efficacy and a positive one with post-intervention fatigue predicted one each. ConclusionFatigue in MS is a multifactorial construct, with perceived fatigue and cognitive performance fatigability largely influenced by indirect psychological and cognitive factors. Future studies need to take these influences into account when developing fatigue assessment tools. Further, targeting influential fatigue drivers such as psychological variables may improve the burden of fatigue and quality of life of people with MS.

Study on correlation between fatigue status and self-management behavior and quality of life in maintenance hemodialysis patients

Objective To explore the relationship between status of maintenance hemodialysis patients, self-management behavior and quality of life, and provide theoretical basis for clinical individualized care and improvement of patients' quality of life. Methods The Fatigue Assessment Instrument (FAI), the self-management scale of hemodialysis patients and the MOS 36-item short-form health survey (SF-36) were used to investigate 140 patients who received long-term hemodialysis treatment in the hospital from June 2014 to June 2016. Results According to the score of FAI rating scale factor 1, there were 45 cases of mild fatigue , 73 cases of moderate fatigue and 22 cases of severe fatigue . There was no significant difference in the total score of self-management behavior between mild fatigue and moderate fatigue patients(P>0.05). The total scores of self-management behaviors, SF-36 physical health and SF-36 mental health of patients with mild fatigue , moderate fatigue and severe fatigue all showed a downward trend, with statistically significant differences (P<0.05). Spearman correlation analysis showed that the factor of maintenance hemodialysis patients were negatively correlated with the total score of self-management behavior, SF-36 physical health score and SF-36 mental health score (P<0.05). Conclusions Fatigue is common in maintenance hemodialysis patients.Severe is not conducive to the maintenance of patients' self-management behavior and can reduce their quality of life. Key words: Hemodialysis; Fatigue; Self-management; Quality of life

The relationship between status of fatigue and compliance, quality of life in patients after liver transplantation

Objective To investigate the relationship between status of fatigue and compliance, quality of life in patients after liver transplantation, which in order to provide a scientific basis for improving compliance and quality of life of them. Methods One hundred and four liver transplant recipients who received liver transplantation from Jun 2012 to Jun 2015 were recruited in this study. The status of fatigue, compliance and quality of life of these patients were assessed by Fatigue Assessment Instrument (FAI) , compliance scale and the MOS 36-item short-form health survey (SF-36) respectively. Spearman correlation coefficients were used to analyze the relationship between status of fatigue and compliance, quality of life. Results The degree of fatigue in patients after liver transplantation was significantly higher than that in the general population and patients with coronary heart disease. Except the fatigue factor 4, the fatigue factor 1, factor 2 and factor 3 scores of the patients at the end of the 12 month after liver transplantation were lower than those at the end of the 1 month and 6 months after liver transplantation (P 0.05). The patients were graded according to the FAI fatigue rating scale factor 1 score, of which 63 cases were moderate fatigue, and the other was severe fatigue (n=41). The results showed that the total score of compliance, the total score of SF-36 physical health and the total score of SF-36 mental health of the moderate fatigue group were higher than that of the severe fatigue group(P<0.05). Spearman correlation coefficients showed that all fatigue factors of patients post-transplantation was negatively correlated with quality of life and compliance (P<0.05). Conclusions There is high level of fatigue in patients after liver transplantation, and which negatively correlated with quality of life and compliance. Nursing staff should comprehend the fatigue status of patients after liver transplantation and relieve timely. Which could improve the quality of life of patients post-transplantation. Key words: Liver transplantation; Fatigue; Quality of life; Compliance

Efficacy of acupoint catgut embedding combined with ginger-partitioned moxibustion on chronic fatigue syndrome of spleen-kidney yang deficiency syndrome and its effects on T lymphocyte subsets and activity of NK cell

To observe the efficacy differences between acupoint catgut embedding combined with ginger-partitioned moxibustion and regular acupuncture on chronic fatigue syndrome (CFS) of spleen-kidney yang deficiency syndrome, and to explore its effects on T lymphocyte subsets and activity of NK cell. A total of 60 patients with CFS of spleen-kidney yang deficiency syndrome were randomly divided into a catgut embedding combined with ginger-partitioned moxibustion (CECGP) group and a regular acupuncture group, 30 cases in each one. The patients in the CECGP group were treated with acupoint catgut embedding combined with ginger-partitioned moxibustion; the acupoint catgut embedding was applied at Guanyuan (CV 4), Shenshu (BL 23), Pishu (BL 20), Zusanli (ST 36), Qihai (CV 6), once a week, while the ginger-partitioned moxibustion was applied at Guanyuan (CV 4), Qihai (CV 6) and Zusanli (ST 36), once every three days for consecutive one month. The patients in the regular acupuncture group were treated with regular acupuncture at Guanyuan (CV 4), Shenshu (BL 23), Pishu (BL 20), Zusanli (ST 36), Qihai (CV 6), once a day, 6 treatments per week (one day for rest) for consecutive one month. The clinical symptom scores, fatigue scale-14 (FS-14), fatigue assessment instrument (FAI), laboratory test results and total effective rate were compared between the two groups before and after treatment. (1) After treatment, the clinical symptom scores, FS-14 and FAI were reduced in the two groups (all P<0.05); after treatment, the clinical symptom scores, FS-14 and FAI in the CECGP group were significantly lower than those in the regular acupuncture group (all P<0.05). (2) After treatment, the CD4+/CD8+, natural killer cell% (NK%), CD3+%, CD% were all increased in the two groups (all +4 P<0.05); the CD4+/CD8+, CD3+%, CD% in the CECGP group were significantly higher than those in the regular acupuncture group (all P<0.05). (3) After treatment, the total effective rate was 96.7% (29/30) in the CECGP group, which was similar to 93.3% (28/30) in the regular acupuncture group (P>0.05). The acupoint catgut embedding combined with ginger-partitioned moxibustion, which could effectively relieve the symptoms, regulate T lymphocyte subsets and the activity of NK cell, is an effective method for CFS of spleen-kidney yang deficiency syndrome.

Psychometric Properties of the Fatigue Questionnaire EORTC QLQ-FA12 in a Sample of Female Cancer Patients

ContextCancer patients frequently suffer from fatigue. Recently, the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life group developed a new 12-item fatigue assessment instrument. ObjectivesThe aim of this study was to psychometrically test this questionnaire in comparison with the three-item fatigue scale of the EORTC QLQ-C30. MethodsA sample of 354 patients who were being treated for breast cancer or gynecologic cancer were examined using the new fatigue questionnaire EORTC QLQ-FA12 and the EORTC QLQ-C30 during their hospital stay (t1) and three months after hospital discharge (t2). Confirmatory factorial analyses, item analyses, test-retest reliability analyses, and correlation analyses were performed. ResultsThe analyses roughly supported the three-factorial structure of the FA12, which comprised the subscales physical, emotional, and cognitive fatigue. The fit indices of the confirmatory factorial analysis were worse than those of the original article but nevertheless acceptable. Cronbach alpha of the total scale was 0.92; the coefficients of the subscales were between 0.79 and 0.93. The correlation between the EORTC QLQ-FA12 total scale and the fatigue scale of the EORTC QLQ-C30 was 0.69 and the correlation between the t1 and t2 scores was 0.45 for the EORTC QLQ-FA12 total scale and between 0.37 and 0.47 for the subscales. ConclusionThe psychometric coefficients justify the calculation of a sum score, which can be used by clinicians to assess the general degree of fatigue. Although the three-item fatigue scale of the EORTC QLQ-C30 stresses the physical aspect of fatigue, the new EORTC QLQ-FA12 covers its emotional and cognitive aspects as well.

Acupuncture and Moxibustion have Different Effects on Fatigue by Regulating the Autonomic Nervous System: A Pilot Controlled Clinical Trial.

In order to investigate the different effects of acupuncture and moxibustion on chronic fatigue syndrome (CFS) and alterations in the autonomic nervous system by measuring heart rate variability (HRV). Forty-five participants were recruited and randomly divided into 3 groups using a randomization schedule. The control group (CG, n = 15) and the acupuncture group (AG, n = 15) were treated by manipulation acupuncture, and the moxibustion group (MG, n = 15) was treated by indirect moxibustion. Primary outcomes were the scores of the Fatigue Assessment Instrument (FAI). Secondary outcomes were the HRV parameters which can reflect activity of the autonomic nervous system. This trial considered both instantaneous changes and long-term effectiveness. FAI scores decreased after the 4th and 10th treatments in the 3 groups. The decrease in FAI in the MG was greater than that in the AG. Acupuncture was more effective in instantaneous changes of HRV and moxibustion in long-term aspects. Both acupuncture and moxibustion improved fatigue in CFS patients, but moxibustion was more effective. The possible mechanism of the intervention may be through activation of the vagus nerve. Moxibustion was more effective than acupuncture in long-term treatment of CFS.

Validation of the Brazilian version of the neurological fatigue index for multiple sclerosis

The Neurological Fatigue Index for Multiple Sclerosis (NFI-MS) is a new fatigue assessment instrument. The aim of this study was to cross-culturally adapt and assess the psychometric properties of the Brazilian version of the NFI-MS (NFI-MS/BR). Two hundred and forty subjects with MS were recruited for this study. The adaptation of the NFI-MS was performed by translation and back translation methodology. In psychometric analysis was performed the administration of the questionnaires Epworth Sleep Scale, Fatigue Severity Scale, Modified Fatigue Impact Scale, Multiple Sclerosis Impact Scale-29, NFI-MS/BR and Pittsburgh Sleep Quality Index with retest of the NFI-MS/BR after 7 days. Reliability was assessed (intraclass correlation coefficients between 0.77 and 0.86), and validity by testing 41 hypotheses about expected correlations between subscales and confirmed 36. The majority of correlations were demonstrated. The NFI-MS/BR is a cross-culturally adapted, valid, and reliable instrument for assessing MS fatigue among Brazilian subjects.

Influence of family function on cancer-related fatigue of patients with cervical cancer radiotherapy

Objective To study the current family function situation of patients with cervical cancer radiotherapy, and analyze its impact on cancer-related fatigue. Methods Using the quota sampling, 124 cervical cancer patients in the radiotherapy department were included in the study. The general information questionnaire, Family Assessment Device(FAD) and Fatigue Assessment Instrument(FAI)were used to survey. Results The patients with mild, moderate and severe family dysfunction accounted for 41.9%, 32.3% and 25.8% respectively. Patients with light, moderate and severe cancer-related fatigue accounted for 31.5%, 11.3% and 57.3% respectively. Pearson correlation analysis showed that family function dimension were negatively correlated with cancer-related fatigue (r=0.336-0.933, P<0.01). The degree of cancer-related fatigue was the heaviest of patients with severe family dysfunction. Patients with mild, moderate and severe family dysfunction were statistically significant (P<0.01). Conclusions Patients with cervical cancer radiotherapy have different degree of family dysfunction and cancer-related fatigue. The family function and cancer-related fatigue is closely related to each other. Medical staff must strengthen the knowledge learning of family function, understand cervical cancer family problems, target guidance of family members of patients care and support them. To some extent, we can prevent and reduce the cancer-related fatigue. Key words: Cervical cancer; Radiotherapy; Family function; Cancer-related fatigue

Effect of moxibustion on the Governor Vessel in combination with acupuncture on ankylosing spondylitis

ObjectiveTo investigate the effect of moxibustion on the Governor Vessel in combination with acupuncture on ankylosing spondylitis.MethodsThirtypatetints with ankylosing spondylitis（kidneyyang deficiency pattern） were recruited and treated with moxibustion on the Governor Vessel in combination with acupuncture. The scores of Scale of Quality of Life for Ankylosing Spondylitis （SQOL-AS）, Bath Ankylosing Spondylitis Disease Activity Index（BASDAI）, Bath Ankylosing Spondylitis Functional Index（BASFI）, Fatigue Assessment Instrument（FAI）and erythrocyte sedimentation rate（ESR） before and after treatment were evaluated.ResultsThe scores of BASDAI（0.427±0.381vs. 6.107±1.375;t=28.986,P〈0.01）, BASFI（0.753±0.504 vs. 7.480±1.152;t=36.580,P〈0.01）, FAI（40.067±14.746vs. 146.967±26.283;t=24.520,P〈0.01）after treatment were significantly lower than those before treatment; ESR after treatment were significantly lower than that before treatment（19.833±13.929 mm/hvs. 31.567± 20.065 mm/h;t=3.708,P〈0.01）. The subscores of Physical Functioning（33.000±1.930vs. 12.033±1.790;t=62.165,P〈0.01）, Mental Health（25.367±2.059vs. 14.067±2.303;t=30.139,P〈0.01）, Social Functioning（21.267±4.025vs. 8.767±1.977;t=26.643,P〈0.01） and General Health Perception （22.733± 2.690vs. 9.767±2.738;t=25.729,P〈0.01） of SQOL-AS after treatment were significantly lower than that before treatment.ConclusionsMoxibustion on the Governor Vessel in combination with acupuncture can improve physical functioning and reduce disease activity in patients with ankylosing spondylitis. Key words: Spondylitis,Ankylosing; Points,Governor vessel; Moxibustion; Acupuncture

Sexual Functioning and the Effect of Fatigue in Traumatic Brain Injury

The primary objective was to examine specific aspects of sexual functioning (frequency, desired frequency, importance, and satisfaction) and their relationship to fatigue in individuals with traumatic brain injury (TBI) compared with those without brain injury. The relationship of demographic variables, emotional well-being, and health-related quality of life to sexual functioning was also explored. 200 community-dwelling adults with self-reported mild-to-severe TBI and 83 individuals without brain injury. Participation Objective, Participation Subjective, Fatigue Assessment Instrument, Global Fatigue Index, Beck Depression Inventory, and SF-36 Health Survey. Data were collected through administration of self-report measures and interviews as part of a larger study of post-TBI fatigue. Several aspects of sexual activity (frequency, desired frequency, and importance) were closely related to specific features of fatigue among individuals with TBI. Women with TBI reported lower frequency and lower importance of sex than men. In individuals without brain injury, the impact of fatigue was limited to the frequency of sexual activity with no sex differences observed. Fatigue plays a different role in the subjective experience of sexual activity for men and women with TBI than for those without brain injuries. Fatigue and sex should be taken into account in future research and interventions focused on sexual function after TBI.