Total Fatigue Score Research Articles

A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study.

Dietary therapy may be beneficial in alleviating symptoms of chronic fatigue syndrome (CFS), a disorder that is characterized by extreme fatigue and other symptoms, but the cause of which remains unclear. The aim of this study was to evaluate the protective effect of a botanical product containing cistanche (Cistanche tubulosa [Schenk] Wight) and ginkgo (Ginkgo biloba L.) extracts on adults with CFS in a randomized, double-blind, placebo-controlled clinical trial. A total of 190 subjects (35–60 years old, non-obese) with CFS were randomized to receive one tablet of a low dose (120-mg ginkgo and 300-mg cistanche), a high dose (180-mg ginkgo and 450-mg cistanche) or a placebo once daily for 60 days. Blood samples and responses on the Chalder fatigue scale (CFQ 11), the World Health Organization's quality of life questionnaire (WHOQOL), and the sexual life quality questionnaire (SLQQ) were collected at baseline and post-intervention. CFS symptoms of impaired memory or concentration, physical fatigue, unrefreshing sleep, and post-exertional malaise were significantly improved (p < 0.001) in both of the treatment groups. The botanical intervention significantly decreased physical and mental fatigue scores of CFQ 11 and improved WHOQOL and SLQQ scores of the subjects (p < 0.01). Levels of blood ammonia and lactic acid in the treatment groups were significantly lower than those of the placebo group (low-dose: p < 0.05; high-dose: p < 0.01). In addition, the change in lactic acid concentration was negatively associated with the severity of CFS symptoms (p = 0.0108) and was correlated with the change in total physical fatigue score of the CFQ (p = 0.0302). Considering the trivial effect size, the results may lack clinical significance. In conclusion, this botanical product showed promising effects in ameliorating the symptoms of CFS. Clinical trials with improved assessment tools, an expanded sample size, and an extended follow-up period are warranted to further validate the findings.Clinical Trial Registration: https://clinicaltrials.gov/, identifier: NCT02807649.

Fatigue in children and adolescents perinatally infected with human immunodeficiency virus: an observational study

BackgroundFatigue is common among adults living with human immunodeficiency virus (HIV) as well as children with a chronic disease (CCD). Fatigue can have disastrous effects on health status, including health related quality of life (HRQOL). Even so, fatigue is underexplored in children and adolescents perinatally infected with HIV (PHIV+) in the Netherlands. The objective of this observational study is to explore fatigue in PHIV+ and its association with their HRQOL.MethodsWe measured HRQOL and fatigue using the Pediatric Quality of Life Inventory™ (PedsQL 4.0) and the PedsQL Multidimensional Fatigue Scale (MFS). The PedsQL MFS encompasses three subscales: general fatigue, sleep/rest fatigue and cognitive fatigue, and a total fatigue score. We compared outcomes of PHIV+ children and adolescents in the Amsterdam University Medical Centre with three groups: 1) HIV-uninfected controls (HIV-) matched for age, sex, region of birth, socioeconomic status and adoption status, 2) CCD, and 3) the general Dutch population. Within the PHIV+ group we explored associations between fatigue and HRQOL.ResultsWe enrolled 14 PHIV+ (median age 10.2 years [IQR 9.2–11.4]) and 14 HIV-. Compared to CCD, PHIV+ significantly reported less general fatigue (mean difference 13.0, 95% CI 1.3 to 24.8). PHIV+ did not score significantly different on any of the other PedsQL MFS scales compared to HIV-, CCD or the general Dutch population. PHIV children scored relatively low on the cognitive fatigue scale in comparison to HIV-uninfected matched controls, CCD and the general population, although these differences did not reach significance. Among PHIV+, a lower score on total fatigue, general fatigue and cognitive fatigue was associated with a lower HRQOL score.ConclusionsThe results of this study suggest that PHIV children and adolescents do not experience more symptoms of fatigue than their healthy peers. However, PHIV children and adolescents may be more likely to experience cognitive fatigue. Fatigue in PHIV also appears to be associated with children’s HRQOL. Further research should confirm these exploratory findings.

Iron deficiency and fatigue among adolescents with bleeding disorders.

Iron deficiency anemia is associated with heavy menstrual bleeding (HMB) and, by extension, a bleeding disorder (BD). It is unknown if iron deficiency without anemia is associated with a BD in adolescents. Moreover, the threshold of ferritin associated with fatigue in adolescents with HMB is unclear. In this multicenter study, we enrolled adolescents with HMB without BD. Participants underwent BD and anemia work-up in Young Women's Hematology Clinics and completed the Peds QL™ fatigue scale. BDs were defined as von Willebrand Disease, platelet function defect, clotting factor deficiencies, and hypermobility syndrome. Two hundred and fifty consecutive adolescents were enrolled, of whom 196 met eligibility criteria. Overall, 43% (95% confidence interval: 36%-50%) were diagnosed with BD. A total of 61% (n= 119) had serum ferritin levels < 15 ng/mL, 23.5% (n= 46) had iron deficiency only, and 37% (n= 73) had iron deficiency anemia. Low ferritin or ferritin dichotomized as < 15 or ≥ 15 ng/mL was not associated with BD on univariable analysis (p= .24) or when accounting for age, race, ethnicity, body mass index, and hemoglobin (p= .35). A total of 85% had total fatigue score below the population mean of 80.5, and 52% (n= 102) were > 2 SD (or < 54) below the mean, the cut-off associated with severe fatigue. A ferritin threshold of < 6ng/mL had a specificity of 79.8% but a sensitivity of 36% for severe fatigue. In conclusion, iron deficiency without anemia is not a predictor of BD in adolescents with HMB in a specialty setting. Severe fatigue, especially sleep fatigue, is prevalent in adolescents with BD. Ferritin of < 6ng/mL has ~80% specificity for severe fatigue in adolescents with HMB.

Longitudinal Development of Health-related Quality of Life and Fatigue in Children on Home Parenteral Nutrition.

ABSTRACTObjectives:The aim of the study was to describe the longitudinal development of health-related quality of life (HRQOL) and fatigue in children with chronic intestinal failure (CIF) on home parenteral nutrition (PN) and compare these children to the general population.Methods:Prospective, observational study conducted over 7 years in patients suffering from CIF receiving home PN from 2 tertiary hospitals in the Netherlands. Every 6 months, parents (if child <8 years old) or patients (if child ≥8 years old) completed 2 questionnaires: Pediatric Quality of Life Inventory 4.0 (PedsQL) Generic and Fatigue on the KLIK (kwaliteit van leven in kaart [Dutch Acronym for Quality of Life in Clinical Practice]) Patient Reported Outcome Measures portal, which were compared with the general population. Linear mixed models (LMMs) were constructed to investigate the course of HRQOL over time.Results:Thirty-five patients were included (40% girls). At time of last KLIK contact, patients received HPN for a median of 5.3 years (interquartile range [IQR]: 2.9–9.7). In total, 272 questionnaires were completed. PedsQL generic total score for ages 5 to 7 and 8 to 12 years was significantly lower than the general population (P < 0.01 for both age groups) with effect sizes of 0.73 and 0.71, respectively. PedsQL fatigue total score for ages 5 to 7 years was also significantly lower (P = 0.01; effect size 0.70). LMMs for PedsQL Generic and Fatigue total score 2 to 7 and 8 to 18 years showed no significant coefficient for duration of home PN.Conclusions:Children suffering from CIF receiving home PN ages 5 to 12 years report lower HRQOL scores than the general population. HRQOL and fatigue do not change during long-term treatment with home PN in these children.

Does the Lightning Process Training Programme Reduce Chronic Fatigue in Adolescent and Young Adult Cancer Survivors? A Mixed-Methods Pilot Study.

Simple SummaryChronic fatigue is a common late adverse effect following oncological therapies. No effective treatments exist, although cognitive behaviour therapy has been reported to offer some benefits. The Lightning Process® is a three-day educational training programme with a six-month follow-up comprising elements derived from cognitive behaviour therapy, neurolinguistic programming, and stress theory, which are presented in a condensed form. This pilot intervention study represents the first systematic account of the experience and perceived efficacy of the LP training programme in 13 adolescent and young adult cancer survivors treated for sarcoma or Hodgkin lymphoma. Statistically significant improvements were documented for all the patient-reported outcome measure (PROM) questionnaires comparing the pre- and post-intervention periods. The qualitative findings of the interviews corresponded well with the PROMs findings, as participants emphasised that they now experienced both less fatigue and explicit improvement in their energy level.Background: We report on a pilot intervention study exploring the efficacy of the Lightning Process® training programme for reducing chronic fatigue and improving health-related quality of life in cancer survivors. Methods: 13 adolescent and young adult cancer survivors previously treated for sarcoma or Hodgkin lymphoma were enrolled. A mixed-methods approach was applied. This involved the use of five validated patient-reported outcome measure (PROM) questionnaires at baseline and the three- and six-month follow-up points to obtain quantitative data. Semi-structured interviews were conducted after the intervention with emphasis on the participants’ experiences and outcomes. A reflexive thematic analysis was applied to the transcripts. Results: A significant reduction (p < 0.001) in the total fatigue score from baseline to the three- and six-month follow-up points was documented. The correlation coefficients between the various PROMs at baseline and the six-month follow-up point indicated considerable overlap between the measures. The qualitative findings of the interviews corresponded well with the PROM findings. Most participants experienced both less fatigue and explicit improvement in their energy level. The aspects of the intervention found to be particularly helpful were the theoretical rationale and the coping techniques mediated. Conclusion: These encouraging results here reported should be of interest to the general oncological community, although they require confirmation through a larger and controlled study.

The effect of warm salt water foot bath on the management of chemotherapy-induced fatigue.

Several studies have shown that the warm water bath can be a beneficial approach in the management of fatigue. This experimental study was conducted to evaluate the effect of warm salt water foot bath in the management of chemotherapy-induced fatigue. This randomized controlled trial was perfomed between November 2017-February 2018. Seventy five patients who experienced moderate or higher level chemotherapy related fatigue were randomly assigned to the intervention or control group. A training booklet about chemotherapy-induced fatigue was given to all patients. In addition, the experimental group performed 20min warm salt water footbath for a week. The primary outcome was the change in fatigue level over 7 days after chemotherapy. The secondary outcome was the difference in physical, affective, emotional, and cognitive fatigue scores of patients. The level of fatigue was grade 2 and grade 3 for 65.3% and 33.3% of patients, respectively. There was no statistically significant difference between groups regarding the mean of total fatigue score before and after bath (p>0.05). However, the amount of decrease observed in the experimental group was found to be statistically significantly higher than the control group (p=0.012; p<0.05). In addition; the score in behavioral/severity, sensory, affective and cognitive dimensions related to fatigue decreased in the experimental group but did not decrease in the control group. This study shown that warm salt water footbath can be an effective approach in enhancing fatigue related quality of life cancer patients. More studies should be conducted to assess the effectiveness of this intervention.

Evaluation of Fatigue among Older Population in Jordan

ABSTRACT Objective: Fatigue among older adults has not received empirical attention in the Arabic region. Thus, this study aimed to assess the levels of fatigue and its related psychosocial factors and examine the predictors of fatigue in older Jordanians aged 60 years and more. Methods: This study used a cross-sectional design and our sample was 250 older adults receiving health services at comprehensive healthcare centers in Amman Governorate, the capital of Jordan. The study used the following scales: Fatigue scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and sociodemographic and lifestyle behaviors datasheet. Results: The results showed that approximately 57% of the participants experienced severe fatigue. Nearly 90% of the older adults reported having moderate to high levels of stress, around 97% experienced moderate and high levels of social support, and almost 68% had normal self-esteem. The significant predictors of the total fatigue scores were, consuming soft drinks, practicing exercise, perceived levels of stress, and social support levels. Conclusions: Awareness of the magnitude and the factors predicting fatigue among elderlies in Jordan should inform the practice and encourage clinicians to implement individualized care plans that include fatigue reduction strategies, to elderlies visiting healthcare centers.

A longitudinal analysis of fatigue in colorectal cancer patients during chemotherapy

PurposeThe aim of this longitudinal study was to analyze trends in fatigue among colorectal cancer patients during chemotherapy and examine the predictors of multidimensional fatigue.MethodsA mixed sample of colorectal cancer patients who were receiving chemotherapy (N = 200) was recruited in China. The patients completed the Cancer Fatigue Scale (CFS) at baseline (before chemotherapy) and after 3 and 6 months of chemotherapy. Repeated measures ANOVAs were conducted to evaluate the effect of time on the CFS score. The data on violations of the statistical assumptions (independence, normality, and sphericity) from the repeated measures ANOVAs were examined. Stepwise regression analyses were conducted to evaluate the associations of the potential predictor variables at baseline on the total fatigue score and subscale scores at follow-up.ResultsAs chemotherapy progressed, significant increases in the three subscale scores and total scores were observed. Physical fatigue and total fatigue scores increased continuously during chemotherapy (P < 0.001). However, affective fatigue and cognitive fatigue scores increased significantly in the first 3 months (P < 0.001) and basically remained stable thereafter (P > 0.05). Multiple stepwise regression was used to analyze the predictors. The results showed that the baseline fatigue subscale score was the strongest predictor of each dimension of fatigue. In addition, age affected physical fatigue, and monthly income and education affected cognitive fatigue.ConclusionFatigue increased during chemotherapy. Early assessment and intervention may be better for controlling fatigue, especially in patients with higher baseline fatigue level, older age, and lower economic and educational levels.

Fatigue and sleep quality in different trimesters of pregnancy.

ObjectivesFatigue is one of the most common and persistent complaints of pregnant women. Increased severity of fatigue during pregnancy can increase the risk of preterm labor, prolonged labor, cesarean section, and postpartum depression. Therefore, this study aimed to determine the fatigue status in different trimesters of pregnancy and its relationship with sleep quality in pregnant women.Material and MethodsThis cross-sectional study was performed by two-stage cluster sampling on pregnant women referred to Tabriz health centers. Data were collected using socio-demographic questionnaire, multidimensional assessment of fatigue and Pittsburgh sleep quality index.ResultsAmong the 605 pregnant women studied, 94.2% of women suffered from fatigue during pregnancy. The mean (standard deviation) of fatigue score in the first, second and third trimesters of pregnancy was 23.53 (8.05), 25.78 (6.56) and 26.46 (6.72), respectively. There was also significant reverse correlation between total fatigue score with total sleep quality score (p=0.031) and with an increase in fatigue, sleep quality was reduced.DiscussionThe findings of this study may be used to design interventional measures for fatigue and medical care to improve quality of sleep in pregnancy.

Assessment of fatigue among aviation personnel involved in military flying in India employing Multidimensional Fatigue Symptom Inventory – Short Form (MFSI-SF)

Introduction: Fatigue has been recognized as a major safety hazard in modern aviation. There are numerous studies which have addressed various aspects such as the subjective symptoms, objective measures to diagnose fatigue, and its link with operator’s performance. This study was a novice attempt to assess the chronic fatigue among the aviation personnel employing “Multidimensional Fatigue Symptom Inventory – Short Form (MFSI-SF),” which is a well validated fatigue questionnaire. Material and Methods: A total of 93 aircrew and 30 ground crew of either sex from three military air bases were randomly selected for this cross-sectional observational study. The selected participants were requested to respond to 30 items listed in the survey form based on various types of symptoms along with severity that they experienced in the preceding 1 week. Results: The total fatigue score in case of the studied ground crew was higher than the studied aircrew group and this was statistically significant (P = 0.00001). The fighter, transport, and helicopter groups were not different from each other as far as their total fatigue score is concerned. However, ground crew group had significantly higher score in comparison to the score of the fighter, transport, and helicopter groups. In this study, 43.33% of ground crew participants and 11.82% of aircrew participants were observed to have fatigue. On stream-wise analysis, 2.94% of transport aircrew, 14.28% of fighter aircrew, 20.83% of helicopter aircrew, 52.17% Air Traffic Control (ATC) ground crew, and 14.28% of other ground crew who had participated in this study were fatigued. Conclusion: Fatigue in either form, i.e., acute or chronic, could affect both aircrew and ground crew. The present study had revealed that the proportion of ground crew suffering from chronic fatigue was more than the aircrew. The aircrew who were found to have such type of fatigue were younger in age and experience in comparison to their counterpart ground crew. Among the ground crew, a large percentage of ATC crew had this form of fatigue.

Understanding the effect of fatigue on the association between sleep disturbances and cognitive function ability among cognitively impaired older adults

AbstractBackgroundFatigue is associated with neuroinflammation of the brain, one of the signatures of neurodegenerative disorders across preclinical and clinical stages. Substantial research evidence demonstrates a bidirectional link between Alzheimer’s neuropathology and poor sleep. Whether neuroinflammation mediates the association between sleep disturbances and cognitive decline remains to be determined. In this pilot study, we examined whether fatigue impacts the relationship between sleep quality and cognitive function ability.MethodWe prospectively recruited adults aged 55‐90 years with mild cognitive impairment to evaluate their symptoms of Fatigue, Sleep, and Cognitive Function Abilities (CFA), using the NIH PROMIS Fatigue short form (v1.0), Sleep Disturbances (SD, v2.0) and Sleep‐related Impairment short form (SRI v2.0), as well as the NIH Neuro‐QOL Cognitive Function Abilities short form (v1.0). The Poor‐sleep group was defined as a T‐score of &gt;50 on either SD or SRI scale. Depression was defined as a Geriatric Depression Scale score of 5 or greater and was a study exclusion criterion.ResultTwenty‐seven patients enrolled in the study, including 14 women and 13 men. The mean age was 67.37+/‐ 9.00 years. The Poor‐sleep group had significantly lower CFA compared to the Good‐sleep group (b=‐6.28, p=0.019). Greater Fatigue scores were significantly associated with lower Cognitive Function Abilities scores (r=.49, p=0.010). These results remained significant after controlling for age. Further, total scale SRI score was significantly associated with total scale Fatigue score (r=.72, p&lt;0.001).ConclusionBoth fatigue and sleep disturbances were significantly associated with low CFA independently, along with a significant correlation between fatigue and poor sleep. The mechanisms by which fatigue and sleep disturbances contribute to cognitive test performance need to be elucidated in future research.

Correlation between compassion fatigue and workplace violence in emergency department nurses

Objective: To investigate the workplace violence and compassion fatigue of nurses in emergency department and to explore the relationship between the two. Methods: The general information questionnaire, workplace violence scale and professional quality of life scale were used to investigate 957 emergency department nurses of 28 Level II hospitals and above. Results: The scores of each dimension of the professional quality of life scale for nurses in the emergency department were: compassion satisfaction score was 29.91±7.82, the burnout score was 26.63±5.66, and the second trauma score was 23.17±5.94. The total score of compassion fatigue is 49.80±10.42. The incidence of workplace violence was 77.6%. Workplace violence was negatively correlated with compassion satisfaction (r=-0.250, P<0.01) , and positively correlated with burnout, secondary trauma, and total compassion fatigue (r=0.349、0.340、0.384, P<0.01) . Whether there is only non-physical violence in the compassion satisfaction, burnout, secondary trauma, compassion fatigue total score is not statistically significant. Conclusion: Compassion fatigue is more serious in emergency department nurses, and the incidence of workplace violence is higher. Workplace violence has a positive effect on compassion fatigue. Nursing managers should actively prevent workplace violence and improve the working environment, thus reducing empathy fatigue.

Exploring the Economic Benefits of Modafinil for Post-Stroke Fatigue in Australia: A Cost-Effectiveness Evaluation

BackgroundIn stroke survivors, post-stroke fatigue predicts dependency in daily living and failure to return to work. Modafinil shows promise as a pharmacotherapy to reduce post-stroke fatigue and related sequelae, e.g., poorer functional and clinical outcomes. AimsThis study explored the cost-effectiveness of modafinil in treating post-stroke fatigue in the Australian context, by determining its incremental cost-effectiveness ratio (ICER) and by simulating the potential cost-savings on a national scale, through a re-analysis of MIDAS trial data. MethodsA post hoc cost-effectiveness analysis was undertaken. Part A: patient-level cost and health effect data (Multidimensional Fatigue Inventory (MFI) scores) were derived from the MIDAS trial and analysis undertaken from a health-system perspective. Part B: a secondary analysis simulated the societal impact of modafinil therapy in terms of national productivity costs. ResultsPart A: Mean cost of modafinil treatment was AUD$3.60/day/patient for a minimally clinically important change (10 points) in total MFI fatigue score, i.e., AUD$0.36/day/unit change in fatigue score per patient. For the base case scenario, the ICER of using modafinil (versus placebo) was AUD$131.73 ($90.17 – 248.15, for minimum and maximum costs, respectively). Part B: The potential productivity cost-savings to society were calculated as nearly AUD$467 million over 1 year, and up to $383,471,991,248 over 10 years, from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors, representing a significant societal benefit. ConclusionsModafinil is a highly cost-effective treatment for post-stroke fatigue, offering significant productivity gains and potential cost-savings to society from the widespread use of modafinil treatment in the Australian population of working-age stroke-survivors.

Regional microglial activation in the substantia nigra is linked with fatigue in MS.

ObjectiveThe goal of our study is to assess the role of microglial activation in MS-associated fatigue (MSAF) using [F-18]PBR06-PET.MethodsFatigue severity was measured using the Modified Fatigue Impact Scale (MFIS) in 12 subjects with MS (7 relapsing-remitting and 5 secondary progressive) and 10 healthy control participants who underwent [F-18]PBR06-PET. The MFIS provides a total fatigue score as well as physical, cognitive, and psychosocial fatigue subscale scores. Standardized Uptake Value (SUV) 60–90 minute frame PET maps were coregistered to 3T MRI. Voxel-by-voxel analysis using Statistical Parametric Mapping and atlas-based regional analyses were performed. SUV ratios (SUVRs) were global brain normalized.ResultsPeak voxel-based level of significance for correlation between total fatigue score and PET uptake was localized to the right substantia nigra (T-score 4.67, p = 0.001). Similarly, SUVRs derived from atlas-based segmentation of the substantia nigra showed significant correlation with MFIS (r = 0.76, p = 0.004). On multiple regression, the right substantia nigra was an independent predictor of total MFIS (p = 0.02) and cognitive MFIS subscale values (p = 0.007), after adjustment for age, disability, and depression. Several additional areas of significant correlations with fatigue scores were identified, including the right parahippocampal gyrus, right precuneus, and juxtacortical white matter (all p < 0.05). There was no correlation between fatigue scores and brain atrophy and lesion load in patients with MS.ConclusionSubstantia nigra microglial activation is linked to fatigue in MS. Microglial activation across key brain regions may represent a unifying mechanism for MSAF, and further evaluation of neuroimmunologic basis of MSAF is warranted.

A Lifestyle (Dietary) Intervention Reduces Tiredness in Children with Subclinical Hypothyroidism, a Randomized Controlled Trial

Purpose: Subclinical hypothyroidism (SH) in children and adults is a subject for discussion in terms of whether to treat it or not with respect to the short-term clinical implications and consequences of SH and in the long term. If treatment with thyroxine supplementation is not indicated, no other treatment is available. We investigated whether a lifestyle (dietary) intervention improves or normalizes SH or decreases the presence of Thyroid Stimulating Hormone (TSH) and/or tiredness. Methods: We randomized children aged 1–12 years with SH to the control group (standard care = no treatment) or intervention group (dietary intervention). The dietary intervention consisted of green vegetables, beef, whole milk and butter for 6 months. The rest of the diet remained unchanged. We measured TSH, FreeT4, Lipid profile, Body Mass Index (BMI) and Pediatric Quality of Life (PedQL) multidimensional fatigue scale scores. Results: In total, 62 children were included. After 6 months, TSH decreased in both groups without a significant difference between the groups (p = 0.98). PedQL fatigue scores for sleep (p = 0.032) and total fatigue scores (p = 0.039) improved significantly in the intervention group, compared to the control group. No unfavorable effects occurred in the lipid profile or BMI. Conclusion: The lifestyle (dietary) intervention did not normalize SH and TSH levels, but it significantly reduced tiredness. These results suggest that children’s well-being can be improved without medication.

Effectiveness of exercise on fatigue in hemodialysis patients: a randomized controlled trial

BackgroundHemodialysis is one of the common therapies in patients with end-stage renal disease. Even patients who receive regular treatment suffer from fatigue, which is one of the main factors leading to poor quality of life. This study aimed to determine the effectiveness of exercising on mini-bikes on fatigue in hemodialysis patients.MethodsThis study is a randomized controlled clinical trial. Thirty-seven hemodialysis patients participated in the study. The patients were randomly allocated to either the intervention group (n = 20) or the control group (n = 17). The participants in the intervention group exercised on mini-bikes for 20 min twice a week for 3 months. The patients’ fatigue was measured four times during and after the intervention. Multidimensional Fatigue Inventory was used to measure the fatigue level. The total score in the MFI is 4 to 20 for each domain, with the resulting total fatigue score ranging from 20 to 100; thus, the higher the score, the higher the level of fatigue. Data were analyzed by SPSS 18. The repeated measures ANOVA was used to compare the fatigue scores within each group and between the groups at different times.ResultsThe mean score of fatigue in the intervention group at the beginning was 58.80 ± 15.29, which steadily decreased to 58.78 ± 13.54, 58.75 ± 14.73, 54.20 ± 15.16, and 54.23 ± 13.60 for the 3 months of intervention and 1 month post-intervention, respectively. In contrast, in the control group, this score was 62.53 ± 16.32 in the beginning, increasing to 64.03 ± 13.91, 64.22 ± 13.07, 69.53 ± 9.22, for the 3 months of intervention and 70.34 ± 7.69 one-month post-intervention. There were significant differences between the intervention group and the control group in the third month (P = 0.001) and 1 month after the intervention (P < 0.001).ConclusionsThe results showed that rehabilitation through exercising using mini-bikes had a significant impact on preventing further fatigue build-up in hemodialysis patients, making the mini-bike an effective non-pharmaceutical intervention preventing the increase in fatigue experienced by patients undergoing hemodialysis.Trial registrationIranian Registry of Clinical Trials: IRCT20180314039100N1. Registered 10 June 2018.

The Effect of Progressive Relaxation Exercises on Pain, Fatigue, and Quality of Life in Dialysis Patients.

Patients receiving hemodialysis treatment may experience several symptoms at the same time, such as fatigue and pain. Progressive relaxation exercises (PRE) have been reported to have positive effect on the control of these symptoms. In this study, a randomized, controlled, and experimental study was conducted to examine the effect of PRE on pain, fatigue, and quality of life in hemodialysis patients; the study was carried out with 48 intervention and 48 control patients receiving treatment in the hemodialysis units of 2 hospitals. Data were collected by a questionnaire prepared by the researcher, which included questions about sociodemographic variables and the disease; Piper Fatigue Scale; Visual Analog Scale that measures pain severity; and SF-36 Quality of Life Scale. The results of study revealed that mean total fatigue score and mean pain score decreased in the intervention group after the application of PRE; whereas no change was observed in the control group (P < .05). It was also found that quality of life physical component mean score and mental component mean score increased in the intervention group after the application of PRE (P < .05).

Assessment of cancer-related fatigue among Jordanian patients: a cross-sectional survey.

Cancer-related fatigue (CRF) is considered to be one of the most common symptoms reported by cancer patients. However, little information is available regarding the variables associated with CRF among Jordanian patients. To assess the prevalence of CRF and explore its predictors among Jordanian patients. A cross-sectional survey design was used. Of the 240 patients surveyed, 210 (87.5%) had fatigue at the time of the survey. The total mean fatigue score was 6.2 (SD=1.7) out of a maximum possible score of 10. The results also showed that being unemployed, with longer hospitalisation, low haemoglobin, and having lung cancer seem to predict higher levels of CRF. Several variables and factors associated with CRF were identified. In response to these results, healthcare providers should pay more attention to CRF, which needs to be assessed on a regular basis and to be managed with the available pharmacological and non-pharmacological interventions.

Fatigue in cancer patients: comparison with the general population and prognostic factors

PurposeThe aims of this examination were to compare cancer patients’ fatigue burden with that of the general population, to identify clinical factors that are associated with fatigue, and to test psychometric properties of the fatigue questionnaire MFI-20 including the short-form MFI-10.MethodsA sample of 1818 German cancer patients was tested with the MFI-20.ResultsThe study confirmed that the cancer patients demonstrate a high level of burden from fatigue. The effect size for the comparison between the cancer patients and a sample of the general population (n = 1993) was d = 0.58 based on MFI-20 total scores. In the cancer patients’ sample, females reported slightly higher levels of fatigue than males did (p < 0.05). There was no significant effect of age on fatigue. Advanced tumor stage, the presence of metastases, and a “poorer” Eastern Cooperative Oncology Group (ECOG) performance status were significantly associated with fatigue. The results of the confirmatory factor analyses (CFAs) only partly confirmed the factorial structure of the MFI-20.ConclusionDespite the insufficient CFA indices, we believe that the scale structure of the MFI-20 should not be changed and that calculating a total fatigue score is justifiable. For those seeking a shorter questionnaire, the MFI-10, which only contains those 10 items which positively indicate fatigue, is a good alternative.

P219 Disease-specific avoidance is a predictor for fatigue in inflammatory bowel disease patients

Abstract Background A substantial group of patients with inflammatory bowel disease (IBD) experience fatigue, even while in clinical remission. At present, disease-specific behaviours that maintain or worsen symptom burden including fatigue have not been explored. We developed a questionnaire evaluating IBD-specific avoidance behaviour and investigated how this relates to self-reported fatigue. Methods This study was a close collaboration between the psychology and gastroenterology department of our tertiary referral centre. A 72-item IBD-specific avoidance behaviour questionnaire (IBD-B) was generated based on literature review and input from clinicians and a patient focus group (n = 10). Between July 2018 and March 2019, 500 consecutive IBD patients were included at our infusion unit (wave 1) (participation rate 79%, 48% male, 66% Crohn’s disease (CD), median age 40). Patients completed the 72-item IBD-B, a demographic questionnaire, patient-reported outcome assessing disease activity (PRO2) and a Visual Analogue Scale (VAS) for fatigue. Test–retest reliability was assessed in 89 patients (54% male, 70% CD, median age of 40) who completed the IBD-B, PRO2 and VAS fatigue scale a second time after 4–12 weeks (wave 2). Clinical remission was defined as an abdominal pain score ≤1 and a liquid to very soft stool frequency ≤1.5 in CD patients and as no rectal bleeding and a stool frequency ≤1 in patients with ulcerative colitis (UC). A principal component analysis (PCA) was then used to reduce the number of items and investigate the underlying factor structure of the IBD-B. The predictive value of IBD-specific behaviours for fatigue was finally investigated both cross-sectionally and prospectively. Results At wave 1, 46% and 69% of CD and UC patients, respectively, were in clinical remission. PCA suggested a reduction of the 72-item to a final 25-item IBD-B and a seven-factor solution for use in clinical practice (loading factors &amp;gt;0.5, Table 1). The final 25-item IBD-B showed good psychometric properties. The median (IQR) total IBD-B and fatigue scores were, respectively, 29 (40-20) and 52 (77-25) for patients in clinical remission compared with 38 (48-28) and 74 (87-50) for patients not in clinical remission (both p &amp;lt; 0.01). Both cross-sectional and prospective significant correlations between IBD-B factors and fatigue were demonstrated (Table 2). Conclusion The IBD-B is a valuable tool to accurately measure IBD-specific avoidance behaviour in IBD patients. IBD patients without clinical remission report higher IBD-B values and show a higher correlation between avoidance behaviour and fatigue. Further research should now focus on identifying predictors for fatigue in IBD patients in clinical remission.