Institute of Cellular Medicine, Newcastle University, Newcastle, NE2 4HH, UK.
QJM. 2009 Sep;102(9):617-24. doi: 10.1093/qjmed/hcp091. Epub 2009 Jul 24.
Studies have established that levels of fatigue vary between different patient groups. It is less clear whether the nature, as opposed to severity of fatigue differs between groups.
To examine descriptions of fatigue by patients with a range of chronic diseases and determine the relationship between symptom domains.
Retrospective review of Fatigue Impact Scale (FIS) data.
Fatigue Research Group.
Six hundred subjects in five chronic disease groups and one (n = 45) normal control group.
Statistical analysis was performed to assess the effect of increasing fatigue and the overlap of FIS domain scores between disease groups by calculation of geometric means as proportions summed to 1 in each FIS domains, whilst controlling for total score.
Those with lower scores exhibit relatively higher physical scores than patients with higher total scores. In contrast, as total score increases, so does the proportion accounted for by the cognitive and psychosocial scores. This was not related to a threshold effect as the maximum total score of 40 in the physical domain was only achieved in three patients (<1%). Average domain proportions between patient groups did not vary to any degree among physical (0.30-0.39), cognitive (0.15-0.23) and psychosocial (0.42-0.47) domain proportions of the patient groups.
Perceived fatigue is similar between patient groups. Increasing scores were not related to simply reaching the maximum threshold in the physical domain. Studies have confirmed a positive-structured approach to symptom management in one fatigue-associated chronic disease, primary biliary cirrhosis, leads to significant improvements in quality of life. We suggest that, with a similar approach, the same might be true in other chronic diseases where moderate fatigue is a significant problem.
研究已经证实，不同患者群体的疲劳水平存在差异。但疲劳的性质（而非严重程度）在不同群体之间是否存在差异尚不清楚。
通过对患有多种慢性疾病的患者进行疲劳描述的检查，确定症状域之间的关系。
疲劳影响量表（FIS）数据的回顾性分析。
疲劳研究组。
五个慢性疾病组中的 600 名受试者和一个（n = 45）正常对照组。
通过计算 FIS 各域得分的几何平均值（每个 FIS 域的得分相加为 1 的比例），同时控制总得分，评估疲劳程度增加的影响以及疾病组之间 FIS 域得分的重叠。
得分较低的患者表现出相对较高的身体得分，而总得分较高的患者则相反。相反，随着总得分的增加，认知和心理社会得分的比例也随之增加。这与阈值效应无关，因为身体域的最高总分为 40 分，仅在 3 名患者（<1%）中达到。患者组之间的平均域比例在身体域（0.30-0.39）、认知域（0.15-0.23）和心理社会域（0.42-0.47）的比例方面没有差异。
患者组之间的感知疲劳相似。分数的增加与身体域达到最高阈值无关。研究已经证实，在原发性胆汁性肝硬化等与疲劳相关的慢性疾病中，采用积极的结构化方法进行症状管理，可显著提高生活质量。我们建议，对于其他慢性疾病，中度疲劳是一个重大问题，采用类似的方法可能也是如此。
