Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA.
Department of Physical Medicine and Rehabilitation, University of Michigan; VA Ann Arbor Health Care System GRECC, Ann Arbor, MI, USA.
Qual Life Res. 2019 May;28(5):1337-1347. doi: 10.1007/s11136-018-2093-z. Epub 2019 Jan 2.
Perceived fatigability, reflective of changes in fatigue intensity in the context of activity, has emerged as a potentially important clinical outcome and quality of life indicator. Unfortunately, the nature of perceived fatigability is not well characterized. The aim of this study is to define the characteristics of fatigability through the development of a conceptual model informed by input from key stakeholders who experience fatigability, including the general population, individuals with multiple sclerosis (MS), and individuals with fibromyalgia (FM).
Thirteen focus groups were conducted with 101 participants; five groups with n = 44 individuals representing the general population, four groups with n = 26 individuals with MS, and four groups with n = 31 individuals with FM. Focus group data were qualitatively analyzed to identify major themes in the participants' characterizations of perceived fatigability.
Seven major themes were identified: general fatigability, physical fatigability, mental fatigability, emotional fatigability, moderators of fatigability, proactive and reactive behaviors, and temporal aspects of fatigability. Relative to those in the general sample, FM or MS groups more often described experiencing fatigue as a result of cognitive activity, use of proactive behaviors to manage fatigability, and sensory stimulation as exacerbating fatigability.
Fatigability is the complex and dynamic process of the development of physical, mental, and/or emotional fatigue. Trait- and state-like biological, psychological, social, and environmental moderators contribute to tremendous variability in fatigability (both between and within-person variability). Future research to further characterize fatigability across populations, test treatments for fatigability, and develop new measures of this construct are greatly needed.
活动背景下感知疲劳度的变化反映了疲劳强度的变化，它已成为一个潜在的重要临床结果和生活质量指标。不幸的是，感知疲劳度的性质还没有很好地描述。本研究的目的是通过开发一个概念模型来定义疲劳度的特征，该模型是由经历疲劳度的主要利益相关者（包括普通人群、多发性硬化症（MS）患者和纤维肌痛（FM）患者）提供信息而制定的。
共进行了 13 次焦点小组讨论，参与者共 101 人；其中 5 个小组，每组 44 人，代表普通人群；4 个小组，每组 26 人，代表 MS 患者；4 个小组，每组 31 人，代表 FM 患者。对焦点小组数据进行定性分析，以确定参与者对感知疲劳度的描述中的主要主题。
确定了 7 个主要主题：一般疲劳度、身体疲劳度、精神疲劳度、情绪疲劳度、疲劳度的调节因素、主动和被动行为以及疲劳度的时间方面。与普通人群相比，FM 或 MS 组更常描述因认知活动而感到疲劳，使用主动行为来管理疲劳度，以及感官刺激会加剧疲劳度。
疲劳度是身体、心理和/或情绪疲劳发展的复杂和动态过程。特质和状态样的生物、心理、社会和环境调节因素导致疲劳度存在巨大的个体间和个体内差异。未来的研究需要进一步描述不同人群的疲劳度，测试疲劳度的治疗方法，并开发新的测量该构念的方法。
