Tag: Jason

A community-based study of chronic fatigue syndrome

Abstract:

BACKGROUND: Most previous estimates of the prevalence of chronic fatigue syndrome (CFS) have derived largely from treated populations, and have been biased by differential access to health care treatment linked with sex, ethnic identification, and socioeconomic status.

OBJECTIVE: To assess the point prevalence of CFS in an ethnically diverse random community sample.

DESIGN AND PARTICIPANTS: A sample of 28,673 adults in Chicago, Ill, was screened by telephone, and those with CFS-like symptoms were medically evaluated.

MAIN OUTCOME MEASURES AND ANALYSES: Self-report questionnaires, psychiatric evaluations, and complete medical examinations with laboratory testing were used to diagnose patients with CFS. Univariate and multivariate statistical techniques were used to delineate the overall rate of CFS in this population, and its relative prevalence was subcategorized by sex, ethnic identification, age, and socioeconomic status.

RESULTS: There was a 65.1% completion rate for the telephone interviews during the first phase of the study. Findings indicated that CFS occurs in about 0.42% (95% confidence interval, 0.29%-0.56%) of this random community-based sample. The highest levels of CFS were consistently found among women, minority groups, and persons with lower levels of education and occupational status.

CONCLUSIONS: Chronic fatigue syndrome is a common chronic health condition, especially for women, occurring across ethnic groups. Earlier findings suggesting that CFS is a syndrome primarily affecting white, middle-class patients were not supported by our findings.

 

Source: Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RR, McCready W, Huang CF, Plioplys S. A community-based study of chronic fatigue syndrome. Arch Intern Med. 1999 Oct 11;159(18):2129-37. http://www.ncbi.nlm.nih.gov/pubmed/10527290

 

Chronic fatigue syndrome: assessing symptoms and activity level

Abstract:

Current approaches to the diagnosis and assessment of Chronic Fatigue Syndrome (CFS) rely primarily on scales that measure only the occurrence of various symptoms related to CFS. Such approaches do not provide information on either the severity of symptoms or on fluctuations in symptom severity and activity level that occur over time. As a result, these measures do not reflect the complexities and the interrelations among symptoms. By obscuring the fluctuating nature of CFS and its high variability, current assessment procedures may prevent health care professionals from understanding the complexities of this disease. The present study provides two CFS case studies to illustrate the advantages of using self-reporting rating scales in combination with a device used to measure the frequency and intensity of activity. The implications of this assessment system, which captures the symptom dynamics and variability involved in CFS, are discussed.

 

Source: Jason LA, King CP, Frankenberry EL, Jordan KM, Tryon WW, Rademaker F, Huang CF. Chronic fatigue syndrome: assessing symptoms and activity level. J Clin Psychol. 1999 Apr;55(4):411-24. http://www.ncbi.nlm.nih.gov/pubmed/10348404

 

Managing chronic fatigue syndrome: overview and case study

Abstract:

1. The basic principles of envelope theory are explained. By not overexerting themselves, people with CFS can avoid the setbacks and relapses that commonly occur in response to overexertion while increasing their tolerance to activity. 2. By collecting time series data on fluctuations in energy levels, important clinical observations can be made in respect to a client’s unique condition and experience with CFS.

 

Source: Jason LA, Melrose H, Lerman A, Burroughs V, Lewis K, King CP, Frankenberry EL. AAOHN J. 1999 Jan;47(1):17-21. http://www.ncbi.nlm.nih.gov/pubmed/10205371

 

Chronic fatigue syndrome, chronic fatigue, and psychiatric disorders: predictors of functional status in a national nursing sample

Abstract:

Members of 2 nurses’ associations (N = 71) were assessed using 2 mail questionnaires, a telephone questionnaire, the Diagnostic Interview Schedule, and medical records. Physicians reviewed participants to determine whether they met current criteria for chronic fatigue syndrome(CFS). Stepwise multivariate regression analyses were conducted to identify predictors of functional status scores.

Impairments in physical, role, and social functioning increased as fatigue severity increased. Bodily pain increased as fatigue severity increased, and ratings of overall health increased as severity of fatigue decreased. Nurses with a current psychiatric diagnosis reported more impairments in emotional functioning than nurses with a lifetime diagnosis or no psychiatric diagnosis.

Quality of life decreased as fatigue severity increased. Nurses with fatigue not meeting CFS criteria reported better quality of life than those with CFS or medical exclusions.

 

Source: Wagner-Raphael LI, Jason LA, Ferrari JR. Chronic fatigue syndrome, chronic fatigue, and psychiatric disorders: predictors of functional status in a national nursing sample. J Occup Health Psychol. 1999 Jan;4(1):63-71. http://www.ncbi.nlm.nih.gov/pubmed/10100114

 

Estimating the prevalence of chronic fatigue syndrome among nurses

Abstract:

The present study assessed the prevalence of chronic fatigue syndrome (CFS) in a sample of nurses. There is a paucity of studies on the prevalence of CFS in healthcare professionals.

Two samples of nurses were recruited through mailed questionnaires. Data were collected on demographic characteristics and symptoms. In addition from the sample, those nurses with CFS-like symptoms were more comprehensively evaluated using a structured clinical interview and reviewing their medical records. A physician review team estimated the prevalence of CFS to be 1,088 per 100,000.

These findings suggest that nurses might represent a high-risk group for this illness, possibly due to occupational stressors such as exposure to viruses in the work setting, stressful shift work that is disruptive to biologic rhythms, or to other possible stressors in the work settings (e.g., accidents).

 

Source: Jason LA, Wagner L, Rosenthal S, Goodlatte J, Lipkin D, Papernik M, Plioplys S, Plioplys AV. Estimating the prevalence of chronic fatigue syndrome among nurses. Am J Med. 1998 Sep 28;105(3A):91S-93S. http://www.ncbi.nlm.nih.gov/pubmed/9790488

 

Chronic fatigue syndrome: relationships of self-ratings and actigraphy

Abstract:

Chronic Fatigue Syndrome is a baffling disease potentially affecting millions of Americans. Self-rating scales were developed to assess this condition but have yet to be validated with objective measures of activity. The present study of a 45-yr.-old man evaluated the relationships between scores on self-rating scales used to measure Chronic Fatigue Syndrome and actigraphy. Measured activity was related to predictors of fatigue but not to fatigue. The implications of these findings are discussed.

 

Source: Jason LA, Tryon WW, Frankenberry E, King C. Chronic fatigue syndrome: relationships of self-ratings and actigraphy. Psychol Rep. 1997 Dec;81(3 Pt 2):1223-6. http://www.ncbi.nlm.nih.gov/pubmed/9461755

 

Outcomes of occupational stressors on nurses: chronic fatigue syndrome–related symptoms

Abstract:

Considering the types and number of occupational stressors involved in caring for patients, nurses may represent a population at high risk for physical illnesses.

A sample of 3400 nurses who belong to a statewide or a national nurses organization were randomly chosen for participation. Of this group, 202 reported 6 months or more of debilitating fatigue and completed a three-page questionnaire assessing symptoms related to chronic fatigue syndrome (CFS) and comorbid medical conditions. This group (N = 202) was mailed a follow-up questionnaire 1 year later that reassessed symptoms of CFS and occupational stressors.

Many sampled nurses reported a high degree of occupationally related stress but did not report CFS symptoms; however, perceived exposure to the threat of an accident as a nurse and poor physical working conditions were significantly related to symptoms reported. These findings are consistent with previous research.

 

Source: Wagner LI, Jason LA. Outcomes of occupational stressors on nurses: chronic fatigue syndrome–related symptoms. Nursingconnections. 1997 Fall;10(3):41-9. http://www.ncbi.nlm.nih.gov/pubmed/9397874

 

Politics, science, and the emergence of a new disease. The case of chronic fatigue syndrome

Abstract:

Chronic fatigue syndrome (CFS) emerged as a diagnostic category during the last decade. Initial research suggested that CFS was a relatively rare disorder with a high level of psychiatric comorbidity. Many physicians minimized the seriousness of this disorder and also interpreted the syndrome as being equivalent to a psychiatric disorder. These attitudes had negative consequences for the treatment of CFS.

By the mid-1990s, findings from more representative epidemiological studies indicated considerably higher CFS prevalence rates. However, the use of the revised CFS case definition might have produced heterogeneous patient groups, possibly including some patients with pure psychiatric disorders.

Social scientists have the expertise to more precisely define this syndrome and to develop appropriate and sensitive research strategies for understanding this disease.

Comment in: The biopsychosocial model and chronic fatigue syndrome. [Am Psychol. 1998]

 

Source: Jason LA, Richman JA, Friedberg F, Wagner L, Taylor R, Jordan KM. Politics, science, and the emergence of a new disease. The case of chronic fatigue syndrome. Am Psychol. 1997 Sep;52(9):973-83. http://www.ncbi.nlm.nih.gov/pubmed/9301342

 

A national assessment of the service, support, and housing preferences by persons with chronic fatigue syndrome. Toward a comprehensive rehabilitation program

Abstract:

Persons with Chronic Fatigue Syndrome (PWCs) completed and returned by mail a brief survey of open- and closed-ended items designed to assess their utilization and preferences for a variety of services. A total of 984 middle-aged adults diagnosed with Chronic Fatique Syndrome (CFS) from across North America returned the survey. During the past 12 months, many of these PWCs reported utilization of a primary care physician, gynecologist, CFS specialist, and self-help group to assist in their recovery from CFS. Most PWCs believed it was important to educate both health-care practitioners and the general public about CFS. In terms of their desire for specific recovery needs, factor analysis of responses indicated that these PWCs preferred self-help/social support services and general advocacy services in the treatment of their illness. The implications of these results for developing rehabilitation programs for PWCs are discussed.

 

Source: Jason LA, Ferrari JR, Taylor RR, Slavich SP, Stenzel CL. A national assessment of the service, support, and housing preferences by persons with chronic fatigue syndrome. Toward a comprehensive rehabilitation program. Eval Health Prof. 1996 Jun;19(2):194-207. http://www.ncbi.nlm.nih.gov/pubmed/10186910

 

Estimating rates of chronic fatigue syndrome from a community-based sample: a pilot study

Abstract:

Most of the Chronic Fatigue Syndrome (CFS) epidemiological studies have relied on physicians who refer patients having at least six months of chronic fatigue and other symptoms. However, there are a number of potential problems when using this method to derive prevalence statistics.

For example, some individuals with CFS might not have the economic resources to access medical care. Other individuals with CFS might be reluctant to use medical personnel, particularly if they have encountered physicians skeptical of the authenticity of their illness. In addition, physicians that are skeptical of the existence of CFS might not identify cases.

In the present pilot study, a random community sample (N = 1,031) was interviewed by telephone in order to identify and comprehensively evaluate individuals with symptoms of CFS and those who self-report having CFS. Different definitions of CFS were employed, and higher rates (0.2%) of CFS were found than in previous studies. Methodological benefits in using more rigorous epidemiological methods when estimating CFS prevalence rates are discussed.

 

Source: Jason LA, Taylor R, Wagner L, Holden J, Ferrari JR, Plioplys AV, Plioplys S, Lipkin D, Papernik M. Estimating rates of chronic fatigue syndrome from a community-based sample: a pilot study. Am J Community Psychol. 1995 Aug;23(4):557-68. http://www.ncbi.nlm.nih.gov/pubmed/8546110