quality of life – Page 9 – American ME and CFS Society

Managing patients suffering from acute and chronic fatigue

Abstract:

The subjective experience of fatigue is common and debilitating, and affects many individuals in various healthcare settings. The condition requires adequate assessment, innovative planning and interventions, and patient-centred evaluations by the nursing profession. Fatigue, whether acute or chronic, needs to be recognized as a true and valid condition in order for treatment to be successful. There are many considerations to be taken into account when working with the fatigued, and this article suggests how the areas needing most attention may be tackled. Chronic fatigue and acute fatigue can be quite different conditions, requiring different approaches, of which nurses need to be aware. In order to reduce the effects of fatigue on the client, nurses need to fully understand the factors surrounding the phenomenon of fatigue to provide expert care, to help educate the patient, and improve the quality of life.

Source: Cook NF, Boore JR. Managing patients suffering from acute and chronic fatigue. Br J Nurs. 1997 Jul 24-Aug 13;6(14):811-5. http://www.ncbi.nlm.nih.gov/pubmed/9283306

The quality of life of persons with chronic fatigue syndrome

Abstract:

This descriptive study used a between-methods triangulation design to analyze the multiple dimensions of quality of life in persons with chronic fatigue syndrome (CFS). This method, which refers to the combination of both quantitative and qualitative methods in the same study, allowed the authors to obtain more comprehensive and robust data than could be obtained by either method alone.

A convenience sample of 110 persons with CFS completed the quality of life index and CFS questionnaire, and a subset of 22 persons were interviewed regarding their lived experience with CFS.

Overall scores on the quality of life index were significantly lower in CFS than for other chronic illness groups. Subjects reported the lowest quality of life scores in health and functioning domain. In depth interviews provided a more complete understanding of the quality of life in CFS and further explained the low ratings that were found on the quality of life index. The findings suggest that quality of life is particularly and uniquely disrupted in CFS.

Source: Anderson JS, Ferrans CE. The quality of life of persons with chronic fatigue syndrome. J Nerv Ment Dis. 1997 Jun;185(6):359-67. http://www.ncbi.nlm.nih.gov/pubmed/9205421

Hypochondriasis influences quality-of-life outcomes in patients with chronic fatigue

Abstract:

BACKGROUND: To determine how hypochondriacal symptoms influence the quality-of-life outcomes of patients with a chief complaint of chronic fatigue.

METHODS: Cross-sectional cohort study of a consecutive sample of 71 patients (mean duration of fatigue of 4.1 years). Forty-eight (68%) patients met criteria for current major depression and 32 (45%) met criteria for chronic fatigue syndrome (CFS). All patients received a comprehensive medical and psychiatric evaluation. Quality-of-life and physical, depressive and hypochondriacal symptom scores were assessed through reliable self-report questionnaires and a structured interview. A path model expressing the relation between predictor variables (hypochondriasis and depression), intervening variables (physical symptoms) and quality of life was postulated and evaluated using structural equation methods.

RESULTS: The paths linking hypochondriasis with physical symptoms and mental health and the path connecting physical symptoms and quality of life were each statistically significant. The model applied especially well to patients who fulfilled CFS criteria.

CONCLUSIONS: The quality of life of chronic fatigue patients correlates with the severity of their physical symptoms and their hypochondriacal disposition toward illness.

Source: Manu P, Affleck G, Tennen H, Morse PA, Escobar JI. Hypochondriasis influences quality-of-life outcomes in patients with chronic fatigue. Psychother Psychosom. 1996 Mar-Apr;65(2):76-81. http://www.ncbi.nlm.nih.gov/pubmed/8711085

alpha-Interferon treatment of patients with chronic fatigue syndrome

Abstract:

Thirty patients who fulfilled clinical criteria defined by the CDC for Chronic Fatigue Syndrome were treated with alfa 2a interferon or placebo in a double-blind crossover study. Outcome was evaluated by Natural Killer (NK) cell function, lymphocyte proliferation to mitogens and soluble antigens, CD4/CD8 counts and a 10 item Quality of Life (QOL) survey.

Although mean NK function rose from 87.8 +/- 19.6 to 129.3 +/- 20.7 lytic untis (LU; p < .05) with 12 weeks of interferon therapy, there was no significant change in the other immunologic parameters or QOL scores. When the 26 patients who completed the study were stratified according to their baseline NK function and lymphocyte proliferation, 4 groups were identified: 3 patients had normal NK cell function and lymphocyte proliferation when compared to normal, healthy controls, 9 had isolated deficiency in lymphocyte proliferation, 7 had diminished NK function only, and 7 had abnormalities for both parameters.

QOL scores were not significantly different for the four groups at baseline. After 12 weeks of interferon therapy, QOL score significantly improved in each of the seven patients with isolated NK cell dysfunction (mean score, 16.3 +/- 7.9) compared to baseline (39.7 +/- 12.1; p < .05). In these patients the mean NK function increased from 35.1 +/- 11.7 to 91.5 +/- 22.7 LU (p < .01). Significant improvement was not recorded for QOL in the other three groups. Thus, therapy with alpha interferon has a significant effect on the QOL of that subgroup of patients with CFS manifesting an isolated decrease in NK function.

Source: See DM, Tilles JG. alpha-Interferon treatment of patients with chronic fatigue syndrome. Immunol Invest. 1996 Jan-Mar;25(1-2):153-64. http://www.ncbi.nlm.nih.gov/pubmed/8675231