The fatigue perception and its role in patient management

Yıl 2018, Cilt: 45 Sayı: 1, 77 - 84, 17.03.2018

Ceyhun Yurtsever , Turan Set Elif Ateş

https://doi.org/10.5798/dicletip.407248

Cited By: 1

Öz

Objective:
Fatigue is one of the most common complaints in primary care. Patients' fatigue
perceptions may be very different from each other. We aimed to determine the
fatigue perception and its relationship with fatigue severity, sociodemographic
characteristics, history, physical examination and laboratory findings in
patients with complaints of fatigue.

Methods:
This study was carried out as a cross-sectional study in a tertiary family
medicine clinic between June 2016 and June 2017. All patients aged 18 years and
over who were complaining of fatigue for at least 1 month were invited to
study. Fatigue perceptions of volunteers who agreed to participate in the study
(n = 116) were evaluated with a structured form prepared by researchers.
Fatigue severity was measured using Fatigue Severity Scale and Checklist
Individual Strength surveys. Patients’ records including history, physical
examination and laboratory results were included in the study.

Results:
The mean age of participants was 29.5 ± 9.8 years and 87.9% were female. We
asked patients “what do they mean by fatigue?” and “what fatigue complaints
contain?”. Tiredness, lack of energy and sleeplessness - somnolence - desire to
sleep were the most common answers. Expression that had the highest score from
the fatigue severity scales was the needle hurt sensation for all body. In
patients’ records, the most common findings in patients with fatigue were
vitamin D deficiency (84.5%), sleeping problem (72.8%) and depression (69%).
When the relationship between fatigue perceptions and possible etiologic
factors was examined, it was observed that most of them were related with the
depression risk. As a result, it was observed that seven different findings
affected nineteen different fatigue perceptions.

Conclusion:
In this study, fatigue perception has been shown to be as important as other
features. The physicians should investigate its content and try to understand
the patient.

Anahtar Kelimeler

Depression, fatigue, perception, primary care

Kaynakça

• 1. Kenter EG, Okkes IM, Oskam SK, Lamberts H. Tiredness in Dutch family practice. Data on patients complaining of and/or diagnosed with "tiredness". Fam Pract. 2003;20:434-40.
• 2. Andrea H, Kant IJ, Beurskens AJHM, Metsemakers JFM, van Schayck CP. Associations between fatigue attributions and fatigue, health, and psychosocial work characteristics: a study among employees visiting a physician with fatigue. Occup Environ Med. 2003;60:99-104.
• 3. Sharpe M, Wilks D. Fatigue. BMJ. 2002;325:480-3.
• 4. Cullen W, Kearney Y, Bury G. Prevalence of fatigue in general practice. Ir J Med Sci. 2002;171:10-2.
• 5. Kenter EG, Okkes IM. [Patients with fatigue in family practice: prevalence and treatment]. Ned Tijdschr Geneeskd. 1999;143:796-801.
• 6. Mengel M, Schwiebert P. Family Medicine: Ambulatory Care and Prevention. McGraw-Hill; 2013;168-73 p.
• 7. Bates DW, Schmitt W, Buchwald D, Ware NC, Lee J, Thoyer E, et al. Prevalence of fatigue and chronic fatigue syndrome in a primary care practice. Arch Intern Med. 1993;153:2759-65.
• 8. Fosnocht KM, Ende J. Approach to the adult patient with fatigue 2017 [updated 13.06.2016. Available from: https://www.uptodate.com/contents/approach-to-the-adult-patient-with-fatigue?source=search_result&search=fatigue&selectedTitle=1~150.
• 9. Holley AB. The Evaluation and Management of Fatigue 2015 [updated 14.10.2015. Available from: http://www.medscape.com/viewarticle/852370.
• 10. Gregory P, Edsell M. Fatigue and the Anaesthetist. Continuing Education in Anaesthesia, Critical Care & Pain. 2014;14(1):18-22.
• 11. Ricci JA, Chee E, Lorandeau AL, Berger J. Fatigue in the U.S. workforce: prevalence and implications for lost productive work time. J Occup Environ Med. 2007;49:1-10.
• 12. Murtagh J. Fatigue--a general diagnostic approach. Aust Fam Physician. 2003;32:873-6.
• 13. Janssen N, Kant IJ, Swaen GMH, Janssen PPM, Schroer CAP. Fatigue as a predictor of sickness absence: results from the Maastricht cohort study on fatigue at work. Occup Environ Med. 2003;60:71-6.
• 14. Nelson E, Kirk J, McHugo G, Douglass R, Ohler J, Wasson J, et al. Chief complaint fatigue: a longitudinal study from the patient's perspective. Fam Pract Res J. 1987;6:175-88.
• 15. Deale A, Wessely S. Patients' perceptions of medical care in chronic fatigue syndrome. Soc Sci Med. 2001;52:1859-64.
• 16. Krupp LB, Larocca NG, Muirnash J, Steinberg AD. The Fatigue Severity Scale - Application to Patients with Multiple-Sclerosis and Systemic Lupus-Erythematosus. Arch Neurol-Chicago. 1989;46:1121-3.
• 17. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res. 2007;30:81-5.
• 18. Gencay-Can A, Can SS. Validation of the Turkish version of the fatigue severity scale in patients with fibromyalgia. Rheumatol Int. 2012;32:27-31.
• 19. Ozturk EA, Gonenli Kocer B, Gundogdu I, Umay E, Cakci FA. Reliability and validity study of a Turkish version of the fatigue severity scale in Parkinson's disease patients. Int J Rehabil Res. 2017;40:185-90.
• 20. Vercoulen JHMM, Swanink CMA, Fennis JFM, Galama JMD, Vandermeer JWM, Bleijenberg G. Dimensional Assessment of Chronic Fatigue Syndrome. Journal of Psychosomatic Research. 1994;38:383-92.
• 21. Ergin G, Yildirim Y. A validity and reliability study of the Turkish Checklist Individual Strength (CIS) questionnaire in musculoskeletal physical therapy patients. Physiotherapy theory and practice. 2012;28:624-32.
• 22. Chaudhuri A, Behan PO. Fatigue in neurological disorders. Lancet. 2004;363:978-88.
• 23. Ream E, Richardson A. Fatigue in patients with cancer and chronic obstructive airways disease: a phenomenological enquiry. International journal of nursing studies. 1997;34:44-53.
• 24. Ream E, Richardson A. Fatigue: a concept analysis. International journal of nursing studies. 1996;33:519-29.
• 25. Kenter E, Okkes I, Oskam S, Lamberts H. Once tired, always tired? Limitations in function over time of tired patients in Dutch general practice. The European journal of general practice. 2007;13:67-74.
• 26. Nijrolder I, van der Windt D, van der Horst H. Prediction of outcome in patients presenting with fatigue in primary care. Br J Gen Pract. 2009;5:e101-9.
• 27. Lavidor M, Weller A, Babkoff H. How sleep is related to fatigue. British Journal of Health Psychology. 2003;8:95-105.
• 28. Hirshkowitz M. Fatigue, Sleepiness, and Safety: Definitions, Assessment, Methodology. Sleep Medicine Clinics. 2013;8:183-9.
• 29. Wong WS, Fielding R. Prevalence of chronic fatigue among Chinese adults in Hong Kong: A population-based study. J Affect Disorders. 2010;127:248-56.
• 30. Walker EA, Katon WJ, Jemelka RP. Psychiatric disorders and medical care utilization among people in the general population who report fatigue. J Gen Intern Med. 1993;8:436-40.
• 31. Cathebras PJ, Robbins JM, Kirmayer LJ, Hayton BC. Fatigue in primary care: prevalence, psychiatric comorbidity, illness behavior, and outcome. J Gen Intern Med. 1992;7:276-86.
• 32. Daniels L, Oerlemans S, Krol A, Creutzberg C, Van de Poll-Franse L. Chronic fatigue in Hodgkin lymphoma survivors and associations with anxiety, depression and comorbidity. Brit J Cancer. 2014;110:868.
• 33. Lim WJ, Hong S, Nelesen R, Dimsdale JE. The association fo obesity, cytokine levels, and depressive symptoms with diverse measures of fatigue in healthy subjects. Archives of Internal Medicine. 2005;165:910-5.
• 34. Stadje R, Dornieden K, Baum E, Becker A, Biroga T, Bosner S, et al. The differential diagnosis of tiredness: a systematic review. BMC Fam Pract. 2016;17:147.
• 35. Nijrolder I, van der Windt D, de Vries H, van der Horst H. Diagnoses during follow-up of patients presenting with fatigue in primary care. Can Med Assoc J. 2009;181:683-7.
• 36. Bultmann U, Kant I, Kasl SV, Beurskens AJ, van den Brandt PA. Fatigue and psychological distress in the working population: psychometrics, prevalence, and correlates. J Psychosom Res. 2002;52:445-52.
• 37. Manu P, Lane TJ, Matthews DA. Chronic fatigue and chronic fatigue syndrome: clinical epidemiology and aetiological classification. Ciba Found Symp. 1993;173:23-31; discussion -42.
• 38. Gerber PD, Barrett JE, Barrett JA, Oxman TE, Manheimer E, Smith R, et al. The relationship of presenting physical complaints to depressive symptoms in primary care patients. J Gen Intern Med. 1992;7:170-3.
• 39. Manu P, Matthews DA, Lane TJ. The mental health of patients with a chief complaint of chronic fatigue. A prospective evaluation and follow-up. Arch Intern Med. 1988;148:2213-7.
• 40. Roy S, Sherman A, Monari-Sparks MJ, Schweiker O, Hunter K. Correction of Low Vitamin D Improves Fatigue: Effect of Correction of Low Vitamin D in Fatigue Study (EViDiF Study). N Am J Med Sci. 2014;6:396-402.
• 41. Nowak A, Boesch L, Andres E, Battegay E, Hornemann T, Schmid C, et al. Effect of vitamin D3 on self-perceived fatigue: A double-blind randomized placebo-controlled trial. Medicine (Baltimore). 2016;95:e5353.
• 42. Euba R, Chalder T, Deale A, Wessely S. A comparison of the characteristics of chronic fatigue syndrome in primary and tertiary care. The British Journal of Psychiatry. 1996;168:121-6.