Symptoms of fatigue in chronic heart failure patients: clinical and psychological predictors.

OBJECTIVE: To examine the role of clinical and psychological characteristics as predictors of fatigue in CHF. BACKGROUND: Little is known about predictors of fatigue in CHF. Next to heart failure characteristics, depressive symptoms and type-D personality may explain individual differences in fatigue. METHODS: At baseline, 136 CHF outpatients (age

Personality and fatigue in patients with benign or malignant breast disease.

GOALS OF WORK: The aim of the study was to examine the role of five general personality traits in fatigue in a group of patients with breast cancer (BC) and a group with benign breast problems (BBP). MATERIALS AND METHODS: Of the 304 participating women, 127 patients had BC and 177 BBP. A fatigue scale was completed before diagnosis and 1, 3, and 6 months after diagnosis (benign patients) or surgical treatment (BC patients). A personality questionnaire (NEO-FFI) and a depression scale (CES-D) were completed before diagnosis. MAIN RESULTS: The BC group was less tired before diagnosis, more tired 1 month after diagnosis, and equally tired 3 and 6 months after diagnosis. In the total group, women were more tired over time when they were more neurotic, less agreeable, or more introverted. After controlling for depressive symptoms, demographics, and medical factors, baseline depressive symptoms (beta = 0.29, p < 0.05), neuroticism (beta = 0.29, p < 0.05), and extraversion (beta = -0.25, p < 0.05) predicted fatigue 6 months later. After also including baseline fatigue, only neuroticism (beta = 0.22, p < 0.05) and baseline fatigue (beta = 0.79, p < 0.001) predicted fatigue. CONCLUSIONS: Personality is more strongly related to fatigue than demographics, the diagnosis cancer, receiving cancer treatment, and baseline depressive symptoms and fatigue. When replicated, screening and treating women who are at risk to experience high levels of fatigue is recommended.

Relationship between symptoms and quality of life in a sarcoidosis population.

BACKGROUND: As sarcoidosis is a multisytemic disorder, patients may suffer from various symptoms. The relationship between frequently reported symptoms and quality of life (QOL) has not yet been studied. OBJECTIVES: The aim of the present cross-sectional study was to examine the predictive value of the most frequently reported subjective symptoms on QOL after controlling for demographic variables and clinical parameters. METHODS: A cross-sectional study was conducted at an outpatient pulmonary clinic in Zagreb, Croatia. One hundred and fifty outpatients with sarcoidosis were seen between January 2002 and May 2004. Symptoms were assessed with a symptom inventory questionnaire, and QOL was measured using the World Health Organization Quality of Life Assessment Instrument. Clinical parameters were derived from the patients' medical files. Regression analyses were performed to examine the predictive value of symptoms on QOL. RESULTS: The four most frequently mentioned symptoms were fatigue, breathlessness, reduced exercise capacity and arthralgia. In various combinations, being female, using corticosteroids and fatigue predicted the QOL domains physical and psychological health as well as level of independence. CONCLUSIONS: Fatigue appeared to be the most important symptom in predicting various QOL domains after controlling for demographics, disease stage and clinical parameters. Therefore, considering improvement in the patients' QOL, it is recommended to focus not only on objective health parameters, but also on fatigue in the management of sarcoidosis.

Predictors of quality of life: a model based study.

In this study, predictors of quality of life (QOL) in psychiatric outpatients (n = 410) were investigated using the psychological stress model developed by Taylor and Aspinwall (Psychosocial Stress. Perspective on Structures, Theory, Life-Course and Methods. San Diego, CA: Academic Press, 1996; pp. 71-110). External resources, personal resources, stressors, appraisal of stressors, social support, coping, and QOL were assessed with several questionnaires. The complete original Taylor and Aspinwall model was tested with SEM analyses. These analyses were not able to explain the data adequately. Therefore, initially a more exploratory data analytic strategy was followed using a series of multiple regression analyses. These analyses only partially supported the Taylor and Aspinwall model. In fact, QOL was not predicted by coping, while all other antecedents affected QOL directly, explaining considerable amounts of QOL variance. As a next step, taking the outcomes of the regression analyses as point of departure, new SEM analyses were carried out, testing a modified model. This model, without coping, had an excellent fit. Consequently, modifications of the model are recommended concerning psychiatric outpatients when QOL is the psychosocial outcome measure.

Fatigue is associated with quality of life in sarcoidosis patients.

BACKGROUND: Fatigue is one of the core symptoms of sarcoidosis patients. Although it is known that fatigue affects quality of life (QOL) in other patient groups, this relationship has never been studied in sarcoidosis patients using a reliable and valid fatigue scale and a multidimensional QOL instrument. The present cross-sectional study among sarcoidosis patients attempts to gain more insight into this relationship. METHODS: One hundred forty-five sarcoidosis patients of an outpatient pulmonary clinic in Zagreb, Croatia, completed the Fatigue Assessment Scale (FAS) and QOL scale (World Health Organization Quality of Life Assessment Instrument-100) between January 2002 and May 2004. Clinical parameters were derived from the patients' medical files. RESULTS: Tired patients reported a worse QOL in all domains and fatigue negatively predicted all QOL domains by means of multivariate regression analyses (beta values ranging from - 0.31 to - 0.64, all p < 0.001). Corticosteroid use was not a predictor of QOL. Diffusion capacity of the lung for carbon monoxide was the only clinical parameter associated with a QOL domain, namely level of independence. CONCLUSIONS: Fatigue was related to all QOL domains. Furthermore, standard clinical parameters were not associated with fatigue or QOL, except for level of independence. If these results were to be replicated in a prospective study, fatigue as measured by the FAS could be a good indicator of QOL in sarcoidosis patients.

Psychometric qualities of the Fatigue Assessment Scale in Croatian sarcoidosis patients.

BACKGROUND AND AIM: Fatigue is an unspecific symptom, but a major problem in sarcoidosis patients. There is a need for a reliable and valid way to measure fatigue. The Fatigue Assessment Scale (FAS) has good psychometric properties in healthy and sarcoidosis samples in the Netherlands, but nothing is known about the psychometric qualities of the FAS in sarcoidosis samples from other countries. Therefore, we examined the reliability, construct, and content validity in Croatian sarcoidosis patients. METHODS: Croatian sarcoidosis patients from a pulmonary outpatient clinic completed the FAS and a symptom inventory questionnaire. RESULTS: The internal consistency of the FAS was 0.91. Using exploratory factor analysis and Mokken scale analysis, the scale was unidimensional. A dichotomous fatigue item distinguished between individuals who scored high or low on the FAS. Concerning discriminant validity, individuals reporting health complaints were more tired. The FAS correlated moderately with a number of neurological and psychological problems. Females and lower educated individuals reported more fatigue. CONCLUSIONS: The Croatian translation of the FAS has good reliability and validity in a sarcoidosis sample. Future research is needed to explore the psychometric qualities (i) of the Croatian FAS in healthy individuals and (ii) of the FAS in other languages.

Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale.

OBJECTIVE: The main aim of this study was to examine the dimensionality and psychometric qualities of a new 10-item fatigue measure, the Fatigue Assessment Scale (FAS). METHODS: As part of a longitudinal study, the respondents, all workers with at least 20 working hours per week, completed the FAS, four related fatigue measures, a depression questionnaire, and an emotional stability scale. RESULTS: The FAS had a high internal consistency. The pattern of correlations and factor analysis showed good convergent and divergent validity. The FAS correlated strongly with the other fatigue scales. In a factor analysis of the five fatigue questionnaires, the FAS had the highest factor loading on a clear one-factor solution. Moreover, factor analyses revealed that fatigue, on the one hand, and depression and emotional stability, on the other hand, are separate constructs. Finally, it was shown that 8 out of the 10 FAS items were unbiased concerning gender; two had a uniform bias. CONCLUSIONS: The FAS represents a potentially valuable assessment instrument with promising internal consistency reliability and validity. Gender bias in the FAS does not have consequences for use of the FAS.