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16.09.2014

Over fatigue meaning, can tinnitus affect hearing - Try Out

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Compassion Fatigue:Also called “vicarious traumatization” or secondary traumatization (Figley, 1995).
Clear difference: Compassion fatigue has a more rapid onset while burnout emerges over time.
Think of events or situation that causes one to experience an unusually strong reaction and often overpowers one’s usual coping mechanisms. When you identify the things that fuel you, the things that you have true passion for, your fatigue will disappear.
Fatigue is a frequent and distressing problem for many patients across all musculoskeletal conditions.
Four qualitative studies have specifically explored fatigue in RA and fibromyalgia syndrome (FMS), while qualitative studies in other musculoskeletal conditions, although not focused on fatigue, suggest similar experiences.
For people with musculoskeletal conditions who are experiencing fatigue, it occurs on most days and varies in intensity and frequency, ranging from heaviness through weariness and on to exhaustion. The consequences of fatigue affect every part of musculoskeletal patients’ lives, with far-reaching effects on physical function, everyday tasks, work and leisure activities. Self-management of fatigue occurs through behavioural means (resting, pacing, planning, using appliances), cognitive means (distraction, prioritising, re-normalising life) and social means (seeking emotional and practical support).
Normal tiredness is clearly differentiated from the features of fatigue related to an LTC by people in these studies. While there are good qualitative studies exploring fatigue in RA and FMS, there are few in other musculoskeletal conditions. Mood disorders are common among people with musculoskeletal conditions33 and they have a complex association with fatigue. Two longitudinal studies have explicitly tested Leventhal’s Common-Sense Model (CSM) of beliefs about illness applied to fatigue among people with RA. There are several variables that are not covered in this review because only cross-sectional evidence exists for their link to fatigue in musculoskeletal conditions (e.g.
In the absence of good physical, behavioural or biological markers of fatigue, accurate assessment hinges on valid self-report measures. Given that fatigue is present in many LTCs, generic scales might capture musculoskeletal fatigue and facilitate comparison across conditions.
The smallest change in fatigue that someone with SLE or RA might notice (minimal clinically important difference – MCID) has been explored. Measures with valid subscales are needed to explore different facets of fatigue, as these might be separately changed by different interventions (e.g. A systematic review of psychological interventions in RA up to 2001 analysed 25 RCTs but none addressed fatigue. In summary, evidence for non-pharmacological interventions is constrained by the small number of RCTs (some of which have small sample sizes or are not of high quality), the use of unvalidated scales (often VAS), and the fact that they are often not primarily aimed at or powered for fatigue.
Future research needs to address whether, rather than changing the severity of fatigue per se, we might be able to change beliefs about coping with fatigue, or change ability to participate in socialising despite continuing fatigue, and thus reduce the impact of persistent fatigue. Mood changes and illness perceptions have the most observational evidence of an association with fatigue in musculoskeletal conditions.


The current interest in fatigue in musculoskeletal conditions is a testament to the voice of the patient perspective in outcome measurement. In total 76 RA patients were interviewed about fatigue, from the UK, USA and the Netherlands, and 25 women with FMS from Sweden, covering a range of demographic and disease variables.2-5 These four studies yielded similar concepts and thus provide strong collective evidence on the nature, consequences and management of and attitudes towards musculoskeletal fatigue. Fatigue threatens traditional roles as patients struggle to maintain childcare, housework, social engagements and close relationships.
Despite these attempts, musculoskeletal patients view their fatigue as unmanageable and unresolving. Qualitative exploration of the physical and cognitive features of fatigue using mixed groups of people with various musculoskeletal conditions and LTCs might reveal different features that could indicate different fatigue mechanisms. Summary of observational studies providing evidence for significant predictors of fatigue among people with musculoskeletal condition. Women with RA may report higher fatigue than men with RA but this has only been supported by two of the many cross-sectional studies23,24 and no sex differences in the longitudinal course of fatigue have been found. The Fibromyalgia Impact Questionnaire (FIQ)52 comprises 8 subscales, one of which is fatigue. Further research is needed into the meaning, mechanisms, measurement and management of fatigue. Patient perspective: fatigue as a recommended patient centred outcome measure in rheumatoid arthritis. The meaning of fatigue and tiredness as narrated by women with fibromyalgia and healthy women. The contribution of pain, reported sleep quality, and depressive symptoms to fatigue in fibromyalgia.
Pain, stiffness, and fatigue in juvenile polyarticular arthritis: contemporaneous stressful events and mood as predictors.
Psychosocial variables and fatigue: a longitudinal study comparing individuals with rheumatoid arthritis and healthy controls. History of affective disorder and the temporal trajectory of fatigue in rheumatoid arthritis. The experience of rheumatoid arthritis pain and fatigue: examining momentary reports and correlates over one week. Fatigue assessments in rheumatoid arthritis: comparative performance of visual analog scales and longer fatigue questionnaires in 7760 patients.
Fatigue in patients with ankylosing spondylitis: a comparison with the general population and associations with clinical and self-reported measures. The Multidimensional Fatigue Inventory (MFI) psychometric qualities of an instrument to assess fatigue. Assessment of fatigue in patients with fibromyalgia and chronic widespread pain: reliability and validity of the Swedish version of the MFI-20. Validation of the functional assessment of chronic illness therapy fatigue scale relative to other instrumentation in patients with rheumatoid arthritis. Minimal clinically important difference for 7 measures of fatigue in patients with systemic lupus erythematosus.


Determining the minimal clinically important differences in activity, fatigue, and sleep quality in patients with rheumatoid arthritis.
Understanding multiple sclerosis fatigue: a synthesis of biological and psychological factors. The patient perspective on priorities for different symptoms has been a catalyst for the adoption of fatigue as a recommended measure in all clinical trials in rheumatoid arthritis (RA).1 This review covers the meaning, mechanisms, measurement and management of fatigue, and suggests (with caveats) practical approaches for the clinician. They feel unsupported by health professionals, and report that clinicians rarely ask about fatigue – thus patients believe clinicians are not interested in fatigue and so fail to raise it themselves. Quantitative studies on the variations of fatigue during the day and the patterns of fatigue over the seasons may also help elucidate mechanisms and self-management solutions.
This VAS subscale was not validated against a gold standard fatigue scale, but shows reliability over 1 week and has been used in many FMS studies. Standardised fatigue VAS and NRS should be formally compared as the trend for transforming VAS into boxes, numbers or circles for ease of on-line computer-based studies, or for scanning data into spreadsheets, may alter the psychometric properties of the VAS. While debate continues about whether fatigue is specific to inflammatory arthritis or is simply the fatigue of an LTC, patients still have to manage this difficult symptom. Fatigue is considered equal to or worse than pain and is deemed unearned (and thus unfair and unpredictable) and unresolving.
The emotional consequences of fatigue are graphically described by patients as frustration, irritability, resentment and tearfulness. However, when patients did raise the problem of fatigue they perceived it was dismissed or they were offered generic advice that was unhelpful. Evidence for a relationship between fatigue and time since diagnosis with a musculoskeletal condition is inconsistent.
Further patient perspective workshops at the international consensus group OMERACT (Outcome Measurements in Rheumatology Clinical Trials) could usefully provide important additions to this researcher-generated list of potential predictors of fatigue.
The Multidimensional Assessment of Fatigue (MAF) scale is RA-specific and was developed from a USA cancer fatigue scale.53 It has 16 questions measuring 4 physical fatigue dimensions (fatigue severity, distress, impact and timing) and yields a global score. In all of these qualitative studies patients described not only physical fatigue but also cognitive fatigue, manifesting as an inability to think clearly, concentrate, or be motivated to do anything. Fatigue has sometimes been found to be higher in people who have been diagnosed with RA for a longer time25,26 and sometimes higher among those with more recent RA onset.23 People with RA of any duration should therefore be included in interventions aimed at avoiding the onset of fatigue or bolstering coping with existing fatigue.
There is good evidence of construct validity, discrimination between patients and controls, internal consistency and sensitivity to change.39,40 However, it lacks cognitive items and (anecdotally) the questionnaire layout leads patients to answer the questions in terms of disability rather than fatigue. Studies should have fatigue as their primary outcome, be well designed, robust, and adequately powered, and should address interventions that can be easily translated into clinical practice (e.g. Age and ethnicity have not been reported to relate to fatigue in musculoskeletal conditions. It would be optimal to ask patients to complete a structured log of their fatigue for a few days or weeks before their appointment.



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Comments to “Over fatigue meaning”

  1. KAYFUSA:
    Hip feel pain in the front perhaps more important to exclude other causes of hemorrhoid-like symptoms.
  2. VORZAKON:
    Through the hypothalamic-pituitary axis), disrupted sleep or circadian rhythms, and because you suffer.
  3. EleqantniY:
    Thinking about how nice it would breathing.