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The impact of disability, fatigue and sleep quality on the quality of life in multiple sclerosis
Ghaem Haleh,Haghighi Afshin
Annals of Indian Academy of Neurology , 2008,
Abstract: Background: Only few papers have investigated the impact of multiple sclerosis (MS), especially MS-related fatigue and the impact of the quality of sleep on the quality of life (QoL) in MS patients. Objective: The objective of this study was to measure the quality of life in MS patients and the impact of disability, fatigue and sleep quality, using statistical modeling. Materials and Methods: A cross-sectional study was conducted and data was collected from 141 MS patients, who were referred to the Mottahari Clinic, Shiraz, Iran, in 2005. Data on health-related quality of life (MSQoL-54), fatigue severity scale (FSS), and Pittsburgh sleep quality Index (PSQI) were obtained in the case of all the patients. Epidemiology data concerning MS type, MS functional system score, expanded disability status scale (EDSS) etc. were also provided by a qualified neurologist. Spearman a coefficient, Mann-Whitney U test, and linear regression model were used to analyze the data. Results : The mean ±SD age of 141 MS patients was 32.6±9.6 year. Thirty five (24.8%) of them were male and the others were female. Eighty two (58.1%) of the patients had EDSS score of ≤ 2, 36 (25.5%) between 2.5 and 4.5, and 23 (16.3%) ≥ 5. As per PSQI scores, two (1.4%) of the patients had good sleep, 16 (11.3%) had moderate sleep and 123 (87.2%) had poor sleep. There was a significant high positive correlation between the quality of mental and physical health composite scores (r = 0.791, P < 0.001). There was a significant negative correlation between the quality of physical score and age (r = -0.88, P < 0.001), fatigue score (r = -0.640, P < 0.001), EDSS score (r = -0.476, P < 0.001) and PSQI (sleep quality r = -0.514, P < 0.000). Linear regression analysis showed that PSQI score, EDSS, and fatigue score were predictors in the model between the quality of physical score and covariates ( P < 0.001). Linear regression model showed that fatigue score and PSQI were predictors in the model between the quality of mental score and covariates ( P < 0.001). Discussion and Conclusion: In conclusion, it may be said that MS patients had poor and moderate quality of mental and physical health. The quality of life was impaired as seen by PSQI, EDSS, and FSS. It is our suggestion that these patients require the attention of health care professionals, to be observed for the need of possible psychological support.
Fatigue in patients with COPD participating in a pulmonary rehabilitation program  [cached]
Cindy J Wong,Donna Goodridge,Darcy D Marciniuk,et al
International Journal of COPD , 2010,
Abstract: Cindy J Wong1, Donna Goodridge1, Darcy D Marciniuk2, Donna Rennie1,31College of Nursing, 2College of Medicine, 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, CanadaBackground: Fatigue is a distressing, complex, multidimensional sensation common in individuals with chronic obstructive pulmonary disease (COPD). While fatigue negatively impacts functional performance and quality of life, there has been little study of the fatigue that affects participants in pulmonary rehabilitation programs. The purpose of this study was to examine the emotional, behavioral, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiologic factors.Patients and methods: A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other clinical variables were abstracted from pulmonary rehabilitation program health records.Results: Almost all (95.3%) participants experienced high levels of physical fatigue. High levels of fatigue were also reported for the dimensions of reduced activity (88.1%), reduced motivation (83.3%), mental fatigue (69.9%), and general fatigue (54.5%). Close to half (42.9%) of participants reported symptoms of anxiety, while almost one quarter (21.4%) reported depressive symptoms. Age was related to the fatigue dimensions of reduced activity (ρ = 0.43, P < 0.01) and reduced motivation (ρ = 0.31, P < 0.05). Anxiety was related to reduced motivation (ρ = -0.47, P < 0.01). Fatigue was not associated with symptoms of depression, sleep quality, gender, supplemental oxygen use, smoking status, or Medical Research Council dyspnea scores.Conclusions: Fatigue (particularly the physical and reduced motivation dimensions of fatigue) was experienced by almost all participants with COPD attending this pulmonary rehabilitation program. Fatigue affected greater proportions of participants than either anxiety or depression. The high prevalence of fatigue may impact on enrolment, participation, and attrition in pulmonary rehabilitation programs. Further investigation of the nature, correlates, and impact of fatigue in this population is required.Keywords: COPD, fatigue, pulmonary rehabilitation, anxiety, depression, sleep quality
Fatigue in patients with COPD participating in a pulmonary rehabilitation program
Cindy J Wong, Donna Goodridge, Darcy D Marciniuk, et al
International Journal of Chronic Obstructive Pulmonary Disease , 2010, DOI: http://dx.doi.org/10.2147/COPD.S12321
Abstract: tigue in patients with COPD participating in a pulmonary rehabilitation program Short Report (8175) Total Article Views Authors: Cindy J Wong, Donna Goodridge, Darcy D Marciniuk, et al Published Date September 2010 Volume 2010:5 Pages 319 - 326 DOI: http://dx.doi.org/10.2147/COPD.S12321 Cindy J Wong1, Donna Goodridge1, Darcy D Marciniuk2, Donna Rennie1,3 1College of Nursing, 2College of Medicine, 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada Background: Fatigue is a distressing, complex, multidimensional sensation common in individuals with chronic obstructive pulmonary disease (COPD). While fatigue negatively impacts functional performance and quality of life, there has been little study of the fatigue that affects participants in pulmonary rehabilitation programs. The purpose of this study was to examine the emotional, behavioral, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiologic factors. Patients and methods: A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other clinical variables were abstracted from pulmonary rehabilitation program health records. Results: Almost all (95.3%) participants experienced high levels of physical fatigue. High levels of fatigue were also reported for the dimensions of reduced activity (88.1%), reduced motivation (83.3%), mental fatigue (69.9%), and general fatigue (54.5%). Close to half (42.9%) of participants reported symptoms of anxiety, while almost one quarter (21.4%) reported depressive symptoms. Age was related to the fatigue dimensions of reduced activity (ρ = 0.43, P < 0.01) and reduced motivation (ρ = 0.31, P < 0.05). Anxiety was related to reduced motivation (ρ = -0.47, P < 0.01). Fatigue was not associated with symptoms of depression, sleep quality, gender, supplemental oxygen use, smoking status, or Medical Research Council dyspnea scores. Conclusions: Fatigue (particularly the physical and reduced motivation dimensions of fatigue) was experienced by almost all participants with COPD attending this pulmonary rehabilitation program. Fatigue affected greater proportions of participants than either anxiety or depression. The high prevalence of fatigue may impact on enrolment, participation, and attrition in pulmonary rehabilitation programs. Further investigation of the nature, correlates, and impact of fatigue in this population is required.
Effects of Oral Supplementation with Pyrroloquinoline Quinone on Stress, Fatigue, and Sleep  [PDF]
Masahiko Nakano,Tetsuro Yamamoto,Hisayoshi Okamura,Akira Tsuda
Functional Foods in Health and Disease , 2012,
Abstract: ABSTRACT:Seventeen adult male and female subjects participated in a clinical trial using an open-label trial to evaluate the effectiveness of pyrroloquinoline quinone (PQQ) on stress, fatigue, qualityof life and sleep. They ingested 20 mg of PQQ daily for 8 weeks. Changes in stress, fatigue, quality of life measures and sleep were evaluated using various inventories and questionnaires. For example, the results of the Profile of Mood States-Short Form revealed that all six measures of vigor, fatigue, tension-anxiety, depression, anger-hostility and confusion were significantly improved following PQQ administration compared with scores for thosemeasures before administration of PQQ. Measures for quality of life, appetite, sleep, obsession and pain, also improved significantly. The results of the Oguri-Shirakawa-Azumi Sleep Inventory (Middle Aged and Aged version) showed significant improvement in sleepiness at awakening, sleep onset and maintenance, and sleep duration. For validation, thePittsburgh Sleep Quality Index Japanese version also showed significant improvement in sleep-related behavior. Furthermore, the changes in these global scores were correlated withFunctional Foods in Health and Disease 2012, 2(8):307-324 changes in the cortisol awakening response (R = -0.55), i.e. the effects of PQQ on improvement of sleep quality are supported by a biomarker.
Psychometric characteristics of the short form 36 health survey and functional assessment of chronic illness Therapy-Fatigue subscale for patients with ankylosing spondylitis
Dennis A Revicki, Anne M Rentz, Michelle P Luo, Robert L Wong
Health and Quality of Life Outcomes , 2011, DOI: 10.1186/1477-7525-9-36
Abstract: We analyzed clinical and patient-reported outcome (PRO) data collected during 12-week, double-blind, placebo-controlled periods of two randomized controlled trials comparing adalimumab and placebo for the treatment of active AS. The Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and other clinical measures were collected during the clinical trial. We evaluated internal consistency/reliability, construct validity, and responsiveness to change for the SF-36 and FACIT-Fatigue.The SF-36 (Cronbach alpha, 0.74-0.92) and FACIT-Fatigue (Cronbach alpha, 0.82-0.86) both had good internal consistency/reliability. At baseline, SF-36 and FACIT-Fatigue scores correlated significantly with Ankylosing Spondylitis Quality of Life scores (r = -0.36 to -0.66 and r = -0.70, respectively; all p < 0.0001). SF-36 scores varied by indicators of clinical severity, with greater impairment observed for more severe degrees of clinical activity (all p < 0.0001). FACIT-Fatigue scores correlated significantly with SF-36 scores (r = 0.42 to 0.74; all p < 0.0001) and varied by clinical severity (p < 0.05 to p < 0.0001).The SF-36 is a reliable, valid, and responsive measure of health-related quality of life and the FACIT-Fatigue is a brief and psychometrically sound measure of the effects of fatigue on patients with AS. These PROs may be useful in evaluating effectiveness of new treatments for AS.ClinicalTrials.gov: NCT00085644 and NCT00195819Ankylosing spondylitis (AS) is a chronic and progressive inflammatory disorder that primarily affects the axial skeleton, sacroiliac joints of the pelvis, and thoracic cage [1,2]. Patients experience pain, joint stiffness, and the eventual loss of spinal mobility with disease progression. Patients with AS frequently experience impaired physical function and well-being, require time away from work because of disability, and suffer from diminished health-related quality of life (HRQOL) [3-7]. The impact of AS on
Oral health in individuals with psychotic disorders  [PDF]
Jovanovi? Svetlana,Gaji? Ivanka
Stomatolo?ki Glasnik Srbije , 2008, DOI: 10.2298/sgs0803180j
Abstract: Mental disorders are an important problem in every national health care service. The importance of psychotic disorders is not only their frequency but also their long-term character, recurrence, association with other diseases, costs and consequences for the family and society. Psychotic disorders (schizophrenia, schizoaffective disorder, bipolar disorders and depression) and their treatment may result in serious oral diseases. These disorders and medications used to treat them may lead to a series of oral complications and side effects, predominantly high prevalence of carious and extracted teeth, periodontal disease, inadequate oral hygiene, xerostomia, burning mouth syndrome, bad breath and gustatory sense dysfunction. Psychotic disorders affect oral and dental health in two ways. Behavioural changes affect the oral hygiene maintenance and lead to bad habits and attitudes towards oral health. Antipsychotic therapy has adverse effects on oral health. Literature data suggest that oral health in patients with psychotic disorders is poor and highlight the need to develop specific preventive programmes, which would be aimed at improving behaviour of this population at risk in the oral health care system.
Oral health in individuals with psychotic disorders  [PDF]
Jovanovi? Svetlana,Gaji? Ivanka
Stomatolo?ki Glasnik Srbije , 2008, DOI: 10.2298/sgs0802115j
Abstract: Mental disorders are an important problem in every national health care service. The importance of psychotic disorders is not only their frequency but also their long-term character, recurrence, association with other diseases, costs and consequences for the family and society. Psychotic disorders (schizophrenia, schizoaffective disorder, bipolar disorders and depression) and their treatment may result in serious oral diseases. These disorders and medications used to treat them may lead to a series of oral complications and side effects, predominantly high prevalence of carious and extracted teeth, periodontal disease, inadequate oral hygiene, xerostomia, burning mouth syndrome, bad breath and gustatory sense dysfunction. Psychotic disorders affect oral and dental health in two ways. Behavioral changes affect the oral hygiene maintenance and lead to bad habits and attitudes towards oral health. Antipsychotic therapy has adverse effects on oral health. Literature data suggest that oral health in patients with psychotic disorders is poor and highlight the need to develop specific preventive programmes, which would be aimed at improving behavior of this population at risk in the oral health care system.
The State of Fatigue and Sleep among Clinical Nurses in Japan  [PDF]
Naomi Sumi, Naotaka Sugimura, Yuko Yoshida, Rika Yano
Open Journal of Nursing (OJN) , 2017, DOI: 10.4236/ojn.2017.712104
Abstract:
The objective of this study was to investigate the state of fatigue and sleep among clinical nurses in Japan. This descriptive cross-sectional study was conducted from December 2015 to January 2016. The participants were nurses who worked in public hospitals with 500 beds in the major cities and regional cities of Hokkaido. Fatigue was quantitatively assessed using the Cumulative Fatigue Symptoms Index (CFSI). Among nurses in their twenties, the rate of complaints about anxiety and decrease in vitality were high, which was replaced with complaints about irritability among nurses in their thirties. The most popular complaint among nurses in their forties was general fatigue. There was no difference in complaint ratios concerning the workplace location among nurses in their twenties and thirties, nurses in their forties working in suburban areas complained about fatigue more than their urban area. Nurses with sleep problems related to anxiety have a significantly higher complaint rate for all the eight items of CFSI compared with the nurses who do not have such problems (p < 0.001). This is an intermediate report and is part of a study that aims to develop a health management program for hospital nurses regarding fatigue and sleep.
Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients
Moreira, N.C.V.;Damasceno, R.S.;Medeiros, C.A.M.;de Bruin, P.F.C.;Teixeira, C.A.C.;Horta, W.G.;de Bruin, V.M.S.;
Brazilian Journal of Medical and Biological Research , 2008, DOI: 10.1590/S0100-879X2008001000017
Abstract: we have tested the hypothesis that restless leg syndrome (rls) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (ms). the diagnosis of rls used the four minimum criteria defined by the international restless legs syndrome study group. fatigue was assessed by the fatigue severity scale (fss >27), quality of sleep by the pittsburgh sleep quality index (psqi >6), excessive daytime sleepiness by the epworth sleepiness scale (ess >10) and clinical disability by the expanded disability status scale (edss). forty-four patients (32 women) aged 14 to 64 years (43 ± 14) with disease from 0.4 to 23 years (6.7 ± 5.9) were evaluated. thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. edss varied from 0 to 8.0 (3.6 ± 2.0). rls was detected in 12 cases (27%). patients with rls presented greater disability (p = 0.01), poorer sleep (p = 0.02) and greater levels of fatigue (p = 0.03). impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). fatigue was present in 32 subjects (73%) and was associated with clinical disability (p = 0.000) and sleep quality (p = 0.002). age, gender, disease duration, ms pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of rls. fatigue was best explained by clinical disability and poor sleep quality. awareness of rls among health care professionals may contribute to improvement in ms management.
Sleep Disordered Breathing, Fatigue, and Sleepiness in HIV-Infected and -Uninfected Men  [PDF]
Susheel P. Patil, Todd T. Brown, Lisa P. Jacobson, Joseph B. Margolick, Alison Laffan, Lisette Johnson-Hill, Rebecca Godfrey, Jacquett Johnson, Sandra Reynolds, Alan R. Schwartz, Philip L. Smith
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0099258
Abstract: Study Objectives We investigated the association of HIV infection and highly active antiretroviral therapy (HAART) with sleep disordered breathing (SDB), fatigue, and sleepiness. Methods HIV-uninfected men (HIV?; n = 60), HIV-infected men using HAART (HIV+/HAART+; n = 58), and HIV-infected men not using HAART (HIV+/HAART?; n = 41) recruited from two sites of the Multicenter AIDS cohort study (MACS) underwent a nocturnal sleep study, anthropometric assessment, and questionnaires for fatigue and the Epworth Sleepiness Scale. The prevalence of SDB in HIV- men was compared to that in men matched from the Sleep Heart Health Study (SHHS). Results The prevalence of SDB was unexpectedly high in all groups: 86.7% for HIV?, 70.7% for HIV+/HAART+, and 73.2% for HIV+/HAART?, despite lower body-mass indices (BMI) in HIV+ groups. The higher prevalence in the HIV? men was significant in univariate analyses but not after adjustment for BMI and other variables. SDB was significantly more common in HIV? men in this study than those in SHHS, and was common in participants with BMIs <25 kg/m2. HIV+ men reported fatigue more frequently than HIV? men (25.5% vs. 6.7%; p = 0.003), but self-reported sleepiness did not differ among the three groups. Sleepiness, but not fatigue, was significantly associated with SDB. Conclusions SDB was highly prevalent in HIV? and HIV+ men, despite a normal or slightly elevated BMI. The high rate of SDB in men who have sex with men deserves further investigation. Sleepiness, but not fatigue, was related to the presence of SDB. Clinicians caring for HIV-infected patients should distinguish between fatigue and sleepiness when considering those at risk for SDB, especially in non-obese men.
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