PubMed · 10696672
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J Iriarte, P de Castro. [Fatigue in multiple sclerosis].. https://pubmed.ncbi.nlm.nih.gov/10696672/
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This paper compares and contrasts four fatigue allowance worksheets commonly used to establish fatigue (relaxation) allowances for production standards; the factors, weights, degree of documentation and other operational characteristics of these worksheets are also examined. We briefly review the fatigue literature including objective physical measures of fatigue. Results of an experiment in which 11 industrial engineers independently applied the four worksheets to a standardized job analysis and video tape of a grocery order selector are reported. We conclude that inter-rater reliability and cross-validation are very low for the four worksheets and suggest validation studies using objective physiological measures of fatigue would be appropriate.
Fatigue is the most commonly reported symptom in cancer patients and has a profound effect on patient quality of life (QOL). The Fatigue-1 and Fatigue-2 surveys performed by the Fatigue Coalition have shown that fatigue occurs on a consistent basis in approximately three quarters of patients treated for cancer. Fatigue-2 study results show that fatigue is associated with significant physical, emotional, psychologic, and social consequences, with virtually every aspect of daily life being affected. Patients also report that fatigue interferes with both their own and their caregivers' careers and economic status. Fatigue-2 documented a significant communication gap between patient and physician regarding fatigue and nonspecific physician responses to patient reports. This finding suggests that patients may benefit from physician initiation of discussion of the causes and treatments of fatigue and from physician education regarding available treatment modalities. Additional research is needed to elucidate the nature of fatigue in cancer patients. Algorithms for the differential diagnosis and treatment of cancer fatigue need to be developed and implemented to assist in timely recognition and management.
If patients experience extreme fatigue during treatment, they may judge the level of fatigue following this experience differently from how they would have judged it before. This change in internal standard is referred to as a response shift. We explored whether a response shift might have occurred in patients receiving radiotherapy (n = 199). Fatigue was assessed before and after radiotherapy. Following completion of the post-test, a thentest was administered where patients had to provide a renewed judgment of their pre-treatment level of fatigue. Response shift was assessed by the mean difference between the pre-test and thentest scores. Comparing the thentest with the pretest scores, patients retrospectively minimized their pre-treatment level of fatigue. The thentest-post-test difference was significant, whereas the conventional pretest-post-test difference was not. These results are in line with the occurrence of a response shift. Additional hypotheses regarding response shift were partially supported. It is concluded that the potentially large implications of response shift justify further research.