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Prognosis of fatigue and functioning in primary care: a 1-year follow-up study.
- Source :
-
Annals of family medicine [Ann Fam Med] 2008 Nov-Dec; Vol. 6 (6), pp. 519-27. - Publication Year :
- 2008
-
Abstract
- Purpose: Although fatigue is a common presenting symptom in primary care and its course and outcomes often remain unclear, cohort studies among patients seeking care for fatigue are scarce. We therefore aimed to investigate patterns in the course of fatigue and relevant secondary outcomes in a large cohort of patients who sought care for a main symptom of fatigue.<br />Methods: We performed an observational cohort study in 147 primary care practices. Patients consulting their general practitioner for a new episode of fatigue were sent questionnaires at 1, 4, 8, and 12 months after baseline. We collected measures of fatigue, perceived health and functioning, absenteeism, psychological symptoms, and sleep using the Checklist Individual Strength, the 36-Item Short Form Health Survey, the Four-Dimensional Symptoms Questionnaire, and the Pittsburgh Sleep Questionnaire Inventory. Patients were classified into 4 subgroups based on fatigue severity scores over time. We assessed patterns in the course of all outcomes in these subgroups and in the total population, and tested changes over time and differences between subgroups.<br />Results: A total of 642 patients were enrolled in the study. Response rates during follow-up ranged between 82% and 88%. For 75% of the patients, 4 distinct groups could be discerned: 26% of patients had continuously high scores for fatigue, 17% had a fast recovery, 25% had a slow recovery, and 32% initially improved but then had a recurrence of fatigue. Patterns for the secondary outcomes of symptoms and functioning were all similar to the pattern for fatigue within each of the subgroups.<br />Conclusions: The findings of this study suggest a longitudinal relationship between the severity of fatigue, impaired functioning, psychological symptoms, and poor sleep. Physicians should be aware that a substantial proportion of patients seeking care for fatigue have these additional health and psychosocial problems.
- Subjects :
- Absenteeism
Adult
Fatigue psychology
Fatigue Syndrome, Chronic diagnosis
Fatigue Syndrome, Chronic psychology
Fatigue Syndrome, Chronic therapy
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Severity of Illness Index
Sleep physiology
Sleep Wake Disorders diagnosis
Sleep Wake Disorders psychology
Sleep Wake Disorders therapy
Surveys and Questionnaires
Treatment Outcome
Fatigue diagnosis
Fatigue therapy
Primary Health Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 1544-1717
- Volume :
- 6
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Annals of family medicine
- Publication Type :
- Academic Journal
- Accession number :
- 19001304
- Full Text :
- https://doi.org/10.1370/afm.908