By Lauren Krupp
This functional consultant for physicians and different overall healthiness care pros discusses the effect of fatigue at the person with MS, the capability etiologies underlying MS-related fatigue, its paintings up and prognosis, and pharmacologic and nonpharmacologic administration concepts.
Fatigue may be the one such a lot popular and disabling symptom of the a number of sclerosis, and bounds sufferers' task greater than the other MS symptom. The id of fatigue as a unique medical entity calls for either artwork and technological know-how, and so much of all, a willingness and skill to hear rigorously to sufferers and their households. The physician's skill to procure a entire heritage calls for a whole figuring out of the situations within which fatigue happens (physical, cognitive, and psychosocial) and calls for attention of a giant variety of issues, together with nervousness, melancholy, over the top sunlight hours sleepiness, discomfort, and spasticity, all of which could mimic or give a contribution to fatigue.
While fatigue is sort of completely a subjective adventure, reckoning on the patient's skill to appreciate and record this symptom, there are potent equipment for choosing the lifestyles of fatigue, selecting its severity, and distinguishing it from similar or contributing problems corresponding to melancholy, soreness, and sleep issues.
Readers will study that fatigue don't need to be tolerated by way of the MS sufferer. quite a few remedies, help structures, and therapy of underlying affective issues can all alleviate fatigue or lessen its influence, restoring the patient's power degrees and skill to take part in existence. nearly each MS sufferer with fatigue can reap the benefits of intervention, and failing to regard the symptom of fatigue with the distinction that it merits is a major detriment to sufferer care.
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Extra resources for Fatigue in Multiple Sclerosis
Example text
29. Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM. The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum. 1998;25:677-684. Hartz A, Bentler S, Watson D. Measuring fatigue severity in primary care patients. J Psychosom Res. 2003;54:515-521. Iriarte J, Katsamakis G, deCastro P. The Fatigue Descriptive Scale (FDS): a useful tool to evaluate fatigue in multiple sclerosis. Mult Scler. 1999;5:10-16. Chalder T, Berelowitz G, Pawlikowska T, et al.
I am more irritable and more easily angered. 13. I have to be careful about pacing my physical activities. 14. I am less motivated to do anything that requires physical effort. 15. I am less motivated to engage in social activities. 16. My ability to travel outside my home is limited. 17. I have trouble maintaining physical effort for long periods. 18. I find it difficult to make decisions. 19. I have few social contacts outside of my own home. 20. Normal day-to-day events are stressful to me. _____ _____ _____ _____ _____ _____ _____ Cognitive Social Social Social Cognitive Cognitive Social _____ Social _____ _____ _____ _____ _____ _____ Social Physical Cognitive Social Physical Physical _____ _____ _____ Social Social Physical 22 _____ Cognitive _____ Social _____ Social (continued on next page) Krupp 03 2/5/04 4:26 PM Page 23 The Measurement of Fatigue TABLE 3 The Fatigue Impact Scale (continued) For each of the following statements, rate your score as a small problem (score of 1), moderate problem (2), big problem (3), or extreme problem (4).
40. Minor difficulties seem like major difficulties. _____ Cognitive _____ _____ _____ _____ _____ _____ Social Physical Physical Social Cognitive Social _____ Social _____ _____ Social Cognitive _____ Physical _____ _____ _____ _____ _____ _____ _____ _____ Physical Social Cognitive Cognitive Social Physical Physical Social _____ Social The total points for each subgroup (physical, cognitive, social) and the entire questionnaire are summed. For the Cognitive subscale (10 questions) and Physical subscale (10 questions), the maximum scores are 40 for each.