Patterns of Utilization of Medical Care and Perceptions of the Relationship between Doctor and Patient with Chronic Illness Including Chronic Fatigue Syndrome

1997 ◽  
Vol 80 (2) ◽  
pp. 643-658 ◽  
Author(s):  
Stuart W. Twemlow ◽  
Lolafaye Coyne ◽  
Samuel L. Bradshaw ◽  
Barbara H. Lerma
Keyword(s):  
Chronic Illness ◽  
Chronic Fatigue Syndrome ◽  
Chronically Ill ◽  
Chronic Fatigue ◽  
Medical Patients ◽  
Fatigue Syndrome ◽  
Health And Illness ◽  
Patterns Of Utilization ◽  
Chronically Ill Patients ◽  
The Relationship

To what extent do personal constructs affect the relationship between doctor and patient when the ill patient does not readily recover with treatment? Questionnaires were returned anonymously by 609 patients with a self-reported diagnosis of chronic fatigue syndrome, who were considered chronically ill. Findings were compared with those of an earlier study of a population of 397 general medical patients. The chronically ill patients lost an average of 65 days of work per year due to illness compared to general medical patients who missed six or fewer days per year because they were ill. The chronically ill patients also reported a 66% higher frequency of iatrogenic illness, spent more money on health care, took more medication, saw more specialists, and were more litigious than the general medical population. Research suggested several patterns of relationships between doctors and patients, and attitudes to health and illness, which may alert doctors to patients' perceptions, beliefs, encoded constructs, and patterns of relating that affect responses to treatment. More attention by doctors to patients who are experiencing the stress of chronic illness is indicated.

Educational strategies for chronically ill students: Chronic Fatigue Syndrome

1999 ◽  
Vol 16 (2) ◽  
pp. 5-21 ◽  
Author(s):  
Katherine Rowe ◽  
Patricia Fitzgerald
Keyword(s):  
Chronic Illness ◽  
Chronic Fatigue Syndrome ◽  
Chronically Ill ◽  
Well Being ◽  
Chronic Fatigue ◽  
Teaching Staff ◽  
Educational Strategies ◽  
Social Emotional ◽  
Fatigue Syndrome ◽  
Returning To School

AbstractChronic illness, such as Chronic Fatigue Syndrome, has a major impact on the sociol, emotional, and educational well-being of the young people affected by it. Many students are either absent from school for prolonged periods or able to attend for only a few classes each week. Students have identified the importance of educational strategies in the management of their illness. If the school or educational setting is functioning appropriately, then social, emotional, developmental, and academic issues associated with chronic illness gradually resolve. A program developed in conjunction with the Victorian Visiting Teacher Service is described. Strategies used to assist housebound students, their carers, teaching staff, and students who are gradually returning to school are outlined.

scholarly journals Exploratory study into the relationship between the symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM) using a quasiexperimental design

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041947
Author(s):  
Pamela G Mckay ◽  
Helen Walker ◽  
Colin R Martin ◽  
Mick Fleming
Keyword(s):  
Quality Of Life ◽  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Anxiety And Depression ◽  
Symptom Experience ◽  
Fatigue Syndrome ◽  
The Impact ◽  
The Relationship

ObjectiveTo explore the relationship between symptoms of chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) and fibromyalgia (FM). The hypothesis predicated that there would be no significant differences between the group’s symptom experience.DesignA quasiexperimental design. Structural equation modelling (SEM) and invariance testing.ParticipantsMales (M) and females (F) >16 with a confirmed diagnosis of CFS/ME or FM by a general practitioner or specialist. CFS/ME (n=101, F: n=86, M: n=15, mean (M) age M=45.5 years). FM (n=107, F: n=95, M: n=12, M=47.2 years).Outcome measuresDiagnostic criteria: the American Centers for Disease Control and Prevention (CDC) for CFS/ME and the American College of Rheumatology (ACR) criteria for FM. Additional symptom questionnaires measuring: pain, sleep quality, fatigue, quality of life, anxiety and depression, locus of control and self-esteem.ResultsInvariance was confirmed with the exception of the American CDC Symptom Inventory, Fibromyalgia Impact Questionnaire and Hospital Anxiety and Depression Scale (p<0.05) based on five questions. Consequently, it was erroneous to conclude differences. Therefore, the Syndrome Model was created. SEM could not have tested the ACR previously, as it comprised a single data point. Thus, it was combined with these three questionnaires, increasing the data points, to create this new measurable model. Results confirmed no significant differences between groups (p=0.07 (p<0.05)).ConclusionParticipants responded in a similar manner to the questionnaire, confirming the same symptom experience. It is important to consider this in context with differing criteria and management guidelines, as this may influence diagnosis and the trajectory of patient’s management. With the biomedical cause currently unclear, it is the symptom experience and the impact on quality of life that is important. These findings are meaningful for patients, clinicians and policy development and support the requirement for future research.

The neuroendocrinology of chronic fatigue syndrome and fibromyalgia

2001 ◽  
Vol 31 (8) ◽  
pp. 1331-1345 ◽  
Author(s):  
A. J. R. PARKER ◽  
S. WESSELY ◽  
A. J. CLEARE
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Cochrane Collaboration ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
King's College ◽  
Populations At Risk ◽  
Challenge Tests ◽  
Neuroendocrine Challenge ◽  
The Cochrane Collaboration ◽  
The Relationship

Background. Disturbance of the HPA axis may be important in the pathophysiology of chronic fatigue syndrome (CFS) and fibromyalgia. Symptoms may be due to: (1) low circulating cortisol; (2) disturbance of central neurotransmitters; or (3) disturbance of the relationship between cortisol and central neurotransmitter function. Accumulating evidence of the complex relationship between cortisol and 5-HT function, make some form of hypothesis (3) most likely. We review the methodology and results of studies of the HPA and other neuroendocrine axes in CFS.Method. Medline, Embase and Psychlit were searched using the Cochrane Collaboration strategy. A search was also performed on the King's College CFS database, which includes over 3000 relevant references, and a citation analysis was run on the key paper (Demitrack et al. 1991).Results. One-third of the studies reporting baseline cortisol found it to be significantly low, usually in one-third of patients. Methodological differences may account for some of the varying results. More consistent is the finding of reduced HPA function, and enhanced 5-HT function on neuroendocrine challenge tests. The opioid system, and arginine vasopressin (AVP) may also be abnormal, though the growth hormone (GH) axis appears to be intact, in CFS.Conclusions. The significance of these changes, remains unclear. We have little understanding of how neuroendocrine changes relate to the experience of symptoms, and it is unclear whether these changes are primary, or secondary to behavioural changes in sleep or exercise. Longitudinal studies of populations at risk for CFS will help to resolve these issues.

scholarly journals HERV-K and HERV-W transcriptional activity in myalgic encephalomyelitis/chronic fatigue syndrome

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Lucas S. Rodrigues ◽  
Luiz H. da Silva Nali ◽  
Cibele O. D. Leal ◽  
Ester C. Sabino ◽  
Eliana M. Lacerda ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Neurological Diseases ◽  
Life Quality ◽  
Chronic Fatigue ◽  
Myalgic Encephalomyelitis ◽  
Endogenous Retroviruses ◽  
Human Endogenous Retroviruses ◽  
Fatigue Syndrome ◽  
The Relationship ◽  
Increased Activity

Abstract Background Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/MS) is an incapacitating chronic disease that dramatically compromise the life quality. The CFS/ME pathogenesis is multifactorial, and it is believed that immunological, metabolic and environmental factors play a role. It is well documented an increased activity of Human endogenous retroviruses (HERVs) from different families in autoimmune and neurological diseases, making these elements good candidates for biomarkers or even triggers for such diseases. Methods Here the expression of Endogenous retroviruses K and W (HERV-K and HERV-W) was determined in blood from moderately and severely affected ME/CFS patients through real time PCR. Results HERV-K was overexpressed only in moderately affected individuals but HERV-W showed no difference. Conclusions This is the first report about HERV-K differential expression in moderate ME/CFS. Although the relationship between HERVs and ME/CFS has yet to be proven, the observation of this phenomenon deserves further attention.

Prevalence of ADHD in chronic fatigue syndrome

2011 ◽  
Vol 26 (S2) ◽  
pp. 1574-1574
Author(s):  
N. Sáez Francàs ◽  
J. Alegre ◽  
N. Calvo Piñero ◽  
J.A. Ramos Quiroga ◽  
E. Ruiz ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Rating Scale ◽  
Chronic Fatigue ◽  
Diagnostic Interview ◽  
Initial Sample ◽  
Hyperactivity Disorder ◽  
Fatigue Syndrome ◽  
Severe Fatigue ◽  
Severe Psychopathology ◽  
The Relationship

IntroductionChronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.ObjectivesTo describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.AimsTo study the relationship between CFS and ADHD.MethodsThe initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.Results38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).ConclusionsADHD is frequent in CFS patients and it is associated with more severe clinical profile.

The Relationship Between Fatigue and Personality in a Student Population

2009 ◽  
Vol 37 (10) ◽  
pp. 1357-1368 ◽  
Author(s):  
Ahmed M. Abdel-Khalek
Keyword(s):  
College Students ◽  
Chronic Fatigue Syndrome ◽  
Stepwise Regression ◽  
Chronic Fatigue ◽  
High Loading ◽  
Eysenck Personality Questionnaire ◽  
Arabic Version ◽  
Personality Questionnaire ◽  
Fatigue Syndrome ◽  
The Relationship

To investigate the relationship between fatigue or Chronic Fatigue Syndrome (CFS)-like symptoms and basic dimensions of personality, a sample of 466 Kuwaiti college students took part in the study (M age = 19.0 years, SD = 2.1). Participants completed the Arabic Scale of Chronic Fatigue Syndrome (ASCFS; Abdel-Khalek & Al-Theeb, 2006) and the Arabic version of the Eysenck Personality Questionnaire (EPQ; Abdel-Khalek & Eysenck, 1983; Eysenck & Eysenck, 1975). The ASCFS was found to be significantly and positively correlated with neuroticism and psychoticism and negatively correlated with extraversion. Two high-loading factors were extracted from both sexes and labeled “Fatigue and neuroticism versus extraversion”, and “Psychoticism versus lie”. A multiple stepwise regression was carried out and the predictors of ASCFS were found to be neuroticism and psychoticism (positive) and extraversion (negative) among men, while in women the predictors were neuroticism and psychoticism. It was concluded that high scores on neuroticism, psychoticism, and introversion may predispose people to CFS. Clinicians treating CFS could find this result useful. It is suggested that treating neurotic symptoms may ameliorate CFS symptoms.

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