AASLD 2016: The Liver Conference – Alan Franciscus
Source: Abstract # 1639: Fatigue & Hepatitis C: A Focus Group Study—S K Afdhal et. al
Up to 97% of people with hepatitis C report fatigue with 88% reporting some form of fatigue every day. The current study sought to understand the degree of fatigue by a qualitative—describing the fatigue—focus group approach. The study enrolled patients who would describe their experiences of fatigue and how it influenced their lives. There were three focus groups with 3-7 hepatitis C patients in each group—a total of 16 patients were enrolled. The study was approved by Institutional Review Board—this is standard practice in clinical trials. The patient characteristics were ~58 years old, 56% female and 50% Caucasian. The patients were asked to focus on their experiences of fatigue and to describe their symptoms. Their responses were audio recorded and analyzed by two independent researchers.
Conclusion: The researchers broke down the experiences into two first measurements of fatigue: capacity and engagement. The subcategories (italics) with patient responses for examples.
Capacity: access: “e.g. I don’t have a lack of energy; I have an inability to access that energy. It’s like a car that won’t start,” depletion: “e.g. If I got up today and worked a whole eight hour day, I wouldn’t make it tomorrow.”), and restoration: (e.g. “It’s like a car running out of gas. Sooner or later, you better stop and get the fill up or you’re just going to be dead on the side of the road”).
Engagement: initiation: “(e.g. “My mental self can see myself getting up but my physical self can’t do it. Frustrating because I want to.”) and personal satisfaction: (e.g. “Affects activity schedule because I have to balance activity and can’t do all the things I want to do”).”
The authors concluded that these domains need to be incorporated to validate future studies of fatigue in people infected with chronic hepatitis C.
Editorial Comments: Fatigue is very hard to measure since it is self-reported. To my knowledge, few self-reported scales accurately measure fatigue. I well remember fatigue when I had chronic hepatitis C. The descriptions reported by patients ring true to me. I will be interested if others with hepatitis C feel the same.
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