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02-01-2019 | Uitgave 5/2019

Quality of Life Research 5/2019

Development of a person-centered conceptual model of perceived fatigability

Quality of Life Research > Uitgave 5/2019
Anna L. Kratz, Susan L. Murphy, Tiffany J. Braley, Neil Basu, Shubhangi Kulkarni, Jenna Russell, Noelle E. Carlozzi
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The online version of this article (https://​doi.​org/​10.​1007/​s11136-018-2093-z) contains supplementary material, which is available to authorized users.
Portions of these data were presented in an oral paper presentation at the 25th Annual Conference of the International Society for Quality of Life Research, Dublin, Ireland, October 27, 2018.

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Perceived fatigability, reflective of changes in fatigue intensity in the context of activity, has emerged as a potentially important clinical outcome and quality of life indicator. Unfortunately, the nature of perceived fatigability is not well characterized. The aim of this study is to define the characteristics of fatigability through the development of a conceptual model informed by input from key stakeholders who experience fatigability, including the general population, individuals with multiple sclerosis (MS), and individuals with fibromyalgia (FM).


Thirteen focus groups were conducted with 101 participants; five groups with n = 44 individuals representing the general population, four groups with n = 26 individuals with MS, and four groups with n = 31 individuals with FM. Focus group data were qualitatively analyzed to identify major themes in the participants’ characterizations of perceived fatigability.


Seven major themes were identified: general fatigability, physical fatigability, mental fatigability, emotional fatigability, moderators of fatigability, proactive and reactive behaviors, and temporal aspects of fatigability. Relative to those in the general sample, FM or MS groups more often described experiencing fatigue as a result of cognitive activity, use of proactive behaviors to manage fatigability, and sensory stimulation as exacerbating fatigability.


Fatigability is the complex and dynamic process of the development of physical, mental, and/or emotional fatigue. Trait- and state-like biological, psychological, social, and environmental moderators contribute to tremendous variability in fatigability (both between and within-person variability). Future research to further characterize fatigability across populations, test treatments for fatigability, and develop new measures of this construct are greatly needed.

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