Chest
Volume 130, Issue 4, October 2006, Pages 989-994
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Original Research
Fatigue Is Associated With Quality of Life in Sarcoidosis Patients

https://doi.org/10.1378/chest.130.4.989Get rights and content

Background

Fatigue is one of the core symptoms of sarcoidosis patients. Although it is known that fatigue affects quality of life (QOL) in other patient groups, this relationship has never been studied in sarcoidosis patients using a reliable and valid fatigue scale and a multidimensional QOL instrument. The present cross-sectional study among sarcoidosis patients attempts to gain more insight into this relationship.

Methods

One hundred forty-five sarcoidosis patients of an outpatient pulmonary clinic in Zagreb, Croatia, completed the Fatigue Assessment Scale (FAS) and QOL scale (World Health Organization Quality of Life Assessment Instrument-100) between January 2002 and May 2004. Clinical parameters were derived from the patients’ medical files.

Results

Tired patients reported a worse QOL in all domains and fatigue negatively predicted all QOL domains by means of multivariate regression analyses (β values ranging from − 0.31 to − 0.64, all p < 0.001). Corticosteroid use was not a predictor of QOL. Diffusion capacity of the lung for carbon monoxide was the only clinical parameter associated with a QOL domain, namely level of independence.

Conclusions

Fatigue was related to all QOL domains. Furthermore, standard clinical parameters were not associated with fatigue or QOL, except for level of independence. If these results were to be replicated in a prospective study, fatigue as measured by the FAS could be a good indicator of QOL in sarcoidosis patients.

Section snippets

Patients

The sample consisted of consecutive patients from Jordanovic Hospital in Zagreb, Croatia, who were asked by their pulmonary physician to complete a questionnaire. One hundred fifty patients participated in this study. Complete spirometry and diffusion capacity of the lung for carbon monoxide (Dlco) data were available from 145 patients. Therefore, these 145 patients were selected for all analyses. Fifty-two men (36%) and 93 women (64%) had a mean age of 44.3 years (SD, 9.1; range, 21 to 75

Results

The demographic, medical, and psychological characteristics are summarized in Table 1. The population consisted of a vast majority of women, and the mean age was 44.33 ± 9.91 years. Women had more fatigue than men (t[1,133] = − 3.18, p < 0.01; Table 2). Mean time since diagnosis was 4.04 ± 7.80 years, and nearly half of the sample used corticosteroids. The patients using corticosteroids were more tired than the patients who did not (t[1,133] = − 3.50, p < 0.01). Of the patients who did not use

Discussion

Although fatigue is one of the major symptoms in sarcoidosis and is known to affect different aspects of QOL, the association between these two important concepts has never been the main object of study in sarcoidosis patients. Using psychometrically sound questionnaires, the current cross-sectional study was the first to scrutinize this relationship thoroughly. Fatigue appeared to be strongly related to all aspects of QOL, independently of other frequently reported symptoms, clinical

FAS

The following 10 statements refer to how you usually feel. For each statement, you can choose one of five answer categories varying from never to always (1 = never; 2 = sometimes; 3 = regularly; 4 = often, and 5 = always):

1. I am bothered by fatigue.

2. I get tired very quickly.

3. I don’t do much during the day.

4. I have enough energy for everyday life.

5. Physically, I feel exhausted.

6. I have problems getting started.

7. I have problems thinking clearly.

8. I feel no desire to do anything.

9.

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