Factors associated with fatigue in patients attending a family medicine health center in Erbil city

Authors

  • Jwan Muhammad Sabir Department of Community Medicine, College of Medicine , Halwer Medical University, Erbil, Iraq.

DOI:

https://doi.org/10.15218/zjms.2013.0012

Keywords:

fatigue, anxiety, depression, family medicine

Abstract

Background and objective: Fatigue, is a common presenting symptom in primary care which negatively impacts work performance, family life, and social relationships. The aim of this study is to determine the causes of fatigue and to explore the relationship between fatigue and physical, mental, social and demographic factors among patients with special reference to gender. Methods: A cross sectional study was carried out at the Brayati Family Medicine Center in Erbil city from 1st of July to the 31st of October 2011. We studied 320 patients of both genders attending the center for various reason complaining from fatigue. Formal consent was obtained. Demographic data in addition to two questionnaires were completed, Lowa fatigue scale and Hospital Anxiety and Depression Scale. Results: 86 males (26.88%) and 234 females (73.12%). The age of the subjects varied from 16-74 years .The mean age was 29.2 years, 39.69% were in the age range 30-44 years. 58.12% were illiterate or read and write only; 65.63% were married and 57.19% reported their economic level as medium. 38.44% were fatigued according to lowa fatigue scale. Higher level was detected among older age group, singles, and low economic and minimum educational status (51.16%, 45.31%, 41.80%, 41.18 and 42.57% respectively). Depression was significantly associated with fatigue, 70% of patients who were depressed complained from fatigue. Findings indicated that, in addition to increasing anxiety among the study sample, higher levels of fatigue were detected in 61.36% of them. Conclusion: Fatigue as a symptom is very common both in community and health care settings but remains medically unexplained. The most important confounders in our studied population were depression and anxiety.

Metrics

Metrics Loading ...

References

Thomas C. Rosenthal, MD; Barbara A. Majeroni, MD; Richard Pretorius, MD, MPH; and Khalid Malik, MD, MBA, Fatigue overview, Am Fam Physician. 2008 Nov 15;78(10):1173-1179.

Deale A, Wessely S: Patients' perceptions of medical care in CFS. Social Science and Medicine 2001, 52:1859-1864.

Kisely S: Treatment for CFS and in the internet: a systematic survey of what your patients are reading. Austraia and New Zealand Journal of Psychiatry 2002, 36:240-245.

Steven S: General Practitioners' beliefs, attitudes and reported actions towards CFS. Australian Family Physician 2000, 29:80-85.

Bowen J, Pheby D, Charlett A, McNulty C: Chronic Fatigue Syndrome: a survey of GPs' attitudes and knowledge. Family Practice 2005, 389-393.

Cullen W, Kearney Y, Bury G. Prevalence of fatigue in general practice. Ir J Med Sci 2002;171:10-2.

Nelson E, Kirk J, McHugo G. Chief complaint fatigue: a longitudinal study from the patient’s perspective. Fam Pract Res J 1987;6:175–88.

Sharpe M, Wilks D. ABC of psychological medicine: fatigue. BMJ 2002;325:480–3.

Chaudhuri A, Behan PO. Fatigue in neurological disorders. Lancet 2004;363:978–88.

Cornuz J, Guessous I, Favrat B. Fatigue: a practical approach to diagnosis in primary care. CMAJ 2006;174:765–7.

Dick ML, Sundin J. Psychological and psychiatric causes of fatigue. Assessment and management. Aust Fam Physician 2003;32:877–81.

Lewis G, Wessely S. The epidemiology of fatigue: more questions than answers. J Epidemiol Community Health 1992;46:92–7.

Kenter EG, Okkes IM. Patients with fatigue in family practice: prevalence and treatment [article in Dutch]. Ned Tijdschr Geneeskd 1999;143:796–801.

Zautra AJ, Fasman R, Parish BP, et al. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2007;128:128–35.

Hwang SS, Chang VT, Rue M, et al. Multidimensional independent predictors of cancer-related fatigue. J Pain Symptom Manage 2003;26:604–14.

Nijrolder I, van der Windt D, de Vries H, van der Horst H: Diagnoses during follow-up of patients presenting with fatigue in primary care. CMAJ 2009.DOI:10.1503/cmaj.090647.

Wockenfuss R, Frese T, Herrmann K, Claussnitzer M, Sandholzer H: Three- and four-digit ICD-10 is not a reliable classification system in primary care. Scand J Prim Health Care 2009;27:131-136.

Hartz A, Bentler S, Watson D. Measuring fatigue severity in primary care patients. J Psychosom 2003; 54(6):515-21.

Snaith RP. The Hospital Anxiety and Depression Scale. Health and Quality of Life Outcomes 2003;1:29 http://www.hqlo.com/content/1/1/29 cited 15th may 2011

Mclivenny S, DeGlume AM, Elewa M, Fernandez DT, and Dormer P, Factors associated with fatigue in a family Medicine clinic in the United Arab Emirates. Family Practice 2000; 17: 408-413.

David A. Pelosi A, McDonald E. Tired, weak or in need of rest; fatigue among general practice attainders. Br Med J 1990: 301: 1190-1202.

Kroenke K, Price R. Symptoms in the community: prevalence, classification and psychiatric comorbidity. Arch Intern Med 1993;153:2474–2480.

Wessely S, Hotopf M, Sharpe M. Chronic Fatigue and its Syndromes. Oxford: Oxford University Press, 1998.

OPCS. Morbidity Statistics from General Practice: Third National Morbidity Survey, 3rd edn. London: HMSO, 1985.

Pawlikowska T, Chalder T, Hirsch SR, Wallace P, Wright DJM, Wessely SC. Population-based study of fatigue and psychological distress. Br Med J 1994;308:763–766.

Jason LA, Richman JA, Rademaker AW, Jordan KM, Plioplys AV, Taylor RK, et al. A community based study of chronic fatigue syndrome. Arch Intern Med 1999;159: 2129–2137.

Cox B, Blaxter M, Buckle A. The Health and Lifestyle Survey. London: Health Promotion Research Trust, 1997.

Fuhrer R, Wessely S. Fatigue in French primary care. Psychol Med 2005;25:895–905.

Henningsen P, Zimmermann T, Sattel H. Medically unexplained physical symptoms, anxiety, and depression: a meta-analytic review. Psychosom Med 2003;65:528–533.

Skapinakis P, Lewis G, Mavoreas V. Unexplained fatigue syndromes in a multinational primary care sample: specificity of definition and prevalence and distinctiveness from depression and generalised anxiety. Am J Psychiatry 2003;160:785–787.

Sullivan PF, Kovalenko P, York TP, Prescott CA, Kendler KS. Fatigue in a community sample of twins. Psychol Med 2003;33:263–281.

Downloads

Published

2013-04-01

How to Cite

Sabir, J. M. (2013). Factors associated with fatigue in patients attending a family medicine health center in Erbil city. Zanco Journal of Medical Sciences (Zanco J Med Sci), 17(1), 337_343. https://doi.org/10.15218/zjms.2013.0012

Issue

Section

Original Articles