Development of a conceptual model of subjective physical and mental fatigability: the MI-FI study

主观身心疲劳概念模型的开发：MI-FI 研究

• 批准号: 9152898
• 负责人: Anna Louise Kratz
• 金额: $ 23.25万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-01 至 2018-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9152898
• 关键词: Activities of Daily Living; Acute; Address; Adult; Age; Arts; Characteristics; Chronic; Chronic Disease; Clinical; Clinical Research; Clinical Trials; Cognitive; Collection; Common Cold; Development; Diabetes Mellitus; Diagnosis; Distress; Elderly; Ensure; Equipment and supply inventories; Evaluation; Fatigue; Fibromyalgia; Focus Groups; Foundations; General Population; Goals; Health; Heart; Individual; Interview; Joints; Life Style; Longevity; Malignant Neoplasms; Masks; Measurement; Measures; Medical; Methods; Michigan; Mission; Modeling; Multiple Sclerosis; National Cancer Institute; National Institute on Aging; Outcome; Patient Self-Report; Patients; Performance; Persons; Phase; Population; Primary Health Care; Process; Psyche structure; Reporting; Research; Review Literature; Rheumatism; Risk; Sampling; Severities; Staging; Surveys; Symptoms; Testing; Work; base; clinical care; clinical practice; clinically relevant; design; disabling symptom; exhaustion; experience; health related quality of life; improved; interest; literacy; mortality; nervous system disorder; normal aging; novel therapeutics; patient oriented; theories; tool; university student

Fatigue is a common, distressing, and disabling symptom across the lifespan and general population, but particularly in older adults and those with chronic illness. Although fatigue - perceived tiredness, lack of energy, or exhaustion - is often the focus of clinical care and research, it does not reflect how fatigue is experienced in the context of activity. Specifically, it is important to know how fatigued a person becomes as a result of engaging in different types of activities in order to fully understand their fatigue experience. For example, a person could report what looks to be a positive, low level of fatigue intensity. However their low fatigue could be due to the fact that they have severely restricted their lifestyle in order to avoid fatigue and would fatigue quickly if they attempted a more active lifestyle. In this scenario, the low fatigue score would mask the true severity of fatigue for the individual. Focus has recently turned to the concept of fatigability, or the level of mental or physical fatigue that results from activity, as a more comprehensive and informative measure of the fatigue experience. Two main types of fatigability have been identified: perceived fatigability (changes in self- reported fatigue in the context of activity) and performance fatigability (decrement in performance during activity). The emerging concept of fatigability has the potential to expand our understanding of the experience of fatigue and better evaluate the outcomes of clinical trials that are aimed at treating fatigue and fatigability. Unfortunately, the advancement of fatigability research is currently stymied by two major factors, the lack of a foundational conceptual model and inadequate measures of perceived fatigability. The goal of this study is to address these limitations through a two-phase study to develop a foundational conceptual model of fatigability and lay the ground work for a state-of-the-art self-report measure of fatigability, the Michigan Fatigability Inventory (MI-FI). We will conduct focus groups with normal aging adults, individuals with multiple sclerosis (MS), and individuals with fibromyalgia (FM) to develop a patient-centered conceptual model of fatigability (Specific Aim 1). Then, we will develop item pools for fatigability, the MI-FI, which is appropriate for use across the adult lifespan and individuals with medical conditions (Specific Aim 2). Item pool development will involve a multi-stage process including extensive literature review, development of items based on focus group content, cognitive interviews with normal aging adults and adults with MS or FM, translatability and literacy evaluation, and expert input. The patient-centered conceptual model produced in the proposed study will inform the development of other measures of fatigability (e.g., performance-based measures) and will provide a patient-centered focus to future research and treatment efforts. The item pools are a foundation for developing state-of-the art self-report measures of fatigability (the MI-FI) that will help to personalize clinical practice, provide tools to accelerate the testing of new therapies in clinical trials research, and significantly improve the lives of individuals who experience high fatigability.

疲劳是整个生命周期和普通人群中常见，令人痛苦和残疾的症状，但是 特别是在老年人和患有慢性病的老年人中。虽然疲劳 - 感知到疲倦，缺乏能量， 或精疲力尽 - 通常是临床护理和研究的重点，它不能反映出疲劳的经历 活动的背景。具体而言，重要的是要知道一个人的疲劳是如何导致的 从事不同类型的活动，以充分了解其疲劳经历。例如， 人们可以报告看起来是积极的，低疲劳强度的水平。但是他们的低疲劳可能 由于他们严重限制了自己的生活方式以避免疲劳，并会疲劳 如果他们尝试更积极的生活方式，很快。在这种情况下，低疲劳得分将掩盖真实 个人的疲劳严重程度。重点最近转向了疲劳的概念，或 由活动引起的精神或身体疲劳，作为对 疲劳经验。已经确定了两种主要类型的疲劳性：可感知的疲劳性（自我的变化 在活动背景下报告的疲劳）和性能疲劳性（在 活动）。疲劳性的新兴概念有可能扩大我们对体验的理解 疲劳并更好地评估旨在治疗疲劳和疲劳性的临床试验结果。 不幸的是，疲劳性研究的进步目前受到两个主要因素的困扰，缺乏 基础概念模型和可感知疲劳性的度量不足。这项研究的目的是 通过两阶段研究来解决这些限制，以开发疲劳性的基础概念模型 并为最先进的自我报告的疲劳性测量，密歇根州的疲劳性措施奠定基础 库存（Mi-Fi）。我们将与正常老龄化的成年人，多发性硬化症的个体进行焦点小组 （MS）和具有纤维肌痛（FM）的个体，以发展为以患者为中心的概念模型 （特定目标1）。然后，我们将开发用于疲劳性的物品池，Mi-Fi，适用于跨越 成人寿命和患有医疗状况的人（特定目标2）。项目池开发将涉及 一个多阶段的过程，包括广泛的文献综述，基于焦点小组的项目的开发 内容，与正常老龄化的成年人和具有MS或FM的成年人的认知访谈，可翻译和识字能力 评估和专家投入。拟议研究中产生的以患者为中心的概念模型将 告知其他疲劳性措施（例如，基于绩效的措施），并将提供 以患者为中心的专注于未来的研究和治疗工作。物品池是 制定最先进的自我报告疲劳性措施（MI-FI），这将有助于个性化临床 练习，提供工具以加速临床试验研究中的新疗法的测试，并显着 改善经历高疲劳的个人的生活。