Patterns of morning and evening fatigue among adults with HIV/AIDS
Patterns of morning and evening fatigue among adults with HIV/AIDS
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DOI：
10.1111/j.1365-2702.2011.03751.x
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发表时间：
2011-08-01
影响因子：
4.2
通讯作者：
Lee, Kathryn A.
中科院分区：
文献类型：
--
作者：
Lerdal, Anners;Gay, Caryl L.;Lee, Kathryn A.
目的和目标。描述成人艾滋病毒感染者早晨和晚上的疲劳模式，并检查它们与人口统计和临床因素以及其他症状的关系。背景。大多数与艾滋病毒相关的疲劳研究评估了疲劳的平均水平，但没有解决其昼夜波动问题。一天中的疲劳模式可能对评估和治疗具有重要影响。设计。采用横断面相关设计，在 72 小时内进行六次重复测量。方法。在旧金山招募了 318 名感染艾滋病毒的成年人作为方便样本。通过问卷收集社会人口统计、临床和症状数据。 CD4(+) T 细胞计数和病毒载量从病历中获得。参与者连续三天每天早上和晚上完成四项版本的李疲劳量表。根据参与者的每日疲劳模式进行分组（仅晚上疲劳程度高、仅早晨疲劳程度高、早晨和晚上疲劳程度高以及早晨和晚上疲劳程度低）。使用组比较和逻辑回归来确定每种疲劳模式的独特预测因子。结果。夜间高疲劳模式与焦虑相关，而早晨高疲劳模式与焦虑和抑郁相关。早晨的疲劳模式早晚波动很小，晚上的疲劳模式波动最大。早晨和晚上的高频率模式与焦虑、抑郁和睡眠障碍有关，该组报告了与疲劳相关的痛苦和功能干扰最多。结论。这些结果为评估患者日常疲劳波动模式的重要性提供了初步证据，因为不同的模式与不同的症状体验以及可能不同的病因相关。与临床实践的相关性。不同的疲劳模式可能会受益于量身定制的干预策略。可以在早晨高度疲劳的患者中测试抑郁症状的治疗。
Aims and objectives. Describe patterns of morning and evening fatigue in adults with HIV and examine their relationship to demographic and clinical factors and other symptoms.Background. Most studies of HIV-related fatigue assess average levels of fatigue and do not address its diurnal fluctuations. Patterns of fatigue over the course of the day may have important implications for assessment and treatment.Design. A cross-sectional, correlational design was used with six repeated measures over 72 hours.Method. A convenience sample of 318 HIV-infected adults was recruited in San Francisco. Socio-demographic, clinical and symptom data were collected with questionnaires. CD4(+) T-cell count and viral load were obtained from medical records. Participants completed a four-item version of the Lee Fatigue Scale each morning and evening for three consecutive days. Participants were grouped based on their diurnal pattern of fatigue (high evening only, high morning only, high morning and evening and low morning and evening). Group comparisons and logistic regression were used to determine the unique predictors of each fatigue pattern.Results. The high evening fatigue pattern was associated with anxiety and the high morning pattern was associated with anxiety and depression. The morning fatigue pattern showed very little fluctuation between morning and evening, the evening pattern showed the largest fluctuation. The high morning and evening pattern was associated with anxiety, depression and sleep disturbance and this group reported the most fatigue-related distress and interference in functioning.Conclusions. These results provide initial evidence for the importance of assessing the patient's daily pattern of fatigue fluctuation, as different patterns were associated with different symptom experiences and perhaps different aetiologies.Relevance to clinical practice. Different fatigue patterns may benefit from tailored intervention strategies. Management of depressive symptoms could be tested in patients who experience high levels of morning fatigue.