Preliminary Data on the Effects of Fatigue Self-Management Across Ethnically Different Populations

Background: Fatigue self-management programs have shown difficulty in consistently capturing improvements in fatigue and its impact on mood, psychosocial functioning, and quality of life.  This lack of consistency may in part be due to the demographics of those participating in such programs. 

Objectives: The objective of this preliminary report on data gathered from a clinical fatigue self-management program is to examine the impact of ethnicity on outcome measures across time (approximately 6 months after initial assessment and intake into the program).

Methods: Paired Samples T tests were used to compare outcome data for Caucasians and African Americans, respectively, from pre-test to post-test on a number of variables aimed at measuring severity of fatigue and the impact of fatigue on psychosocial functioning, mood, and quality of life.  Outcome measures included an author-derived Health Behavior Scale, the Abbreviated Modified Fatigue Impact Scale, the Stigma Scale for Chronic Illnesses, a Three Item Loneliness Scale, the Hospital Anxiety and Depression Scale, the Multiple Sclerosis Fatigue Self Efficacy scale, the Multidimensional Assessment of Fatigue scale, and the Patient Determined Disease Steps.

Results: In a sample of 6 Caucasian patients with multiple sclerosis who have completed pre-test and post-test significant reductions in scores over time were obtained for the Anxiety subscale of the Hospital Anxiety and Depression Scale (p < 0.05), the Enacted Stigma subscale of the Stigma Scale for Chronic Illnesses (p < 0.05), and the Interference with Activities subscale of the Multidimensional Assessment of Fatigue Scale (p < 0.01).  However, in a sample of 4 African American identified patients with multiple sclerosis, no significant changes in scores were observed over time.

Conclusions: Clinicians working to improve patient self-managment of fatigue are advised to consider the population served in identifying measures that are likely useful in capturing change in fatigue and the impact of fatigue on indices of mood, psychosocial functioning, and quality of life.