• Title/Summary/Keyword: chalder

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Clinical Investigation and Follow-up Monitoring of Fatigue Patients Visiting the Oriental Medical Hospital (한방병원 보양클리닉에 내원하는 피로환자의 임상적 분석 및 치료경과 관찰)

  • 이종훈;이지현;박신명;김영철;이장훈;우홍정
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.55-63
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    • 2000
  • Objectives : Fatigue is a common symptom experienced by everyone. Nevertheless, clinicians have a tendency of ignoring it since fatigue itself is not considered a distinct disease. Actually, some limited research about chronic fatigue syndrome has been made within the country, but in reality, the probability of getting this syndrome is still considered very low due to the strict diagnosis standard. Therefore, there are tremendous numbers of patients who do not get enough attention from clinicians for their fatigue symptoms only because technically they do not belong to the syndrome. Therefore, a basic statistical database must be compiled and patient management programs must be developed. To accomplish this, we conducted this study by measuring degree of fatigue, clinical characteristics and processes of Oriental medical treatment of fatigue patients. Methods : The objects of this study were selected from the new patients who entered the tonification Clinic in Kynnghee Oriental Medical Center between August 11, 2000 and October 7, 2000. Their main complaint was fatigue and they did not suffer from any physical or mental problem either historically or at the time of the study. The objects were divided into two groups based on duration of fatigue; fatigue under 6 months is considered as acute fatigue and fatigue for longer than 6 months is chronic fatigue. The prepared survey sheet for measuring fatigue degree was distributed to the patients with their consent. The patients were divided again into three subgroups : the fIrst group went through 1st test and constitution test after tonification clinic; the second one went into constitution test skipping Ist measuring test; the third one went into only tonification clinic with neither 1st measuring test nor constitution test. Results : The total number of object patients was 47 and 80% of them were considered as 'fatigue patients' by the Chalder scale. Among all patients, 29.5% requested treatment for chronic fatigue, which is over 6 months. The average of scale II for all patients was 14.8, which indicates moderate fatigue. The averages of scale II-1, II-2, II-3 were respectively 7.5, 5.9, and 3.7 so the most common complaint was physical fatigue. When compared scale II based on occupations, student group scored 6.9 and office man group scored 8.5 in scale II-1, physical fatigue, but it was not significant. Conclusions : Numerous number of patients have come to Oriental medical centers or hospitals in Korea. Therefore, deeper statistical research and follow-up-monitoring are reqnired in the Oriental medical academic world. In this study, among all patients who entered the tonification Clinic in Kyunghee Oriental Medical Center, 29.5% requested treatment for chronic fatigue, which is over 6 months. This kind of statistical report is the first time trial in the Oriental medical academy world. Through these steps, more objective treatment can be made and standards of prognosis assessment can be established.tablished.

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Analytic Study for Syndrome-differentiation and Sasang-constitution in 72 Adults with Chronic Fatigue (만성 피로를 주증으로 하는 성인 72명의 변증과 체질별 분석 연구)

  • Cho, Jung-Hyo;Yoo, Sa-Ra;Cho, Jong-Kwan;Son, Chang-Gue
    • The Journal of Internal Korean Medicine
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    • v.28 no.4
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    • pp.791-796
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    • 2007
  • Objective : This study was conducted to find the relationship between syndrome-differentiation and Sasang-constitution in chronic fatigue patients. Methods : The subjects were 72 adults with chronic fatigue who visited Dunsan Oriental Hospital of Daejeon University between March 2007 and April 2007. Their main complaint was fatigue for longer than 6 months and they did not have any physical or mental problems. We measured their fatigue degree by using Chalder fatigue scale and health habits. To evaluate relationship between syndrome-differentiation with sasang-constitution, The patients were divided into four syndrome-differentiations, such as liver and kidney asthenia of Yin, spleen and kidney deficiency of Yang, deficiency of lung and spleen qi, and deficiency of heart and spleen blood. We also diagnosed Sasang-constitution by using Questionnaire for Sasang Constitution Classification II (QSCCII). Results : Among the 72 patients, 41.4%, 34.5% and 24.1% of belonged in Soyangin, Soeumin and Taeumin respectively. Interestingly, we found a meaningful correlation between syndrome-differentiation and physiological function by Sasang-constitution. Conclusion : The result may help Oriental medicine understanding and treatment of chronic fatigue-related diseases and patients.

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A Case Report of Chronic Fatigue Syndrome treated by Jisilchija-tang based on Shanghanlun Provisions (『상한론(傷寒論)』 변병진단체계(辨病診斷體系)에 근거하여 지실치자탕(枳實梔子湯) 투여 후 호전된 만성피로증후군 1례)

  • Ryu, Hee-Chang;Rho, Yeong-Beom
    • 대한상한금궤의학회지
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    • v.9 no.1
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    • pp.115-123
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    • 2017
  • Objective : The purpose of this paper is to report the improvement of patient with Chronic Fatigue Syndrome(CFS) treated by herb medication based on Shanghanlun disease pattern identification diagnostic system. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', the patient was diagnosed with Eumyangyeokchahunobok-byung, number 393 provision, and took Jisilchija-tang herb medication for 75days. The changing symptom of chronic fatigue syndrome was estimated by QOL-CFS(Chalder Fatigue Scale) and VAS(Visual Analogue Scale). Results : The QOL-CFS changed 21 to 8 and VAS changed 10 to 1. Conclusions : It is existing theory that Eumyangyeokchahunobok-byung is caused by 'having too much sex relation'. But the author diagnosed Eumyangyeokchahunobok-byung as 'Symptoms worsen when awaken at night, and sleep at day caused by poor sleep pattern' according to the palaeography about shanghanlun, and got a good results.

Tongue of Fatigue by Classification of Sasang Constitution and Qi Blood Pattern Identification (특발성 피로의 사상체질 및 기혈변증 설진 분석)

  • Choi, Na-Rae;Park, Soo-Jung;Joo, Jong-Cheon;Kwon, Young-Mi
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.4
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    • pp.379-387
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    • 2015
  • Objectives The purpose of this study was to investigate the relevance of Sasang constitution, Qi Blood pattern identification, and tongue diagnosis in subjects complaining of fatigue.Methods Seventy-three subjects who complained of fatigue were assessed using the Chalder Fatigue Scale, tongue diagnosis, pattern identification questionnaire and Sasang constitution diagnosis. The association of tongue diagnosis with Qi Blood pattern identification and Sasang constitution was evaluated.Results 1. There was no significant association between tongue diagnosis and Sasang constitution.2. Tongue color, which is one of the diagnostic indicators in tongue diagnosis, was redder in the Qi stagnation group than in the Qi deficiency and Blood deficiency groups.Conclusions Tongue diagnosis can be utilized in future if proper research regarding Sasang constitution and Sasang constitution pattern identification is conducted.

Analysis of Patients Visiting an Oriental Hospital with Idiopathic Chronic Fatigue or Chronic Fatigue Syndrome (한방병원에 내원한 만성피로증후군과 특발성만성피로 환자에 대한 분석연구)

  • Son, Chang-Gue
    • The Journal of Korean Medicine
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    • v.34 no.3
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    • pp.119-125
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    • 2013
  • Objectives: Medically unexplained fatigue includes chronic fatigue syndrome (CFS) and idiopathic chronic fatigue (ICF). These disorders quite impair quality of life while no effective therapies exist. Therefore, patients with CFS or ICF frequently choose treatments based on traditional Korean medicine. The study aimed to analyze characteristic of patients visiting an Oriental clinic with CFS or ICF. Methods: Patients who met criteria for CFS or ICF were enrolled in this study, from March 2011 to Jun 2013. Clinical information focused on symptom differentiation and Sasang constitution was analyzed. Pearson's chi-square test was used to compare the frequency among sub-groups. Results: In total, 77 patients (49 male and 28 female) were diagnosed with CFS (17 male and 13 female) or ICF (32 male and 15 female). The symptom differentiation was 37.7%, 26.0%, 13.0%, and 23.3% for "Qi deficiency of both spleen and lung (脾肺氣虛)", "Yin deficiency of both liver and kidney (肝腎陰虛)", "Blood deficiency of both heart and spleen (心脾血虛)" and "Yang deficiency of both spleen and kidney (脾腎陽虛)", while Sasang constitutional distribution was 59.7%, 22.1% and 18.2% Soeumin, Taeumin and Soyangin, respectively. The fatigue severity was notably different between CFS ($63.7{\pm}12.1$) or ICF ($52.2{\pm}15.3$) according to the Chalder fatigue scale (10-point scale for eleven questions). There was statistical significance regarding symptom differentiation and Sasang constitution (p < 0.05). Conclusions: In the process of traditional Korean medicine-based development of therapeutics for patients with chronic fatigue or related conditions, this report can serve as reference data.

A Study on the Relationships between Breathing Disorders and Pathological Patterns Based on the Cold-Heat, Phlegm-, Yin Deficiency-, Lao Juan (勞倦)-Pattern Questionnaires and the Nijmegen Questionnaire (호흡실조와 증형간 연관성 연구: 한열, 담음, 음허, 노권 및 네이메헨 설문을 중심으로)

  • Hong, Hanna;Oh, Hwan-Sup;Park, Young-Bae;Park, Young-Jae
    • Journal of Oriental Neuropsychiatry
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    • v.27 no.4
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    • pp.215-221
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    • 2016
  • Objectives: The purpose of this study was to examine the relationship between pathological patterns and hyperventilation syndrome, using pathological pattern and Nijmegen questionnaires. Methods: 33 healthy adults were asked to complete the Cold-Heat-, Phlegm-, Yin deficiency, and Lao Juan (勞倦)-pattern questionnaires, the Chalder fatigue scale, and the Nijmegen questionnaire at Kyung Hee University Hospital. We performed Pearson correlation analyses between the pathological pattern questionnaires and the Nijmegen questionnaire. The questionnaires were composed of several factors. Therefore, each factor and Nijmegen questionnaire score were also analyzed. Results: All of the pattern questionnaire scores had a positive correlation with the Nijmegen questionnaire score. The phlegm pattern, in particular, and the LaoJuan (勞倦) questionnaire scores had high correlation coefficients. The coefficient for the phlegm pattern was 0.856 and the coefficient for the LaoJuan (勞倦) pattern questionnaire was 0.855. Conclusions: The results mean that the pathological pattern questionnaires could be one of the reference materials to evaluate hyperventilation syndrome. Furthermore, improvement of pathological patterns may be helpful for treating hyperventilation syndrome, together with conventional therapies including breathing training.

Chronic Fatigue and Related Factors in Adults (성인의 만성피로와 그 관련 요인에 대한 연구)

  • Byun Young-Soon;Park Mi-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.3
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    • pp.302-313
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    • 2001
  • Purpose: To identify characteristics of chronic fatigue, difference between the duration of fatigue and characteristics of chronic fatigue, and association between chronic fatigue and related factors in adults. Method: The subjects for this study were 180 adults who had experienced fatigue for over one month The measurement tools were the Revised Fatigue Scale by Chalder et al. (1993), the Visual Analogue Scale-energy developed by Lee et al. (1991), the BEPSI (Brief Encounter Psychosocial Instrument) by Frank & Zyzanski (1988), Zung's self rating depression scale (1965) and life style items including exercise sleep, drinking smoking and diet as developed by the researchers. Results : Those who complained of fatigue over six months experienced higher disturbances in their daily life compared to those who had suffered from fatigue less than six months. There were a significant correlation between severity of fatigue and depression (r=.46, p<.001), stress (r=.41, p<.001), and sleep (r=.20, p<.01) Statistically significant relationships were found between severity of fatigue and amount of exercise per week (F=3.79. p<.05) disturbed sleep (t=-2.66, p<.01), number of times awakened during the night (F=3.48, p<.05) types of drinking (F=2.65, p<.05), and diet regularity (F=5.83, p<.01). The construction of a multiple regression model revealed an adjusted $R^2$ of .27 with the depression score serving the major predictor variables for severity of fatigue. Men and people in the younger age group were more energetic than women and those in other age groups. Also married people experienced more fatigue than people who were single. divorced or separated. Conclusion: In nursing interventions for fatigue, medical personnel should consider sociodemographic characteristics of the clients, ways to reduce of stress and counter disturbances in daily life and develop strategies for a health promoting life style.

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Development and Validation of Questionnaire for Chronic Fatigue Syndrome (CFS) Diagnosis Based on Systemic Exertion Intolerance Disease (SEID) Criteria (전신성 활동불능증(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군(Chronic Fatigue Syndrome) 진단 설문지 개발 및 신뢰도 평가)

  • Lim, Eun-jin;Son, Chang-gue;Jang, Eun-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.293-305
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    • 2020
  • Purpose: This study aimed to develop a questionnaire for the diagnosis of chronic fatigue syndrome (CFS) designed based on the systematic exertion intolerance disorder (SEID) criteria, and to validate the reliability of the questionnaire. Methods: A literature search on questionnaires for CFS diagnosis was conducted to develop a SEID questionnaire (SEID-Q27), followed by a pilot survey to identify the reliability of the questionnaire. Adults (Daejeon university personnel) with a Chalder fatigue scale (CFQ) score ≥15 were invited for the survey. We commenced the survey in November 2019 with a two weeks of interval for the test and retest method. The reliability of the questionnaire was investigated in three angles: 1. Cronbach's α, 2. correlations (r) of the questions, numerical rating scale (NRS), and visual analog scale (VAS), and 3. kappa (k) analysis. Results: Among the total 275 adults registered, 55 (20%) participants with a CFQ score ≥15 were invited, and 31 (11%) [15 male, 16 female] completed the questionnaire. The total Cronbach's α was 0.944 for the test and 0.949 for the retest. The reliability (r) of questions by CFQ score (≥15, ≥18, ≥20) ranged from 0.533-0.928 (p <0.05), and the r score of the NRS and VAS were the highest in CFQ scores ≥20, at 0.933 (p<0.001). The agreement rate of the SEID-Q27 between the test and retest was 87% (kappa k=0.743). Conclusions: The SEID-Q27 seems to be reliable. Further studies are needed to measure the validity of the tool and the cutoff point.

Evaluating Interactive Fatigue Management Workshops for Occupational Health Professionals in the United Kingdom

  • Ali, Sheila;Chalder, Trudie;Madan, Ira
    • Safety and Health at Work
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    • v.5 no.4
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    • pp.191-197
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    • 2014
  • Background: Disabling fatigue is common in the working age population. It is essential that occupational health (OH) professionals are up-to-date with the management of fatigue in order to reduce the impact of fatigue on workplace productivity. Our aim was to evaluate the impact of one-day workshops on OH professionals' knowledge of fatigue and chronic fatigue syndrome (CFS), and their confidence in diagnosing and managing these in a working population. Methods: Five interactive problem-based workshops were held in the United Kingdom. These workshops were developed and delivered by experts in the field. Questionnaires were self-administered immediately prior to, immediately after, and 4 months following each workshop. Questionnaires included measures of satisfaction, knowledge of fatigue and CFS, and confidence in diagnosing and managing fatigue. Open-ended questions were used to elicit feedback about the workshops. Results: General knowledge of fatigue increased significantly after training (with a 25% increase in the median score). Participants showed significantly higher levels of confidence in diagnosing and managing CFS (with a 62.5% increase in the median score), and high scores were maintained 4 months after the workshops. OH physicians scored higher on knowledge and confidence than nurses. Similarly, thematic analysis revealed that participants had increased knowledge and confidence after attending the workshops. Conclusion: Fatigue can lead to severe functional impairment with adverse workplace outcomes. One-day workshops can be effective in training OH professionals in how to diagnose and manage fatigue and CFS. Training may increase general knowledge of fatigue and confidence in fatigue management in an OH setting.

Validity Study of the Systemic Exertion Intolerance Disease Questionnaire (SEID-Q27) for Chronic Fatigue Syndrome (CFS) Diagnosis (SEID(Systemic Exertion Intolerance Disease) 진단 기준을 바탕으로 한 만성 피로 증후군 진단 설문지(SEID-Q27) 타당도 연구)

  • Lim, Eun-jin;Son, Chang-gue;Jang, Eun-su
    • The Journal of Internal Korean Medicine
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    • v.41 no.6
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    • pp.1015-1029
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    • 2020
  • Purpose: This study assessed the validity of a questionnaire (SEID-Q27) for diagnosis of chronic fatigue syndrome (CFS), designed based on the systematic exertion intolerance disorder (SEID) criteria. Methods: Two groups of participants were recruited: 1. a non-CFS control group: adult university personnel with a Chalder fatigue scale (CFQ) score ≥15, and 2. a CFS patient group: patients from an online CFS community diagnosed with CFS (diagnostic code of G93.3) with the symptoms present. The survey ran from September to October, 2020. The validity of the questionnaire was investigated by factor analysis and receiver operator characteristic (ROC) analysis. Results: Among the 35 adults surveyed, 30 (86%) participants had CFQ scores ≥15 (15 males and 15 females) and 5 (14%) had a CFS diagnosis (2 males and 3 females). The total mean score was significantly different between the two groups (CFS: 6.8±2.2 vs. control: 4.4±2.4, p<0.05). The area under the curve (AUC) was 0.827. With a cut-off point 62, the sensitivity was 60%, specificity 97%, and the discriminant ability of the survey was 79%. Conclusions: The SEID -Q27 appears to be a useful instrument for the diagnosis of CFS using SEID criteria. However, further large-scale studies are needed with greater numbers of participants.