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Research Objectives
To study daily variability in fatigue after subarachnoid hemorrhage (SAH) using the
ecological momentary assessment (EMA) method.
Design
Observational study with repeated-measures of fatigue during 7 consecutive days using
EMA.
Setting
General community.
Participants
Patients (n=42) with SAH who suffer from chronic fatigue, recruited by their treating
physician.
Interventions
Not applicable.
Main Outcome Measures
Momentary fatigue on a 1 to 7 scale, assessed 10-12 times per day for 7 consecutive
days using the EMA method and average fatigue on a 1 to 7 scale assessed with the
Fatigue Severity Scale (FSS).
Results
Mean age of the group was 53.9 years (SD=13.0), 43% male, and mean time post SAH onset
was 9.3 months (SD=3.2). All patients completed in total 2872 momentary fatigue questions.
Mean momentary fatigue over all days was 3.22 (SD=1.47) and mean FSS score was 5.02
(SD=1.18). Total variance in fatigue (2.21) was explained for 52.3% by between-person
variance and for 47.7% by within-person variance. Multilevel analyses revealed that
fatigue varied significantly (p<0.001) within the day. Moreover, diurnal patterns
of fatigue differed between and within individuals.
Conclusions
Fatigue is often assessed retrospectively with a questionnaire (e.g. FSS), in which
daily variability in fatigue is not reflected. This study shows that fatigue after
SAH is not stable: momentary fatigue varies over the day and is lower than retrospectively
assessed fatigue. In addition, individuals show different momentary fatigue patterns
between days. These results imply that fatigue is an ambiguous construct; retrospectively
assessed fatigue might not capture all the aspects of fatigue as experienced by patients
after SAH. Therefore it should be considered to also take into account EMA measures
in the assessment of fatigue, this might provide valuable input to optimize personalized
interventions to treat fatigue after SAH.
Author(s) Disclosures
The authors have no conflicts of interest to disclose.
Keywords
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© 2022 Published by Elsevier Inc.
