Fatigue and spinal cord injury: a qualitative analysis.
OBJECTIVE
To explore experiences of fatigue among people with spinal cord injuries (SCIs) and factors perceived to contribute to fatigue.


METHODS
Kelowna, Prince George, Vancouver and Victoria, British Columbia, Canada.


METHODS
Collaborative, qualitative methodology.


METHODS
Four focus groups were undertaken simultaneously with a total of 29 participants, comprising a purposive sample of men and women: 21 people with complete and incomplete SCI of high and low tetraplegia and paraplegia, 2 family members, 2 assistants and 4 occupational therapists. Interpretive analysis was grounded in the themes identified in the data.


RESULTS
Fatigue was perceived to have cognitive, emotional and physical dimensions and to exert a profound effect on the lives of many people with SCI, such that pleasurable activities were often eschewed to enable the accomplishment of more mundane tasks. Factors most consistently associated with fatigue were pain, depression and hopelessness, side effects of medications, poor quality sleep, spasticity, poor posture, diet, and the effort required to accomplish routine and self-care tasks.


CONCLUSIONS
Fatigue is a complex phenomenon, interlinked with pain, depression and hopelessness that significantly diminishes the quality of life following SCI. Further research is required to provide greater understanding of this issue and to determine appropriate and comprehensive forms of intervention.
Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
K W
KW
Hammell
W C
WC
Miller
S J
SJ
Forwell
B E
BE
Forman
B A
BA
Jacobsen
D000328:Adult; D000368:Aged; D002170:Canada; D003071:Cognition / Q000502:physiology; D003863:Depression / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D004644:Emotions / Q000502:physiology; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D017144:Focus Groups / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*