title: Comparison of fatigue levels in patients with stroke and patients with end-stage heart failure: application of the fatigue assessment scale.
abstract: OBJECTIVE
  To examine the assessment of fatigue using the Fatigue Assessment Scale (FAS) in patients with stroke and to compare the levels of fatigue reported by patients with stroke, patients with chronic heart failure (CHF), and healthy controls.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Stroke rehabilitation unit, heart failure outpatient clinic, general Dutch population.
  
  
  METHODS
  Three different samples were included: 80 patients with stroke, 137 patients with CHF, and 160 healthy controls.
  
  
  METHODS
  Fatigue was measured according to the FAS at baseline and at 2-month follow-up. Depressive symptoms were assessed at baseline using the Beck Depression Inventory (BDI).
  
  
  RESULTS
  The internal consistency (alpha) of the FAS was 0.77 at baseline and at 2-month follow-up. Test-retest reliability was 0.81 for a 2-month interval. Factor analysis of the combined pool of FAS and BDI items revealed two distinct factors that measure fatigue and depression as two separate constructs. Patients with stroke (15.3+/-7.6) and patients with CHF (16.5+/-7.9) reported similar levels of fatigue (P=.44). The level of fatigue in patients with stroke and patients with CHF was considerably higher than in healthy controls (9.2+/-5.6; P<.001). Using the healthy controls as a reference group, multivariable logistic regression revealed that patients with stroke were at six times greater risk (odds ratio (OR)=6.18, 95% confidence interval (CI)=3.31-11.55; P<.001) and patients with CHF were at eight times greater risk (OR=8.03; 95% CI=4.63-13.94; P<.001) for having fatigue symptoms.
  
  
  CONCLUSIONS
  The FAS is an adequate measure of fatigue in patients with stroke. Levels of fatigue in patients with stroke are similar to levels in patients with CHF, emphasizing its clinical significance in stroke.
authors.affiliation: Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, the Netherlands. robert.smith@psy-uvt.nl
authors.forename: Otto R F
authors.initials: OR
authors.lastname: Smith
authors.forename: Krista C
authors.initials: KC
authors.lastname: van den Broek
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Renkens
authors.forename: Johan
authors.initials: J
authors.lastname: Denollet
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D020521:Stroke / Q000150:complications*; D011795:Surveys and Questionnaires