Chronic fatigue syndrome and quality of life

Figures & data

Table 1 Questionnaires

	Description
Chalder Fatigue Questionnaire^Citation31	Ten questions designed to describe difficulties with fatigue and associated symptoms, with four scored categories ranging from 0 (less than) to 3 (much more than)
Epworth Sleepiness Scale^Citation32	Eight activity inquiries and likelihood of sleeping: 0 (never) to 3 (high chance of dozing)
Self-Efficacy Scale for Chronic Illness^Citation33	Six inquiries beginning “How confident are you …” managing fatigue, physical, emotional/other symptoms, tasks, and other on a 10-point scale: 1 (not confident) to 10 (completely confident)
Visual Analog Scale – pain^Citation34	Measured 0–100%
Short Form 36^Citation35	Ten questions about physical activity, with three responses: 1 (limited a lot), 2 (a little), or 3 (not at all)
Hospital Anxiety and Depression Scale^Citation36	Mood measure with seven questions for anxiety and seven for depression; four score responses: 0 (no impact) to 3 (frequently affected)
European Quality of Life Measure^Citation37	Five questions on mobility, self-care, activity, pain, and mood in three categories: 1 (no problems) to 3 (extremely disabling) difficulties
Clinical Global Impression^Citation38	Seven questions, with responses ranging from 1 (very much better) to 7 (very much worse)

Table 2 UK NICE definition of CFS

Guidelines for evaluation and diagnosis
Fatigue with the following symptoms:
• new or had a specific onset (ie, not lifelong)
• persistent and/or recurrent
• unexplained by other conditions
• has resulted in substantial reduction in activity level characterized by postexertion malaise and/or fatigue (typically delayed, eg, by at least 24 hours, with slow recovery over several days)
and one or more of the following symptoms:
• difficulty with sleeping, such as insomnia, hypersomnia, unrefreshing sleep, disturbed sleep–wake cycle
• muscle and/or joint pain that is multisite and without evidence of inflammation
• headaches
• painful lymph nodes without pathological enlargement
• sore throat
• cognitive dysfunction, such as difficulty thinking, inability to concentrate, impairment of short-term memory, and difficulties with word finding, planning/organizing thoughts, and information processing
• physical or mental exertion or flu-like symptoms
• dizziness and/or nausea
• palpitations in the absence of identified cardiac pathology
The symptoms of CFS/ME fluctuate in severity, and may change in nature over time.

Notes: Reproduced with permission from © NICE (2007) CG53 Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management.⁸ Available from www.nice.org.uk/guidance/cg53. All rights reserved. Subject to Notice of rights NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

Abbreviations: CFS, chronic fatigue syndrome; ME, myalgic encephalomyelitis; NICE, National Institute of Health and Care Excellence.

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