Unraveling Fatigue in Hemodialysis Patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method

Astrid DH. Brys; Frank Stifft; Caroline M. Van Heugten; Maurizio Bossola; Giovanni Gambaro; Bert Lenaert

doi:10.1016/j.jpainsymman.2020.06.042

Unraveling Fatigue in Hemodialysis Patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method

Astrid DH. Brys^*, Frank Stifft, Caroline M. Van Heugten, Maurizio Bossola, Giovanni Gambaro, Bert Lenaert

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

CONTEXT: Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias due to their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called 'memory-experience' gap). Experience sampling Methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data.

OBJECTIVES: We investigated to what extent retrospective symptom reporting accurately represents real-time experiences of fatigue and mood in HD patients using an ESM mobile Health application (PsyMateTM).

METHODS: Forty HD patients used the PsyMateTM for one week to assess real-time fatigue and mood. Additionally, they retrospectively evaluated their symptom experience completing end-of-day and end-of-week questionnaires; and the conventional Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS).

RESULTS: Results of real-time observations (N=1777) showed that fatigue and mood varied between and within individuals. Retrospective end-of-week fatigue evaluation was significantly higher than the average real-time fatigue score, t(38)=3.54, p=0.001, d=0.57. FSS and HADS correlated moderately to strong with the average ESM score for fatigue and mood: r=0.66 and r=0.77, respectively.

CONCLUSION: Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.

Original language	English
Pages (from-to)	1100-1108.e2
Number of pages	11
Journal	Journal of Pain and Symptom Management
Volume	60
Issue number	6
Early online date	6 Jul 2020
DOIs	https://doi.org/10.1016/j.jpainsymman.2020.06.042
Publication status	Published - Dec 2020

Keywords

mHealth
ESM
measurement instrument
fatigue
depressive symptoms
hemodialysis
HOSPITAL ANXIETY
DEPRESSION
MEMORY
ASSOCIATION
DIALYSIS
PATTERNS
RECALL
SCALE

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@article{5c825af15ff94a17b3f2a60cbc790ef2,

title = "Unraveling Fatigue in Hemodialysis Patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method",

abstract = "CONTEXT: Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias due to their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called 'memory-experience' gap). Experience sampling Methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data.OBJECTIVES: We investigated to what extent retrospective symptom reporting accurately represents real-time experiences of fatigue and mood in HD patients using an ESM mobile Health application (PsyMateTM).METHODS: Forty HD patients used the PsyMateTM for one week to assess real-time fatigue and mood. Additionally, they retrospectively evaluated their symptom experience completing end-of-day and end-of-week questionnaires; and the conventional Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS).RESULTS: Results of real-time observations (N=1777) showed that fatigue and mood varied between and within individuals. Retrospective end-of-week fatigue evaluation was significantly higher than the average real-time fatigue score, t(38)=3.54, p=0.001, d=0.57. FSS and HADS correlated moderately to strong with the average ESM score for fatigue and mood: r=0.66 and r=0.77, respectively.CONCLUSION: Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.",

keywords = "mHealth, ESM, measurement instrument, fatigue, depressive symptoms, hemodialysis, HOSPITAL ANXIETY, DEPRESSION, MEMORY, ASSOCIATION, DIALYSIS, PATTERNS, RECALL, SCALE",

author = "Brys, {Astrid DH.} and Frank Stifft and {Van Heugten}, {Caroline M.} and Maurizio Bossola and Giovanni Gambaro and Bert Lenaert",

note = "Copyright {\textcopyright} 2020. Published by Elsevier Inc.",

year = "2020",

month = dec,

doi = "10.1016/j.jpainsymman.2020.06.042",

language = "English",

volume = "60",

pages = "1100--1108.e2",

journal = "Journal of Pain and Symptom Management",

issn = "0885-3924",

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number = "6",

}

Unraveling Fatigue in Hemodialysis Patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method. / Brys, Astrid DH.; Stifft, Frank; Van Heugten, Caroline M. et al.
In: Journal of Pain and Symptom Management, Vol. 60, No. 6, 12.2020, p. 1100-1108.e2.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Unraveling Fatigue in Hemodialysis Patients

T2 - comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method

AU - Brys, Astrid DH.

AU - Stifft, Frank

AU - Van Heugten, Caroline M.

AU - Bossola, Maurizio

AU - Gambaro, Giovanni

AU - Lenaert, Bert

PY - 2020/12

Y1 - 2020/12

N2 - CONTEXT: Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias due to their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called 'memory-experience' gap). Experience sampling Methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data.OBJECTIVES: We investigated to what extent retrospective symptom reporting accurately represents real-time experiences of fatigue and mood in HD patients using an ESM mobile Health application (PsyMateTM).METHODS: Forty HD patients used the PsyMateTM for one week to assess real-time fatigue and mood. Additionally, they retrospectively evaluated their symptom experience completing end-of-day and end-of-week questionnaires; and the conventional Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS).RESULTS: Results of real-time observations (N=1777) showed that fatigue and mood varied between and within individuals. Retrospective end-of-week fatigue evaluation was significantly higher than the average real-time fatigue score, t(38)=3.54, p=0.001, d=0.57. FSS and HADS correlated moderately to strong with the average ESM score for fatigue and mood: r=0.66 and r=0.77, respectively.CONCLUSION: Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.

AB - CONTEXT: Fatigue is prevalent among hemodialysis (HD) patients and associated with depressive mood. To advance our understanding of its etiology and develop appropriate treatments, reliable measurement instruments are needed. However, conventional fatigue and mood questionnaires are prone to bias due to their retrospective nature and may misrepresent or overestimate actual symptom experience (i.e., the so-called 'memory-experience' gap). Experience sampling Methodology (ESM) overcomes this limitation through repeated real-time assessments in patients' natural environment, thereby providing reliable and ecologically valid data.OBJECTIVES: We investigated to what extent retrospective symptom reporting accurately represents real-time experiences of fatigue and mood in HD patients using an ESM mobile Health application (PsyMateTM).METHODS: Forty HD patients used the PsyMateTM for one week to assess real-time fatigue and mood. Additionally, they retrospectively evaluated their symptom experience completing end-of-day and end-of-week questionnaires; and the conventional Fatigue Severity Scale (FSS) and Hospital Anxiety and Depression Scale (HADS).RESULTS: Results of real-time observations (N=1777) showed that fatigue and mood varied between and within individuals. Retrospective end-of-week fatigue evaluation was significantly higher than the average real-time fatigue score, t(38)=3.54, p=0.001, d=0.57. FSS and HADS correlated moderately to strong with the average ESM score for fatigue and mood: r=0.66 and r=0.77, respectively.CONCLUSION: Retrospective fatigue assessment may lead to overestimation of real-time symptom experience. ESM provides detailed insight and personalized information about symptom experiences which may be crucial for the design of more targeted and personalized interventions for fatigue and mood problems in HD patients.

KW - mHealth

KW - ESM

KW - measurement instrument

KW - fatigue

KW - depressive symptoms

KW - hemodialysis

KW - HOSPITAL ANXIETY

KW - DEPRESSION

KW - MEMORY

KW - ASSOCIATION

KW - DIALYSIS

KW - PATTERNS

KW - RECALL

KW - SCALE

U2 - 10.1016/j.jpainsymman.2020.06.042

DO - 10.1016/j.jpainsymman.2020.06.042

M3 - Article

C2 - 32645453

SN - 0885-3924

VL - 60

SP - 1100-1108.e2

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

IS - 6

ER -

Unraveling Fatigue in Hemodialysis Patients: comparing retrospective reports to real-time assessments with an mHealth Experienced Sampling Method

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Keywords

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