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Vanterpool SG, Heidel RE, Snyder K, Keil T, Contreras C, Hartman A, Higdon R, Jeter J. Developing and Validating a Novel Tool to Enhance Functional Status Assessment: The Tennessee Functional Status Questionnaire (TFSQ). J Am Board Fam Med 2023; 36:4-14. [PMID: 36707242 DOI: 10.3122/jabfm.2022.220261r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 01/29/2023] Open
Abstract
PURPOSE Functional status is a major contributor to overall health and reflects both daily activity level (performance) and maximum attainable activity level (capacity). Existing assessment tools evaluate only 1 domain of function and do not provide insight into contributors to functional decline. We addressed these deficiencies by developing the Tennessee Functional Status Questionnaire (TFSQ), which reports activity levels in metabolic equivalents (METs) and evaluates 5 key areas: performance, capacity, activity, pain, and acute care. We validated the activity levels reported by the TFSQ against the Duke Activity Status Index (DASI). METHODS In this prospective, observational study, 120 patients completed both the TFSQ and the DASI. TFSQ-reported functional performance and capacity was correlated with DASI-calculated METs. RESULTS Pearson correlation between TFSQ-reported capacity and DASI-calculated METs was r = 0.69, P < .001. TFSQ capacity was significantly lower in patients who reported recently decreased activity, pain affecting function, or recent acute care exposure. CONCLUSIONS The TFSQ is a brief and efficient assessment of patient function, standardized to METs and validated against the DASI. Our study suggests that many patients may have the functional reserve to increase daily physical activity and that factors such as changes in activity, pain, and recent acute care interaction may lower functional capacity.
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Affiliation(s)
- Stephanie G Vanterpool
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Robert E Heidel
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Kyle Snyder
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Tara Keil
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Cecilia Contreras
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Alexa Hartman
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Rebecca Higdon
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
| | - Julie Jeter
- From the Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, TN (SGV, KS, TK, CC); Department of Surgery, University of Tennessee Graduate School of Medicine, Knoxville, TN (REH); Department of Family Medicine, University of Tennessee Graduate School of Medicine, Knoxville, TN (AH, RH, JJ)
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Oh SM, Bae WK, Choo SR, Kim HT, Kim HH, Lee SH, Jeong HS. Relationship between Changes in Fatigue and Exercise by Follow-Up Period. Korean J Fam Med 2016; 37:78-84. [PMID: 27073605 PMCID: PMC4826995 DOI: 10.4082/kjfm.2016.37.2.78] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 07/17/2015] [Accepted: 09/24/2015] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Fatigue is one of the most common presenting symptoms in primary care in Korea. In this study, we aimed to determine the effect of exercise intervention on the severity of fatigue of unknown medical cause during a period of follow-up. METHODS We used the data collected from an outpatient fatigue clinic in Seoul National University Bundang Hospital. The study was conducted from March 3, 2010 to May 31, 2014. We measured the body mass index of each patient and evaluated variables including lifestyle factors (smoking, alcohol consumption, and regular exercise), quality of sleep, anxiety, depression, stress severity, and fatigue severity using questionnaires. A total of 152 participants who completed questionnaires to determine changes in fatigue severity and the effect of exercise for each period were evaluated. We used univariate analysis to verify possible factors related to fatigue and then conducted multivariate analysis using these factors and the literature. RESULTS Of 130 patients with the complaint of chronic fatigue for over 6 months, over 90 percent reported moderate or severe fatigue on the Fatigue Severity Scale and Brief Fatigue Inventory questionnaires. The fatigue severity scores decreased and fatigue improved over time. The amount of exercise was increased in the first month, but decreased afterwards. CONCLUSION There was no significant relationship between changes in the amount of exercise and fatigue severity in each follow-up period. Randomized controlled trials and a cohort study with a more detailed exercise protocol in an outpatient setting are needed in the future.
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Affiliation(s)
- Seung Min Oh
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Kyung Bae
- Health Promotion Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Se Ryung Choo
- Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hee Tae Kim
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Ho Kim
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sang Hyun Lee
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Han Sol Jeong
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
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