Chronic Fatigue Syndrome (CFS) among overseas development workers: A qualitative study

BACKGROUND: A relatively high proportion of overseas development

workers may develop chronic fatigue syndrome (CFS). A

qualitative study was conducted in order to investigate how

such people perceived their condition.

METHODS: Twelve people

who had developed CFS while working overseas with development

organizations, or shortly after visiting development projects,

were interviewed about their experiences. Their responses were

analyzed using a grounded theory approach.

RESULTS: Most of

the participants considered themselves to have been extremely

healthy before they developed CFS. The syndrome did not appear

to have been caused by depression. The symptoms which were

reported covered the range of symptoms typically found in

studies of CFS. Respondents described difficulty in receiving,

and accepting, a diagnosis. All of the participants attributed

the CFS to multiple causes, the principal causes being

overwork, stress and infections. Among the consequences of CFS

reported to be the most difficult were having to leave the

development project prematurely; pain; powerlessness; loss of

independence, and the unpredictability of CFS. Factors which

had helped respondents cope with these difficulties included

religious beliefs; comparisons with people who were worse off

than they were; thinking about positive consequences of the

condition, and talking with supportive people.


Some theories have suggested that CFS symptoms arise as a

result of depression or other emotional difficulties, which

the individual is not able to acknowledge. The results

indicated that such theories may not apply to this subgroup of

people with CFS. Further research on the etiology of CFS is

warranted. Respondents described high levels of work-related

stress as common to the experience of development work. It

might be beneficial to train development workers in stress

management techniques. Development organizations should be

encouraged to ensure that their workers take sufficient time

to rest, and attempts should be made to reduce work pressures.

Lovell DM

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