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Chronic fatigue syndrome in nursing practice: a concept analysis
Yazhuo Gao1, Qianyin Zhu2, Min Xu3
1School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
BMC Nursing
|May 15, 2026
Summary
Nurses need a framework for chronic fatigue syndrome (CFS) management. This study identified five core CFS features and proposed a nursing framework to guide assessment and interventions, potentially aiding conditions like long COVID.
Area of Science:
- Nursing Science
- Chronic Illness Management
- Symptomology Research
Background:
- Chronic Fatigue Syndrome (CFS) lacks a unified nursing management framework, impacting care coordination and patient advocacy.
- Inconsistent diagnostic criteria and core symptom definitions create challenges for nurses in patient identification and assessment.
- A clear theoretical model is crucial for standardizing nursing assessments, interventions, and overall care for CFS patients.
Purpose of the Study:
- To conduct a concept analysis to develop a nursing-oriented conceptual framework for Chronic Fatigue Syndrome (CFS).
- To identify core attributes, antecedents, and consequences of CFS relevant to nursing practice.
- To provide a foundation for improved nursing assessments, intervention planning, and education for CFS.
Main Methods:
- A systematic literature search and concept analysis using Walker and Avant's eight-step method.
- Inclusion of 68 studies from January 1988 to December 2025 focusing on CFS definitions, criteria, and conceptual frameworks.
- Independent screening and data extraction by two graduate students and professors to ensure analytical rigor.
Main Results:
- Five core attributes defining CFS were identified: persistent severe fatigue, post-exertional malaise (PEM), non-restorative sleep, cognitive impairment/orthostatic intolerance, and multisystem involvement.
- Identified antecedents include infections, immune dysregulation, genetics, and stress.
- Consequences encompass disability, reduced quality of life, psychological distress, social isolation, and economic burden.
Conclusions:
- A nursing-oriented conceptual framework for CFS was proposed, highlighting five core features to differentiate it from general fatigue.
- The framework supports prioritizing PEM assessment and energy management interventions, positioning nurses as key care coordinators.
- Potential applicability to post-infectious fatigue conditions like long COVID is suggested, requiring further empirical validation.
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