Rheumatologists’ knowledge, attitude and current management of fatigue in patients with rheumatoid arthritis (RA) (original) (raw)

New insights into the experience of fatigue among patients with rheumatoid arthritis: a qualitative study

2010

Objectives Patients with rheumatoid arthritis (RA) commonly experience fatigue. The aim of this study was to gain further insight into the experience of fatigue in RA. Methods Participants were 31 outpatients with RA of Medical Spectrum Twente, Enschede, The Netherlands, with all levels of fatigue. In-depth structured interviews on the patients' experience of fatigue were conducted and analysed using a bottom-up coding scheme, meaning that answers of patients were summarised and categorised.

Fatigue in persons with rheumatoid arthritis

2015

Fatigue is a prominent symptom in persons with rheumatoid arthritis (RA) with great impact on daily life. Despite the improvement in pharmacological treatment of RA over the last decades, a large number of persons with RA experience consequences from fatigue. From a patient perspective, fatigue is established as one of the most important symptoms to address in rheumatology. The overall aim of this thesis was to search for deeper knowledge about fatigue in persons with RA of working age and to evaluate a person-centered physical therapy treatment to reduce fatigue and its consequences on daily life. Specific aims of the studies included in the thesis were: To describe how persons with RA experience and manage their fatigue in daily life. To investigate variations in fatigue levels reported by persons with RA at seven different time-points during the four seasons. To investigate how disease-related aspects contribute to the variation in general fatigue and multiple aspects of fatigue ...

The Assessment of Fatigue in Rheumatoid Arthritis Patients and Its Impact on Their Quality of Life

Clinics and Practice

Introduction: Rheumatoid arthritis (RA) is a common autoimmune illness that manifests mostly as chronic, symmetric, and progressive polyarthritis with a global frequency of 0.3–1.0%. RA is a disease that affects people all over the world. In India, the prevalence is estimated to be 0.7%, with around 10 million persons suffering from RA. Most people with rheumatoid arthritis experience fatigue on most days, with over 70% experiencing symptoms similar to chronic fatigue syndrome. Patients rate fatigue as a top priority and believe this unmanageable symptom is ignored by clinicians; a systematic review shows the biological agents for RA inflammation have only a small effect on fatigue. Fatigue predicts and reduces the quality of life, and it is as difficult to cope with as pain. Physicians have traditionally concentrated on the inflammatory aspects of the illness (e.g., synovitis), whereas RA patients have prioritized pain, exhaustion, sleep difficulties, and other quality-of-life issu...

Fatigue and factors related to fatigue in rheumatoid arthritis: a systematic review

2012

ABSTRACT Objective Patients with rheumatoid arthritis (RA) complain about fatigue. However, little is still known about causes and consequences of fatigue. A fully developed theoretical model explaining the experience of fatigue in RA is lacking. Goal of this study was to systematically review studies in RA that examined factors related to fatigue and differences in fatigue between RA patients and other patient groups, to gain more insight in possible causes and consequences of fatigue in RA.

Fatigue as experienced by patients with rheumatoid arthritis (RA): A qualitative study

International Journal of Nursing Studies, 2008

Objective: Interest in fatigue research has grown since the finding that fatigue is, besides pain, the symptom most frequently reported by patients with rheumatoid arthritis (RA). The aim of this study was to explore the experience of fatigue from the patients' perspective. Methods: Twenty-nine patients with RA filled-out written questionnaires on fatigue severity, disability, quality of life and sleep disturbance, and disease activity was calculated using the Disease Activity Score (DAS28). All patients were individually interviewed and asked about fatigue. Qualitative analyses were completed using software program ''The Observer''. Basic codes, a code plan and coding rules were developed by two researchers through a consensus-based review process. Frequencies of the central codes were calculated by the program SPSS. Results: RA fatigue is verbalised as a physical everyday experience with a variety in duration and intensity. Its sudden onset and exhausting nature is experienced as frustrating and causing anger. Patients mentioned having RA as the main cause of their fatigue. The consequences of fatigue are overwhelming and influence patients' everyday tasks, attitudes and leisure time. Patients described how they have to find their own management strategies by trial and error and described pacing and rest, relaxation and planning activities as the most appropriate interventions. Downward comparison and acceptance as part of the disease are also reported as successful coping strategies for fatigue. Most patients did not discuss fatigue with clinicians explicitly, accepting that they were told that fatigue is part of the disease and believing that they have to manage it alone. Conclusion: The results show that RA fatigue is experienced as being different from ''normal'' fatigue. Patients do not expect much support from health care professionals, assuming that they have to manage fatigue alone as it is part of the disease. These results will help professionals caring for RA patients to communicate about fatigue, to explore the nature of fatigue individually and to develop tailored interventions. r

Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study

Journal of rehabilitation medicine, 2016

To investigate the impact of disease-related aspects on long-term variations in fatigue in persons with rheumatoid arthritis. Observational longitudinal study. Sixty-five persons with rheumatoid arthritis, age range 20-65 years, were invited to a clinical examination at 4 time-points during the 4 seasons. Outcome measures were: general fatigue rated on visual analogue scale (0-100) and aspects of fatigue assessed by the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire. Disease-related variables were: disease activity (erythrocyte sedimentation rate), pain threshold (pressure algometer), physical capacity (six-minute walk test), pain (visual analogue scale (0-100)), depressive mood (Hospital Anxiety and Depression scale, depression subscale), personal factors (age, sex, body mass index) and season. Multivariable regression analysis, linear mixed effects models were applied. The strongest explanatory factors for all fatigue outcomes, when recorded at the same time-p...