Fatigue in patients with rheumatoid arthritis: British and Dutch nurses’ knowledge, attitudes and management (original) (raw)
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Clinical Rheumatology, 2008
To describe rheumatologists' knowledge, attitude and current management of fatigue in patients with rheumatoid arthritis (RA), a postal questionnaire was sent to all rheumatologists (N=204) and trainees (N=49), members of the Dutch Society of Rheumatology. The overall response rate was 44% (N =110). In general, rheumatologists' knowledge about RA-related fatigue was in accordance with the literature but they perceive a lack of their own knowledge about aetiology and evidence-based interventions to prevent and treat fatigue. The majority of the rheumatologists believe that fatigue is a multi-disciplinary diagnosis and is preferably managed by the nurse specialist (34%). Assuming that the patient will raise the issue, most of the rheumatologists pay attention to fatigue during the first consultation and less often during follow-up consultations. There is a need for knowledge about causes and treatments for RA-related fatigue to ensure that patient outcomes are improved.
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 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
BMJ Open, 2019
ObjectivePhysical activity plays an important role in the treatment of persons with rheumatoid arthritis (RA) and is the non-pharmacological intervention with the strongest evidence to reduce fatigue. However, physical activity can be challenging for persons who are fatigued. The aim of this study was to investigate factors of importance for reducing fatigue in persons with RA.DesignThis is a qualitative interview study based on semistructured, indepth individual interviews. Interviews were analysed using qualitative content analysis.ParticipantsParticipants were 12 people with RA recruited from a previous randomised controlled trial of a person-centred treatment model focusing on health-enhancing physical activity and daily balance to lessen fatigue in persons with RA.SettingInterviews were conducted in a hospital setting.ResultsThe analysis resulted in one theme: an intellectual and embodied understanding that sustainable physical activity is important to handle fatigue. This incl...
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.
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...