Associations between fatigue and physical capacity in people moderately affected by rheumatoid arthritis

Pettersson, Susanne; Nordgren, Birgitta; Dufour, Alyssa B.; Opava, Christina H.

doi:10.1007/s00296-018-4140-z

Cited by 15 publications

(25 citation statements)

References 46 publications

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“…Cross-sectionally, univariate associations between disability and fatigue levels were significant in all 20 studies, of which 13 reported correlations, with a median of 0.48 (range 0.38–0.61) [10, 12, 14–31]. In nine multivariate analyses, the relationship between disability and fatigue remained significant [17, 24, 26–28, 32–35], in three analyses it was no longer significant [10, 18, 29] and in one analysis, one of two multivariate associations was significant [25]. Longitudinally, disability was univariately and multivariately associated with fatigue over time [27], fatigue was associated with disability over time [36], change in physical disability and change in fatigue were correlated [37] and the improvement of fatigue after anti-TNF treatment was larger for patients with low disability [38].…”

Section: Resultsmentioning

confidence: 99%

A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review

Geenen

Dures

2019

Rheumatology

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Fatigue in RA is prevalent, intrusive and disabling. We propose a network model of fatigue encompassing multiple and mutually interacting biological, psychological and social factors. Guided by this model, we reviewed the literature to offer a comprehensive overview of factors that have been associated with fatigue in RA. Six categories of variables were found: physical functioning, psychological functioning, medical status, comorbidities and symptoms, biographical variables and miscellaneous variables. We then systematically reviewed associations between fatigue and factors commonly addressed by rheumatology health professionals. Correlations of fatigue with physical disability, poor mental well-being, pain, sleep disturbance and depression and anxiety were ∼0.50. Mostly these correlations remained significant in multivariate analyses, suggesting partly independent influences on fatigue and differences between individuals. These findings indicate the importance of research into individual-specific networks of biopsychosocial factors that maintain fatigue and tailored interventions that target the influencing factors most relevant to that person.

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Section: Resultsmentioning

confidence: 99%

A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review

Geenen

Dures

2019

Rheumatology

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“…However, significant fatigue in RA in another study was associated with self-rated poor health, pain and anxiety/depression but not physical capacity/function. 7…”

Section: Scope Of the Problemmentioning

confidence: 99%

“…2 5 6 9 16 Decreases in physical activity and stress due to a chronic disease that is life altering will impact energy in a negative way. 7 Medications such as methotrexate and even sulfasalazine can cause fatigue. 7 37 Different routes of administration or dosing of methotrexate may be helpful to reduce fatigue as a side effect.…”

Section: Scope Of the Problemmentioning

confidence: 99%

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Management of Fatigue in Rheumatoid Arthritis

Pope

2020

RMD Open

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Fatigue in rheumatoid arthritis is highly prevalent. It is correlated only weakly with disease activity but more so with pain, mood, personality features, poor sleep, obesity and comorbidities. Fatigue can be measured by many standardised questionnaires and more easily with a Visual Analogue Scale or numeric rating scale. Most patients with RA have some fatigue, and at least one in six have severe fatigue. Chronic pain and depressed mood are also common in RA patients with significant fatigue. It affects function and quality of life and is worse on average in women. Evidence-based treatment for fatigue includes treatment of underlying disease activity (with on average modest improvement of fatigue), exercise programmes and supervised self-management programmes with cognitive-behavioural therapy, mindfulness and reinforcement (such as reminders). The specific programmes for exercise and behavioural interventions are not standardised. Some medications cause fatigue such as methotrexate. More research is needed to understand fatigue and how to treat this common complex symptom in RA that can be the worst symptom for some patients.

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“…Methods: To measure feelings of shame and guilt, in patients with RA (ACR/EULAR 2010), we used the Experience of Shame Scale (ESS) [1] and the Test of Self Conscious Affect-Version 3 (TOSCA-3S) [2]. The ESS is a 25-item questionnaire that assesses the frequency of characterological, behavioral and bodily shame experiences over the past year.…”

Section: Referencesmentioning

confidence: 99%

Fri0030 feelings of Guilt and Shame in Patients With Rheumatoid Arthritis

Hiba

Fazaa

Miladi

et al. 2019

Poster Presentations

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Background:Rheumatoid arthritis (RA) is a chronic inflammatory disease which causes functional disability, pain, and joint destruction. The disease has a major impact on patient’s independence, social activities and self-image.Objectives:The aims of this study were to assess whether RA is associated with increased feelings of shame and guilt, and to examine possible correlates with socio demographic characteristics and disease activity.Methods:To measure feelings of shame and guilt, in patients with RA (ACR/EULAR 2010), we used the Experience of Shame Scale (ESS) [1] and the Test of Self Conscious Affect- Version 3 (TOSCA-3S) [2].The ESS is a 25-item questionnaire that assesses the frequency of characterological, behavioral and bodily shame experiences over the past year. Respondents rate each item on a scale ranging from 1 (not at all) to 4 (very much), with higher scores indicating greater shame.The TOSCA-3S is presented with 11 brief hypothetical scenarios followed by 3 common reactions, which reflect shame, guilt and externalization of blame. Each possible response is rated on a five-point scale from 1(not likely) to 5 (very likely). For the purpose of this study, only the shame and guilt response items were analyzed. Total scores for Shame Self-Talk and Guilt Self-Talk were calculated and compared to the scoring interpretation. A p<0.05 was considered significant.Results:A total of 40 patients with RA were included, 36 women and 4 men, with a mean age of 54.2 years old [25-75]. Nine patients (22%) were illiterate, 42.5% were professionally active and 82.5% were married. The mean disease duration was 12.8 years [3-33], 80% of patients were on prednisone at a daily posology of 7 mg [2.5-12.5], 82.5% were on csDMARDs and 27.5% on bDMARDs. The mean DAS 28 ESR and CRP were respectively 4.3 [1.6-6.9] and 3.6 [1-6.2].The mean total score of the ESS was 45.3 [27-81] with subscale means of: 19 [12-37] for characterological shame, 19 [10-30] for behavioral shame and 7.4 [4-16] for bodily shame.For the TOSCA-3S, the mean “shame self-talk Total” score was 33.8 [17-44], and the mean “guilt self-talk Total” score was 48 [37-55], which corresponds to “you often use” for men and “you use an average amount” for women, a shame and guilt self-talk.A significant correlation was found between disease activity (DAS 28 ESR) and total score of ESS, shame self-talk total score and guilt shame self-talk score (p=0.000). A significant correlation was also found between these scores and gender, age, level of education, professional activity and marital status.Conclusion:Our RA patients experienced general feelings of shame and guilt, which correlate with demographic items and disease activity. However, a case-control study with a larger population is necessary to determine whether patients with RA express more shame and guilt than their peers without RA.References:[1] Andrews B, Qian M, Valentine JD. Predicting depressive symptoms with a new measure of shame: the Experience of Shame Scale. Br J Clin Psychol 2002;41:29-42.[2] Tangney JP,...

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Associations between fatigue and physical capacity in people moderately affected by rheumatoid arthritis

Cited by 15 publications

References 46 publications

A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review

A biopsychosocial network model of fatigue in rheumatoid arthritis: a systematic review

Management of Fatigue in Rheumatoid Arthritis

Fri0030 feelings of Guilt and Shame in Patients With Rheumatoid Arthritis

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