Fatigue predicts future reduced social participation, not reduced physical function or quality of life in people with systemic sclerosis

Abstract

Objective: Although fatigue is one of the most problematic symptoms for people with systemic sclerosis, little is known about how fatigue impacts daily life over time. Such information is important when developing fatigue management interventions. This study was conducted to examine (1) if fatigue severity predicted outcomes of worse functioning (social participation, physical function), and quality of life and (2) if level of self-efficacy moderated significant relationships between fatigue and these outcomes. Methods: Data were utilized from a clinical trial in which an online self-management intervention was tested (N = 267). Fatigue, social participation, and physical function were assessed by PROMIS measures. Quality of life was assessed by the EuroQol 5-domain instrument. Linear regressions were performed to examine how baseline fatigue related to functioning and quality of life outcomes 16 weeks later controlling for relevant covariates. PROMIS measures were used to measure self-efficacy in managing symptoms, daily activities, medications and treatments, emotions, and social interactions. Results: Fatigue at baseline significantly predicted social participation 16 weeks later, but did not predict physical functioning or quality of life. Self-efficacy variables did not moderate the association between fatigue and social participation. Conclusion: Fatigue severity predicted decreased social participation in people with systemic sclerosis. Interventions targeting fatigue should include support to maintain participation of social roles and activities. The level of reported self-efficacy did not vary the strength of the association between fatigue and decline in social participation indicating that there may be other targets to treat fatigue intervention beyond self-management.

The impact of sleep quality, fatigue and social well‐being on depressive symptomatology in autistic older adolescents and young adults

“…Our third hypothesis was that fatigue, followed by social belonging and social contribution would serially mediate the relationship between sleep quality and depression at T1. However, contrary to reports of fatigue being associated with social support variables in clinical populations (Murphy, Kratz, et al, 2021; Murphy, Whibley, et al, 2021; van Markus‐Doornbosch et al, 2020) we found no significant correlation between fatigue and either social integration or social contribution. We thus explored the mediating effects of fatigue and social well‐being on the relationship between sleep quality and depression at T1 using two separate mediation models.…”

“…Both sleep quality (Cho et al, 2019; Jin et al, 2014; Kent de Grey et al, 2018) and fatigue (Murphy, Kratz, et al, 2021; Murphy, Whibley, et al, 2021; van Markus‐Doornbosch et al, 2020) are also linked with social support in non‐autistic populations. A recent meta‐analysis including 61 studies examining social support (perceived support [84% of studies], received support, social integration, or unspecified social support) and sleep showed that better social support was associated with better sleep in both clinical and non‐clinical samples (Kent de Grey et al, 2018).…”

“…It was suggested that the link between sleep and social support may be one pathway that influences mental health (Kent de Grey et al, 2018). Similarly, increased fatigue in young people with Acquired Brain Injury (ABI) has been associated with reduced home, school and community participation (van Markus‐Doornbosch et al, 2020), fatigue was strongly asociated with social functioning (Murphy, Kratz, et al, 2021) and baseline fatigue predicted reduced social functioning but not physical functioning at 16 weeks in adults with systemic sclerosis (Murphy, Whibley, et al, 2021). Thus, depression, poor sleep and fatigue are all associated with reduced social support.…”

A study on the current state and equity level of social participation ability among older adults in Henan Province, China

“…The SME results indicate that the perception ability is considered to be the most relevant factor for SPAOA. The correlation between daily life, mental state and SPAOA is relatively low, which is consistent with other studies [ 45 ]. On the other hand, both daily life and mental state have a direct impact on SPAOA.…”

Aging with Disability Symptoms and Ability to Participate in, and Satisfaction with, Social Participation among Persons Aged 45–64

“…Their study employed both a PROMIS fatigue measure and the Fatigue Performance Scale; both measures produced similar results. Murphy et al [35] reported similar findings in a fatigue management intervention study of persons with systemic sclerosis with a much smaller sample size. In that study, higher levels of fatigue and worse physical function were significantly associated with lower levels of ability to participate in social roles and activities; self-efficacy education did not moderate this relationship post-intervention.…”