Identification of symptom clusters and their synergistic effects on quality of life in rheumatoid arthritis patients

Abstract

Aims To examine the presence of symptom clusters and synergistic effects of symptom clusters on quality of life in rheumatoid arthritis patients. Background Rheumatoid arthritis patients frequently experience multiple concurrent symptoms of pain, fatigue, and depression. Design A nonexperimental, cross‐sectional correlation design. Methods The study participants were 179 rheumatoid arthritis patients. Data were collected between August and December 2016. A hypothetical model was developed based on the Theory of Unpleasant Symptoms Model: physiological antecedents included disease activity and obesity; symptoms of pain, fatigue, and depression were hypothesized as being clustered, and quality of life was taken as the outcome variable. Results Disease activity had significant direct effects on pain, fatigue, and depression and indirect effects on fatigue and depression, whereas obesity had a significant direct effect on fatigue alone. Three symptom clusters, namely, pain fatigue, fatigue depression, and pain‐fatigue depression were identified and found to have significant synergistic effects on quality of life. Conclusions Our findings support the importance of managing clusters of symptoms simultaneously, that is, collective symptom management. Inter‐cluster dynamics between symptoms should be considered when nurses develop symptom management strategies or self‐management programs to improve the quality of life of rheumatoid arthritis patients.

Mapping publication status and exploring hotspots in a research field: Rheumatoid arthritis with depression

“…Previous studies mainly focused on a single symptom and only a few focused on the symptom group and its synergistic effect on RA patients. Oh, Park, and Seo (2019) studied the existence of symptom groups in patients with RA and its synergistic effect on life quality. They found that disease activity directly affected pain, fatigue and depression and indirectly influenced fatigue and depression, only while obesity had a direct impact on fatigue.…”

Factors That Influence Sleep Disturbance and the Mediating Effects of Depression on Sleep Disturbance in Patients With Rheumatoid Arthritis

“…Smith and Haythornthwaite (2004) reported that patients with little pain also had sleep disturbance and suggested depression might have a mediating effect on this relationship. Because of the clustering effect of pain and depression, as shown in previous studies (Barsevick, 2007;Oh et al, 2019), it would appear that simultaneous management of pain and depression potentially offers a more effective means of relieving sleep disturbance.…”

“…Several authors have concluded that psychoemotional factors are powerful predictors of sleep disturbance in RA (Fang et al, 2019; Oh et al, 2019; Trobojević-Stanković et al, 2014; Yu et al, 2016). Notably, Oh et al (2019) reported that RA patients with depression are 19 times more likely to have sleep disturbance. In fact, sleep disturbance is one of the many diverse symptoms of depression (Murphy & Peterson, 2015).…”

“…It is more prevalent in women than in men, and its prevalence is 0.5%–1.0% worldwide (Matcham et al, 2013; Scott et al, 2010). The most common symptoms of RA are pain, fatigue, depression, and functional disability (Oh et al, 2019). However, sleep disturbance is also a common and disturbing symptom of RA (Drewes et al, 2000).…”

Synergistic Impact of Symptom Clusters on Health-related Quality of Life in Patients With Chronic Obstructive Pulmonary Disease: a Secondary Data Analysis

“…Although patients with COPD often experience multi-dimensional symptoms, in this study we adopted the 'most-common symptom approach' to identify symptom clusters, which aimed to provide an e cient, exible, concise and more clinically de ned model [44]. Therefore, our study measured four common symptoms in COPD patients and identi ed three symptom clusters in COPD patients: dyspnoea and depression; depression and anxiety; anxiety and sleep.…”