Fatigue as experienced by patients with rheumatoid arthritis (RA): A qualitative study
Section snippets
What is already known about the topic?
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Fatigue is besides pain the most disturbing symptom for patients with Rheumatoid Arthritis.
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Even in a well-controlled rheumatoid arthritis (RA) population the level of fatigue can be high.
What this paper adds
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RA related fatigue is different from fatigue as experienced before having RA.
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RA patients manage fatigue by ‘trial and errror’.
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RA patients do not communicate fatigue explicitly with health professionals.
Patients and methods
Thirty-one consecutive patients, attending the rheumatology outpatient clinic, were invited to participate in this study by telephone. Selection criteria were: diagnosis of RA, ability to speak and read the Dutch language, no previous history of a psychiatric illness, and willingness to participate in the study. Experiencing fatigue was not a criterion for inclusion. Patients completed written questionnaires at home prior to their visit to the outpatient clinic. Interviews, lasting 30–60 min,
Study population
Out of 31 patients who were contacted by phone, 30 patients agreed to participate. One patient was excluded from the study because of a psychiatric disorder, so finally 29 patients were enrolled.
Participating patients had a mean age of 59 years (range 36–80 years, S.D. 11.9); the majority were women, lived together with a partner and had an elementary or secondary education. A quarter of the respondents were retired and almost half of the group used family care. The majority of the patients had
Discussion
The results of this study show that fatigue is an unpredictable, almost daily experience for RA patients with a great impact on quality of life, while patients struggle alone to manage it. Furthermore, half of the respondents described fatigue as even more bothersome than pain. The concept of fatigue is described as physical, exhausting and frustrating, having consequences for roles, relationships, leisure time, with emotional aspects, requiring everyday adaptation. Respondents mentioned having
Acknowledgements
The authors would especially like to thank the RA patients who made this study possible and Anita van Rossum (head nurse of the clinical department of rheumatology) for the use of her facilities for this study.
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