RESEARCH - Patients' perceptions of fatigue in RA: overwhelming, uncontrollable, ingnored

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Arthritis Rheum. 2005 Oct 15;53(5):697-702.

Patients' perceptions of fatigue in rheumatoid arthritis: overwhelming,

uncontrollable, ignored.

Hewlett S, Cockshott Z, Byron M, Kitchen K, Tipler S, Pope D, Hehir M.

University of Bristol, UK. .Hewlett@...

OBJECTIVE: Fatigue is commonly reported by patients with rheumatoid

arthritis (RA) but is rarely a treatment target. The aim of this study was

to explore the concept of fatigue as experienced by patients with RA.

METHODS: Fifteen patients with RA and fatigue (> or =7 on a 10-cm visual

analog scale) were individually interviewed and asked about the description,

cause, consequence, and management of fatigue. Transcripts were

systematically analyzed by 2 researchers independently, relevant phrases

were coded, and earlier transcripts were checked for the emerging codes. A

random sample of analyses were independently reviewed. A total of 191 codes

arising from the data were grouped into 46 categories and overarching

themes. RESULTS: Vivid descriptions reflect 2 types of fatigue: severe

weariness and dramatic overwhelming fatigue. RA fatigue is different from

normal tiredness because it is extreme, often not earned, and unresolving.

Participants described physical, cognitive, and emotional components and

attributed fatigue to inflammation, working the joints harder, and

unrefreshing sleep. Participants described far-reaching effects on physical

activities, emotions, relationships, and social and family roles.

Participants used self-management strategies but with limited success. Most

did not discuss fatigue with clinicians but when they did, they felt it was

dismissed. Participants held negative views on the management of fatigue.

CONCLUSION: The data show that RA fatigue is important, intrusive, and

overwhelming, and patients struggle to manage it alone. These data on the

complexity of fatigue experiences will help clinicians design measures,

interventions, and self-managment guidance.

PMID: 16208668

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6208668 & dopt=Abstract

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