RESEARCH - Fatigue as experienced by patients with RA: a qualitative study

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Int J Nurs Stud. 2007 Jul 25

Fatigue as experienced by patients with rheumatoid arthritis (RA): A

qualitative study.

Repping-Wuts H, Uitterhoeve R, van Riel P, van Achterberg T.

Department of Rheumatology, Radboud University, Nijmegen Medical

Centre, Nijmegen, The Netherlands.

OBJECTIVE: Interest in fatigue research has grown since the finding

that fatigue is, besides pain, the symptom most frequently reported by

patients with rheumatoid arthritis (RA). The aim of this study was to

explore the experience of fatigue from the patients' perspective.

METHODS: Twenty-nine patients with RA filled-out written

questionnaires on fatigue severity, disability, quality of life and

sleep disturbance, and disease activity was calculated using the

Disease Activity Score (DAS28). All patients were individually

interviewed and asked about fatigue. Qualitative analyses were

completed using software program " The Observer " . Basic codes, a code

plan and coding rules were developed by two researchers through a

consensus-based review process. Frequencies of the central codes were

calculated by the program SPSS. RESULTS: RA fatigue is verbalised as a

physical everyday experience with a variety in duration and intensity.

Its sudden onset and exhausting nature is experienced as frustrating

and causing anger. Patients mentioned having RA as the main cause of

their fatigue. The consequences of fatigue are overwhelming and

influence patients' everyday tasks, attitudes and leisure time.

Patients described how they have to find their own management

strategies by trial and error and described pacing and rest,

relaxation and planning activities as the most appropriate

interventions. Downward comparison and acceptance as part of the

disease are also reported as successful coping strategies for fatigue.

Most patients did not discuss fatigue with clinicians explicitly,

accepting that they were told that fatigue is part of the disease and

believing that they have to manage it alone.

CONCLUSION: The results show that RA fatigue is experienced as being

different from " normal " fatigue. Patients do not expect much support

from health care professionals, assuming that they have to manage

fatigue alone as it is part of the disease. These results will help

professionals caring for RA patients to communicate about fatigue, to

explore the nature of fatigue individually and to develop tailored

interventions.

PMID: 17662291

http://www.ncbi.nlm.nih.gov/pubmed/17662291

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Not an MD