Fatigue in RA: the role of self-efficacy and problematic social support

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Fatigue in rheumatoid arthritis: the role of self-efficacy and problematicsocial supportAuthors: Riemsma R.1; Rasker J.1; Taal E.1; Griep E.3; Wouters J.4; WiegmanO.1Source: Rheumatology, October 1998, vol. 37, no. 10, pp. 1042-1046(5)Publisher: Oxford University PressAbstract:Objective: To examine the relationship of fatigue in people with rheumatoidarthritis (RA) with self-efficacy, positive and problematic aspects ofsocial support, and demographic and disease-related variables.Method: Out-patients with at least 5 yr RA were studied. Fatigue wasmeasured with a visual analogue scale. Other variables included were:positive social support [social Support List-Interactions (SSL12-I)] andproblematic social support; self-efficacy towards coping with RA and towardsmobilizing support; health status (Dutch-AIMS2); and laboratory tests:erythrocyte sedimentation rate (ESR), haemoglobin (Hb) and rheumatoid factor(RF); and disease duration.Results: A total of 229 out-patients were included. Fatigue correlated withall scales of the Dutch-AIMS2: with pain, physical function and affect (P<0.001). There was no significant correlation with social support, but therewas a highly significant correlation of fatigue with problematic socialsupport (P <0.001). Both forms of self-efficacy correlated strongly withfatigue: patients with high self-efficacy expectations towards coping withRA, and towards mobilizing the social network (P <0.001), had less fatigue.In the regression analysis to explain the variation in fatigue, only pain,self-efficacy expectations towards coping with RA, and towards asking forhelp and problematic social support remained significant.Conclusions: Fatigue can to a large extent (37%) be explained by pain,self-efficacy towards coping with RA, and towards asking for help andproblematic social support. It is known that self-efficacy can be enhancedby self-management courses and it may thus be possible to improve fatigue.http://www.ingentaconnect.com/content/oup/brheum/1998/00000037/00000010/art01042