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Perceptions of the Cause, Impact and Management of Persistent Fatigue in Patients with Rheumatoid Arthritis Following Tumour Necrosing Factor Inhibition Therapy
Author(s) -
Minnock Patricia,
Ringnér Anders,
Bresnihan Barry,
Veale Douglas,
FitzGerald Oliver,
McKee Gabrielle
Publication year - 2017
Publication title -
musculoskeletal care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 28
eISSN - 1557-0681
pISSN - 1478-2189
DOI - 10.1002/msc.1136
Subject(s) - medicine , rheumatoid arthritis , disease , perception , physical therapy , chronic fatigue , chronic fatigue syndrome , psychology , neuroscience
Fatigue is a major symptom of rheumatoid arthritis (RA), the most common chronic inflammatory joint disease. The present study explored patients’ experiences of RA fatigue to elucidate unique elements and management strategies. Methods This single site study recruited tumour necrosis factor‐α inhibitor (TNFi)‐treated RA patients with a moderate/good response in disease activity and persistent moderate/greater fatigue on a five‐point verbal rating scale. This qualitative descriptive design used semi‐structured questions, individual interviews and content analysis of narrative data. Results Ten patients were interviewed (six women), with age and disease duration ranges of 44–75 and 6–36 years, respectively. Perceptions of the RA fatigue experience generated four categories (experiencing a distinct, yet seldom discussed RA symptom; seeking an explanation for fatigue; being in an incapacitating state; and trying to manage) and eight subcategories. Fatigue was newly identified as a distinct part of the entity of RA. While patients proposed many plausible root causes, the only rational explanation for the nature of this fatigue was that it was integral to their RA. Singularly, fatigue contributed considerably to RA‐imposed lifestyle restrictions. Patients had learnt to accommodate and self‐manage fatigue in the absence of professional input. Novel management strategies proposed included patients talking about the nature of RA fatigue with others and the need for staff to alert patients to this distinct symptom of RA. Conclusion Fatigue, branded as a distinct symptom of RA, exerted an identifiable impact on patients. Fatigue is potentially amenable to modification; talking about fatigue was proposed as a novel management strategy. Copyright © 2016 John Wiley & Sons, Ltd.