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Identification of symptom clusters and their synergistic effects on quality of life in rheumatoid arthritis patients
Author(s) -
Oh HyunSoo,
Park JiSuk,
Seo WhaSook
Publication year - 2019
Publication title -
international journal of nursing practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.62
H-Index - 55
eISSN - 1440-172X
pISSN - 1322-7114
DOI - 10.1111/ijn.12713
Subject(s) - rheumatoid arthritis , identification (biology) , quality of life (healthcare) , medicine , quality (philosophy) , physical therapy , biology , nursing , philosophy , botany , epistemology
Aims To examine the presence of symptom clusters and synergistic effects of symptom clusters on quality of life in rheumatoid arthritis patients. Background Rheumatoid arthritis patients frequently experience multiple concurrent symptoms of pain, fatigue, and depression. Design A nonexperimental, cross‐sectional correlation design. Methods The study participants were 179 rheumatoid arthritis patients. Data were collected between August and December 2016. A hypothetical model was developed based on the Theory of Unpleasant Symptoms Model: physiological antecedents included disease activity and obesity; symptoms of pain, fatigue, and depression were hypothesized as being clustered, and quality of life was taken as the outcome variable. Results Disease activity had significant direct effects on pain, fatigue, and depression and indirect effects on fatigue and depression, whereas obesity had a significant direct effect on fatigue alone. Three symptom clusters, namely, pain fatigue, fatigue depression, and pain‐fatigue depression were identified and found to have significant synergistic effects on quality of life. Conclusions Our findings support the importance of managing clusters of symptoms simultaneously, that is, collective symptom management. Inter‐cluster dynamics between symptoms should be considered when nurses develop symptom management strategies or self‐management programs to improve the quality of life of rheumatoid arthritis patients.