Session Title: Clinical Practice/Patient Care
Session Type: Abstract Submissions (ARHP)
Background/Purpose: Patient´s with Rheumatoid arthritis highlight fatigue as a major concern, as well as pain as a priority for improvement. Previous study has found that significant fatigue occurs in up to 70 percent of patients with Rheumatoid arthritis, and 82 percent of Rheumatoid arthritis patients (who consider their disease to be “somewhat to completely controlled”) continue to report moderate to severe pain. Variables that are found to be related to fatigue are illness-related aspects, physical functioning, cognitive/emotional functioning and social environmental aspects. Pain affects quality of life, and the psychological well-being of the individual living with Rheumatoid arthritis is significantly affected by the fundamental life changes and the complexity of the disease process. Emotions have been pointed out as having a key role in the adjustment among people with Rheumatoid arthritis, and in the context of chronic pain in general. Furthermore, the tendency to focus attention on bodily sensations and internal stimuli, i.e. body awareness, has been associated with amplification of both somatic and emotional distress. Negatively toned self-focused bodily attention has been linked to less effective decision making strategies and worse adherence. The purpose of this study was to examine perceptions of fatigue and pain in adult patients with Rheumatoid arthritis and to investigate association with demographic factors, disease related factors, body awareness, emotional and psychosocial factors.
Methods: Data were collected from a convenience sample of patients with Rheumatoid arthritis recruited from a Rheumatology clinic. Eligible for inclusion were patients between 20-80 years diagnosed with Rheumatoid arthritis for at least a period of six months, according to American College of Rheumatology criteria for Rheumatoid arthritis. The patients filled out questionnaires, fatigue was measured by using the Multidimensional Assessment of Fatigue (MAF) scale, and the Visual Analogue Scale (VAS) was used to assess components of pain. To evaluate factors related to fatigue and pain, multiple stepwise linear regression analysis were performed. In the first step a univariate ANOVA was performed for all relevant independent factors. In the next step a backwards stepwise regression was performed. When the final model was found, the model assumptions was evaluated based on the residual diagnosis.
Results: 120 patients with Rheumatoid arthritis participated in the study (female 86%, < 45 years 22.5%, 46-65 years 42.5%, > 65 years 35 %). Fatigue in Rheumatoid arthritis associate significant with no smoking, (p=0.021), disease activity, DAS 28 (p=0.049), body awareness, BAQ (p=0.006) and PANAS, positive affect (p=0.008). The pain in Rheumatoid arthritis was significantly associated with health related quality of life, EQ-5D (p=0.008) and disease activity, DAS 28 (p=0.001). The final models for fatigue and pain were considered acceptable. Adjusted R-square were 28.6 % for fatigue and 50.0 % for pain.
Conclusion: This study identifies that in patients with Rheumatoid arthritis fatigue and pain appears to be associated with disease related factors. Furthermore, fatigue was related to body awareness and emotional factors.
E. Welin Henriksson,
U. B. Johansson,
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/pain-and-fatigue-in-adult-patients-with-rheumatoid-arthritis-associations-with-demographic-factors-disease-related-factors-body-awareness-emotional-and-psychosocial-factors/