Evaluation of Fatigue in Individuals with Arthritis

Year 2009, Volume: 16 Issue: 1, 1 - 10, 01.03.2009

Yrd.doç.dr. Ayla Ünsal

Abstract

Background: Complaints of fatigue are common almost all chronic illnesses, especially prevalent in pain disorders such as fibromyalgia syndrome, rheumatoid arthritis, and osteoarthritis. Objective: This study was conducted for the purpose of determining fatigue in individuals with arthritis. Method: Data had obtained from 250 arthritis patients at Physiotherapy and Immunology policlinics and clinics of Atatürk University Hospital in Turkey between May and July 2005. As the data gathering tools, a questionnaire form and Visual Analogue Scale for Fatigue (VAS-F) were used. Results: Internal consistency for VAS-F was good for arthritis individuals. Cronbach's alpha of fatigue subscale was 0.87 and energy subscale was 0.84. Statistically significant differences were found between fatigue and energy subscales and socio-demographic variables. These differences were identified between the VAS-F point averages and female, older, widowed, literate, more income, carrying on with special exercise programs. Conclusion: Fatigue levels of individuals with arthritis was found to be high. This study had determined socio-demographic variables associated with the fatigue.

Keywords

Arthritis, fatigue, Visual Analogue Scale for Fatigue, nursing, pain

Artritli Bireylerde Yorgunluğun Değerlendirilmesi

Abstract

Giriş: Yorgunluk şikayeti, neredeyse tüm kronik hastalıklarda özellikle de osteoartrit, romatoid artrit, fibromyalji gibi ağrı sorunu yaşanan hastalıklarda yaygın şekilde görülür. Amaç: Bu çalışma artritli bireylerin yorgunluk durumunu belirlemek amacı ile yapılmıştır. Yöntem: Veriler, Atatürk Üniversitesi Araştırma Hastanesi Fizik Tedavi-Rehabilitasyon ve İmmunoloji poliklinik ve kliniklerinde Mayıs-Temmuz 2005 tarihleri arasında 250 artrit hastası üzerinde toplanmıştır. Veri toplama aracı olarak soru formu ve Yorgunluk için Görsel Benzerlik Skalası kullanılmıştır. Bulgular: Artritli bireylerde Yorgunluk için Görsel Benzerlik Skalası'nın iç tutarlılığı iyi bulunmuştur. Yorgunluk alt skalasının Cronbach alfası 0.87, enerji alt skalasının ise 0.84'dür. Sosyo-demografik özellikler ile yorgunluk ve enerji alt skalası puan ortalamaları arasında istatistiksel olarak önemli farklılıklar bulunmuştur. Bu farklılıklar kadın, yaşlı, dul, okur-yazar, ekonomik durumu iyi olan ve özel egzersiz programlarına katılanlar arasında saptanmıştır. Sonuç: Artritli bireylerde yorgunluk seviyesi yüksek bulunmuştur. Bu çalışmada, sosyodemografik değişkenler ile yorgunluk arasında ilişki olduğunu belirlenmiştir.

Keywords

Artrit, yorgunluk, Yorgunluk için Görsel Benzerlik Skalası, hemşirelik, ağrı

References

• Workplace Health and Safety Queensland. Fatigue management guide. URL: http://www.deir.qld.gov. au/pdf/whs/fatigue_management2005.pdf. 12 August 2008.
• Addington AM, Gallo JJ, Ford DE, Eaton WW. Epidemiology of unexplained fatigue and major depression in the community: The Baltimore ECA Follow-up, 1981-1994. Psychological Medicine 2001;31(6):1037-1044.
• Evans EJ, Wickstrom B. Subjective fatigue and self-care in individuals with chronic illness. Medsurgical Nursing 1999;8(6):363-369.
• World Health Organization Department of Chronic Diseases and Health Promotion Chronic Respiratory Diseases and Arthritis (CRA). Chronic rheumatic conditions. URL: http://www.who.int/ chp/topics/rheumatic/en/. 14 January 2008.
• Smeltzer SC, Bare BG. Textbook of Medical-Surgical Nursing 9th edition. Philadelphia: Lippincott Company; 2000.
• Arthritis Foundation. How to cope with fatigue. URL: http://www.arthri tis.org/how-to-cope-withfatigue2.php. 10 April 2008.
• Zautra AJ, Fasman R, Parish BP, Davis MC. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2006;128(1-2):128-135.
• Wolfe F. Determinants of WOMAC function, pain and stiffness scores: evidence for the role of low back pain, symptom counts, fatigue and depression in osteoarthritis, rheumatoid arthritis and fibromyalgia. Rheumatology 1999;38:355-361.
• Jump RL, Fifield J, Tennen H, Reisine S, Giuliano AJ. History of affective disorder and the experience of fatigue in rheumatoid arthritis. Arthritis Rheumatology 2004;51(2):239-245.
• Singh G, Bennett M, Lingala B, Singh A. Significance of fatigue in patients with rheumatoid arthritis. Arthritis Research&Therapy 2003;5(3):122.
• Gulanick M, Klopp A, Galanes S, Gradishar D, et al. Nursing Care Plans Nursing Diagnosis and Intervention Fourth edition. Mosby Ltd. Şti; 1998. s.752-763.
• Belza BL. Comparison of self-reported fatigue in rheumatoid arthritis and controls. The Journal of Rheumatology 1995;22(4):639-643.
• Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Fosomoff RS. Is pain fatiguing? A structured evidence-based review. Pain Medicine 2003;4(1):51-62.
• Ruppl I, Boshuizen HC, Jacobi CE, Dinant HJ, Van den Bos GA. Impact of fatigue on health-related quality of life in rheumatoid arthritis. Arthritis and Rheumatism 2004;51(4):578-585.
• Wolfe F, Hawley DJ, Wilson K. The prevalence and meaning of fatigue in rheumatic disease. The Journal of Rheumatology 1996;23(8):1407-1417.
• Hewlett S, Hehir M, Kirwan JR. Measuring fatigue in rheumatoid arthritis: A systematic review of scales in use. Arthritis&Rheumatism(Arthritis Care&Research) 2007; 57(3):429-439.
• Repping-Wuts H, Fransen J, Achterberg TV, Bleijenberg G, Riel PV. Persistent severe fatigue in patients with rheumatoid arthritis. Journal of Clinical Nursing 2007;16(11): 377-383.
• Wolfe F. Fatigue assessments in rheumatoid arthritis: comparative performance of visual analog scales and longer fatigue questionnaires in 7760 patients. Journal of Rheumatology 2004;31(10):1896-1902.
• Belza BL, Henke CJ, Yelin EH, Epstein WV, Gilliss CL. Correlates of fatigue in older adults with rheumatoid arthritis. Nursing Research 1993;42(2):93-99.
• Stone AA, Broderick JE, Porter LS, Kaell AT. The experience of rheumatoid arthritis pain and fatigue: Examining momentary reports and correlates over one week. Arthritis Care Research 1997;10(3):185-193.
• Lee KA, Hicks G, Nino-Murcia G. Validity and reliability of a scale to assess fatigue. Psychiatry Research 1991;36(3):291-298.
• Yurtsever S, Bedük T. Hemodiyaliz hastalarında yorgunluğun değerlendirilmesi. Hemşirelikte Araştırma Geliştirme Dergisi 2003;5(2):3-12.
• Wolfe F, Michaud K, Pincus T. Preliminary evaluation of a visual analog function scale for use in rheumatoid arthritis. Journal of Rheumatology 2005;32(7):1261-1266.
• Huyser BA, Parker JC, Thoreson R, Smarr KL, Johnson JC, Hoffman R. Predictors of subjective fatigue among individuals with rheumatoid arthritis. Arthritis and Rheumatism 1998;41(12):2230-2237.
• Sale JE, Gianac M, Hawker G. The relationship between disease symptoms, life events, coping and treatment, and depression among older adults with osteoarthritis. Journal of Rheumatology 2008; 35(2):335-342.
• Machado GP, Gianac MA, Badley EM. Participation restrictions among older adults with osteoarthritis: a mediated model of physical symptoms, activity limitations, and depression. Arthritis and Rheumatism 2008;59(1):129-135.
• Haas M, Groupp E, Muench J, Kraemer D, Brummel-Smith K, Sharma R, Ganger B, Attwood M, Fairweather A. Chronic disease self-management program for low back pain in the elderly. Journal of Manipulative and Physiological Therapeutics 2005;28(4):228-237.
• Mancuso CA, Rincon M, Sayles W, Paget SA. Psychosocial variables and fatigue: a longitudinal study comparing individuals with rheumatoid arthritis and healthy controls. Journal of Rheumatology 2006;33(8):1496-1502.
• Tack BB. Fatigue in rheumatoid arthritis. Conditions, strategies, and consequences. Arthritis Care Research 1990;3(2):65-70.
• Crosby LJ. Factors which contribute to fatigue associated with rheumatoid arthritis. Journal of Advanced Nursing 1991;16(8):974-981.
• Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL. Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology 2006;45(7):885-889.
• Sokka T, Häkkinen A, Kautiainen H, Maillefert JF, Toloza S, Mørk Hansen T, Calvo-Alen J, et al. QUEST-RA Group. Physical inactivity in patients with rheumatoid arthritis: data from twenty-one countries in a cross-sectional, international study. Arthritis and Rheumatism 2008;59(1):42-50.
• About.com: Arthritis. Exercise helps fatigue associated with arthritis. URL: http://arthritis.about. com/b/2006/12/05/exercise-helps-fatigue-associated-with-arthritis. htm. 18 August 2008.
• Bourguignon C, Labyak SE, Taibi D. Investigating sleep disturbances in adults with rheumatoid arthritis. Holistic Nursing Practice 2003;17(5):241-249.