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Diz Osteoartritli Yaşlı Hastalarda Yorgunluğun Fonksiyonel Durum, Depresyon ve Yaşam Kalitesi ile İlişkisi

Yıl 2016, Cilt: 16 Sayı: 1, 0 - 0, 04.03.2016
https://doi.org/10.17098/amj.80790

Öz

Amaç: Bu çalışmanın amacı diz osteoartritli yaşlı hastalarda yorgunluk düzeylerini araştırmak, yorgunluğun depresyon ve radyolojik evre, fonksiyonel durum ve ağrı gibi klinik parametrelerle ilişkisini değerlendirmek ve yaşam kalitesi üzerine etkisini saptamaktı.

Materyal ve Metot: Çalışmaya diz osteoartritli, 65-80 yaşları arasında seksen hasta (60 kadın, 20 erkek) alındı. Osteoartritin radyolojik evresi, Kellgren-Lawrence evreleme skalası ile saptandı. Western Ontario ve McMasters Üniversiteleri Osteoartrit İndeksi [Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC)] fonksiyonel durumu belirlemede kullanıldı. Yorgunluk Semptom Envanteri [Fatigue Symptom Inventory (FSI)] yorgunluğu, Nottingham Sağlık Profili [Nottingham Health Profile (NHP)] yaşam kalitesini ve Beck Depresyon Skalası [Beck Depression Scale (BDS) ] ise depresyonu değerlendirmede kullanıldı. Ağrı şiddeti, Görsel Analog Skala [Visual Analog Scale (VAS)]- ağrı ile ölçüldü.

Bulgular: Hastalar günlük ağrı biçimlerinişu şekilde ifade ettiler: daha çok akşamları yorgun (%30), tam olarak yorgun değil (%21,3), daha çok sabahları yorgun (%20), sabit bir günlük ağrı biçimi yok (%17,5), daha çok öğleden sonraları yorgun (%11,3). FSI’nın yorgunluk şiddeti, yorgunluk süresi ve yaşam kalitesine etkisi alt grupları WOMAC, VAS-ağrı, BDS ve NHP’nin ağrı, enerji ve emosyonel reaksiyonlar alt grupları ile belirgin olarak koreleydi (p<0,05). NHP’nin fiziksel mobilite ve uyku alt grupları sadece yorgunluk şiddeti, yorgunluk süresi ile koreleydi (p<0,05). FSI alt grupları ile NHP’nin sosyal izolasyon alt grubu arasında istatistiksel olarak anlamlı bir korelasyon yoktu (p>0,05). Lojistik regresyon analizi; radyolojik evrelerin FSI üzerine anlamlı etkisini ortaya koydu (p<0,05).

Sonuç: Yorgunluk diz osteoartritli yaşlı hastalarda yaygındır ve ağrı, fonksiyonel durum, uyku, enerji ve emosyonel fonksiyonlar açısından kötü yaşam kalitesi ile ilişkilidir. Yorgunluk kompleks bir semptom olduğundan FSI gibi kapsamlı bir anket ile değerlendirilmelidir.

Kaynakça

  • Shelton LR. A closer look at osteoarthritis. Nurse Pract 2013;38(7):30-6.
  • Sulzbacher I. Osteoarthritis: histology and pathogenesis. Wien Med Wochenschr 2013;163(9-10):212-9.
  • Donovan KA, Jacobsen PB. The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 2010;19(2):169-185.
  • Garip Y, Eser F, Aktekin LA, Bodur H. Fatigue in rheumatoid arthritis: association with severity of pain, disease activity and functional status. Acta Reumatol Port 2011;36(4):364-9.
  • Schneeberger EE, Marengo MF, Dal Pra F, Maldonado Cocco JA, Citera G. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis.Clin Rheumatol 2015;34(3):497-501.
  • Pettersson S, Boström C, Eriksson K, Svenungsson E, Gunnarsson I, Henriksson EW. Lifestyle habits and fatigue among people with systemic lupus erythematosus and matched population controls. Lupus 2015; 4(9):955-65.
  • Lukkahatai N, Walitt B, Espina A, Gelio A, Saligan LN. Understanding the association of fatigue with other symptoms of fibromyalgia: Development of a cluster model.Arthritis Care Res (Hoboken). 2015 May 27 (doi: 10.1002/acr.22626).
  • Hewlett S, Hehir M, Kirwan JR. Measuring fatigue in rheumatoid arthritis: a systematic review of scales in use. Arthritis Rheum 2007;57:429-39.
  • Rupp I, Boshuizen HC, Jacobi CE, Dinant HJ, van den Bos GA. Impact of fatigue on health-related quality of life in rheumatoid arthritis. Arthritis Rheum. 2004;51(4):578-85.
  • Oksuz E., Malhan S., Tulunay F.C. Reliability and Validity of the Fatigue Symptom Inventory. In: Value in Health, Greece 2008;11 (6):A426 (meeting abstract).
  • Hann DM, Jacobsen PB, Azzarello LM, Martin SC, Curran SL, Fields KK, et al. Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res 1998;7(4):301-10.
  • Donovan KA, Jacobsen PB. The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 2010;19(2):169-185.
  • Kellgren JH, Lawrence JS. Radiologic assessment of osteoarthritis. Ann Rheum Dis 1957;16(4):494–502.
  • Jhun HJ, Sung NJ, Kim SY. Knee pain and its severity in elderly Koreans: prevalence, risk factors and impact on quality of life. J Korean Med Sci 2013;28(12):1807-13.
  • Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005;13(1):28-33.
  • Kucukdeveci AA, Mc Kenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psycometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 2000;23(1):31-8.
  • Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği ve güvenirliği. Psikoloji Dergisi 1989;7(23):3-13.
  • Price DD, McGrath P, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17(1):45-56.
  • Wolfe F, Hawley DJ, Wilson K. The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol 1996;23(8):1407-17.
  • 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 (Oxford) 1999;38(4):355-61.
  • Allen KD, Bosworth HB, Coffman CJ, Jeffreys AS, Oddone EZ, Yancy WS. Predictors of fatigue in patients with hip and knee osteoarthritis [abstract] Osteoarthritis and cartilage 2013;21:250.
  • Stebbings S, Herbison P, Doyle TC, Treharne GJ, Highton J. A comparison of fatigue correlates in rheumatoid arthritis and osteoarthritis: disparity in associations with disability, anxiety and sleep disturbance. Rheumatology (Oxford) 2010;49(2):361-7.
  • Zautra AJ, Fasman R, Parish BP, Davis MC. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2007;128(1-2):128-35.
  • Power JD, Badley EM, French MR, Wall AJ, Hawker GA. Fatigue in osteoarthritis: a qualitative study.BMC Musculoskelet Disord 2008;9:63.
  • Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Fosomoff RS. Is pain fatiguing? A structured evidence-based review. Pain Med 2003;4(1):51-62.

Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life

Yıl 2016, Cilt: 16 Sayı: 1, 0 - 0, 04.03.2016
https://doi.org/10.17098/amj.80790

Öz

Objectives: Aims of the present study were to investigate fatigue in the patients with knee osteoarthritis, to evaluate association of fatigue with depression and clinical parameters such as radiological grade, functional status and pain; and to determine its impact on quality of life.

Materials and Methods: Eighty patients (60 women, 20 men) with knee osteoarthritis, aged between 65 and 80 were included in the study. Radiological grade of osteoarthritis was determined by Kellgren-Lawrence grading scale. Western Ontario and McMasters UniversitiesIndex of Osteoarthritis(WOMAC) was used for assessing functional status. Fatigue Symptom Invento (FSI) was used for evaluating fatigue, Nottingham Health Profile (NHP) for quality of life, and Beck Depression Scale (BDS) for depression. Pain severity was measured by using Visual Analog Scale (VAS)-pain.

Results:  Patients reported their daily patterns of fatigue as follows:  mostly fatigued in the evenings (30%), not at all fatigued (21.3%), mostly fatigued in the mornings (20%), no consistent daily pattern of fatigue (17.5%), mostly fatigued in the afternoons (11.3%). Intensity of fatigue, duration of fatigue and interference with quality of life subgroups of FSI were found to be significantly correlated with WOMAC, VAS-pain, BDS, and pain, energy, and emotional reactions subgroups of NHP (p<0.05). Physical mobility and sleep subgroups of NHP were only correlated with intensity of fatigue and duration of fatigue (p<0.05). There was no statistically significant correlation between FSI subgroups and social isolation subgroup of NHP (p>0.05) Logistic regression analysis revealed the significant impact of radiological grades on FSI (p<0.05).

Conclusion: Fatigue is common in elderly patients with knee osteoarthritis and associated with poor quality of life regarding pain, functional status, sleep, energy and emotional functions. Since fatigue is a complex symptom; it should be assessed by using a comprehensive questionnaire such as FSI. 

Kaynakça

  • Shelton LR. A closer look at osteoarthritis. Nurse Pract 2013;38(7):30-6.
  • Sulzbacher I. Osteoarthritis: histology and pathogenesis. Wien Med Wochenschr 2013;163(9-10):212-9.
  • Donovan KA, Jacobsen PB. The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 2010;19(2):169-185.
  • Garip Y, Eser F, Aktekin LA, Bodur H. Fatigue in rheumatoid arthritis: association with severity of pain, disease activity and functional status. Acta Reumatol Port 2011;36(4):364-9.
  • Schneeberger EE, Marengo MF, Dal Pra F, Maldonado Cocco JA, Citera G. Fatigue assessment and its impact in the quality of life of patients with ankylosing spondylitis.Clin Rheumatol 2015;34(3):497-501.
  • Pettersson S, Boström C, Eriksson K, Svenungsson E, Gunnarsson I, Henriksson EW. Lifestyle habits and fatigue among people with systemic lupus erythematosus and matched population controls. Lupus 2015; 4(9):955-65.
  • Lukkahatai N, Walitt B, Espina A, Gelio A, Saligan LN. Understanding the association of fatigue with other symptoms of fibromyalgia: Development of a cluster model.Arthritis Care Res (Hoboken). 2015 May 27 (doi: 10.1002/acr.22626).
  • Hewlett S, Hehir M, Kirwan JR. Measuring fatigue in rheumatoid arthritis: a systematic review of scales in use. Arthritis Rheum 2007;57:429-39.
  • Rupp I, Boshuizen HC, Jacobi CE, Dinant HJ, van den Bos GA. Impact of fatigue on health-related quality of life in rheumatoid arthritis. Arthritis Rheum. 2004;51(4):578-85.
  • Oksuz E., Malhan S., Tulunay F.C. Reliability and Validity of the Fatigue Symptom Inventory. In: Value in Health, Greece 2008;11 (6):A426 (meeting abstract).
  • Hann DM, Jacobsen PB, Azzarello LM, Martin SC, Curran SL, Fields KK, et al. Measurement of fatigue in cancer patients: development and validation of the Fatigue Symptom Inventory. Qual Life Res 1998;7(4):301-10.
  • Donovan KA, Jacobsen PB. The Fatigue Symptom Inventory: a systematic review of its psychometric properties. Support Care Cancer 2010;19(2):169-185.
  • Kellgren JH, Lawrence JS. Radiologic assessment of osteoarthritis. Ann Rheum Dis 1957;16(4):494–502.
  • Jhun HJ, Sung NJ, Kim SY. Knee pain and its severity in elderly Koreans: prevalence, risk factors and impact on quality of life. J Korean Med Sci 2013;28(12):1807-13.
  • Tüzün EH, Eker L, Aytar A, Daşkapan A, Bayramoğlu M. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis Cartilage 2005;13(1):28-33.
  • Kucukdeveci AA, Mc Kenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psycometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res 2000;23(1):31-8.
  • Hisli N. Beck Depresyon Envanterinin üniversite öğrencileri için geçerliği ve güvenirliği. Psikoloji Dergisi 1989;7(23):3-13.
  • Price DD, McGrath P, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17(1):45-56.
  • Wolfe F, Hawley DJ, Wilson K. The prevalence and meaning of fatigue in rheumatic disease. J Rheumatol 1996;23(8):1407-17.
  • 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 (Oxford) 1999;38(4):355-61.
  • Allen KD, Bosworth HB, Coffman CJ, Jeffreys AS, Oddone EZ, Yancy WS. Predictors of fatigue in patients with hip and knee osteoarthritis [abstract] Osteoarthritis and cartilage 2013;21:250.
  • Stebbings S, Herbison P, Doyle TC, Treharne GJ, Highton J. A comparison of fatigue correlates in rheumatoid arthritis and osteoarthritis: disparity in associations with disability, anxiety and sleep disturbance. Rheumatology (Oxford) 2010;49(2):361-7.
  • Zautra AJ, Fasman R, Parish BP, Davis MC. Daily fatigue in women with osteoarthritis, rheumatoid arthritis, and fibromyalgia. Pain 2007;128(1-2):128-35.
  • Power JD, Badley EM, French MR, Wall AJ, Hawker GA. Fatigue in osteoarthritis: a qualitative study.BMC Musculoskelet Disord 2008;9:63.
  • Fishbain DA, Cole B, Cutler RB, Lewis J, Rosomoff HL, Fosomoff RS. Is pain fatiguing? A structured evidence-based review. Pain Med 2003;4(1):51-62.
Toplam 25 adet kaynakça vardır.

Ayrıntılar

Bölüm Araştırmalar
Yazarlar

Yeşim Garip

Tuba Güler

Özgül Bozkurt Tuncer Bu kişi benim

Yayımlanma Tarihi 4 Mart 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 16 Sayı: 1

Kaynak Göster

APA Garip, Y., Güler, T., & Tuncer, Ö. B. (2016). Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life. Ankara Medical Journal, 16(1). https://doi.org/10.17098/amj.80790
AMA Garip Y, Güler T, Tuncer ÖB. Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life. Ankara Med J. Mart 2016;16(1). doi:10.17098/amj.80790
Chicago Garip, Yeşim, Tuba Güler, ve Özgül Bozkurt Tuncer. “Fatigue Among Elderly Patients With Knee Osteoarthritis and Its Association With Functional Status, Depression and Quality of Life”. Ankara Medical Journal 16, sy. 1 (Mart 2016). https://doi.org/10.17098/amj.80790.
EndNote Garip Y, Güler T, Tuncer ÖB (01 Mart 2016) Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life. Ankara Medical Journal 16 1
IEEE Y. Garip, T. Güler, ve Ö. B. Tuncer, “Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life”, Ankara Med J, c. 16, sy. 1, 2016, doi: 10.17098/amj.80790.
ISNAD Garip, Yeşim vd. “Fatigue Among Elderly Patients With Knee Osteoarthritis and Its Association With Functional Status, Depression and Quality of Life”. Ankara Medical Journal 16/1 (Mart 2016). https://doi.org/10.17098/amj.80790.
JAMA Garip Y, Güler T, Tuncer ÖB. Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life. Ankara Med J. 2016;16. doi:10.17098/amj.80790.
MLA Garip, Yeşim vd. “Fatigue Among Elderly Patients With Knee Osteoarthritis and Its Association With Functional Status, Depression and Quality of Life”. Ankara Medical Journal, c. 16, sy. 1, 2016, doi:10.17098/amj.80790.
Vancouver Garip Y, Güler T, Tuncer ÖB. Fatigue Among Elderly Patients with Knee Osteoarthritis and Its Association with Functional Status, Depression and Quality of Life. Ankara Med J. 2016;16(1).