Department of Kinesiology and Community Health, University of Illinois, Urbana, IL 61801, USA.
Psychosom Med. 2010 Jan;72(1):88-96. doi: 10.1097/PSY.0b013e3181c68157. Epub 2009 Nov 30.
To examine the role of self-efficacy and depression as potential pathways from physical activity to fatigue in two study samples: breast cancer survivors (BCS) (n = 192) and individuals with multiple sclerosis (MS) (n = 292).
We hypothesized that physical activity would be associated indirectly with fatigue through its influence on self-efficacy and depressive symptomatology. A cross-sectional path analysis (BCS) and a longitudinal panel model (MS) were conducted within a covariance modeling framework.
Physical activity had a direct effect on self-efficacy and, in turn, self-efficacy had both a direct effect on fatigue and an indirect effect through depressive symptomatology in both samples. In the MS sample, physical activity also had a direct effect on fatigue. All model fit indices were excellent. These associations remained significant when controlling for demographics and health status indicators.
Our findings suggest support for at least one set of psychosocial pathways from physical activity to fatigue, an important concern in chronic disease. Subsequent work might replicate such associations in other diseased populations and attempt to determine whether model relations change with physical activity interventions, and the extent to which other known correlates of fatigue, such as impaired sleep and inflammation, can be incorporated into this model.
在两个研究样本（乳腺癌幸存者[BCS]，n=192；多发性硬化症患者[MS]，n=292）中，考察自我效能感和抑郁作为身体活动与疲劳之间潜在中介的作用。
我们假设，身体活动会通过对自我效能感和抑郁症状的影响，间接影响疲劳。在协方差建模框架内进行了横断面路径分析（BCS）和纵向面板模型（MS）。
在两个样本中，身体活动对自我效能感均具有直接影响，而自我效能感又对疲劳具有直接影响，并且通过抑郁症状对疲劳具有间接影响。在 MS 样本中，身体活动也对疲劳具有直接影响。所有模型拟合指标均非常出色。当控制人口统计学和健康状况指标时，这些关联仍然具有统计学意义。
我们的研究结果表明，身体活动与疲劳之间至少存在一组心理社会途径，这是慢性病的一个重要关注点。后续研究可以在其他患病人群中复制这些关联，并尝试确定模型关系是否会随着身体活动干预而发生变化，以及睡眠障碍和炎症等其他已知疲劳相关因素在多大程度上可以纳入该模型。
