Murphy Susan L, Whibley Daniel, Kratz Anna L, Poole Janet L, Khanna Dinesh
Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.
Geriatric Research Education and Clinical Center (GRECC), VA Ann Arbor Health Care System, Ann Arbor, Michigan, USA.
J Scleroderma Relat Disord. 2021 Jun 1;6(2):187-193. doi: 10.1177/2397198320965383. Epub 2020 Sep 20.
Although fatigue is one of the most problematic symptoms for people with systemic sclerosis, little is known about how fatigue impacts daily life over time. Such information is important when developing fatigue management interventions. This study was conducted to examine 1) if fatigue severity predicted outcomes of worse functioning (social participation, physical function), and quality of life and 2) if level of self-efficacy moderated significant relationships between fatigue and these outcomes.
Data were utilized from a clinical trial in which an online self-management intervention was tested (N = 267). Fatigue, social participation, and physical function were assessed by PROMIS measures. Quality of life was assessed by the EuroQol 5-domain instrument (EQ-5D-5L). Linear regressions were performed to examine how baseline fatigue related to functioning and quality of life outcomes 16 weeks later controlling for relevant covariates. PROMIS measures were used to measure self-efficacy in managing symptoms, daily activities, medications and treatments, emotions, and social interactions.
Fatigue at baseline significantly predicted social participation 16 weeks later; but did not predict physical functioning or quality of life. Self-efficacy variables did not moderate the association between fatigue and social participation.
Fatigue severity predicted decreased social participation in people with systemic sclerosis. Interventions targeting fatigue should include support to maintain participation of social roles and activities. The level of reported self-efficacy did not vary the strength of the association between fatigue and decline in social participation indicating that there may be other targets to treat fatigue intervention beyond self-management.
NCT02494401.
尽管疲劳是系统性硬化症患者最棘手的症状之一，但对于疲劳如何随时间影响日常生活却知之甚少。在制定疲劳管理干预措施时，此类信息至关重要。本研究旨在检验：1）疲劳严重程度是否可预测功能恶化（社会参与、身体功能）、生活质量的结果；2）自我效能水平是否调节疲劳与这些结果之间的显著关系。
数据来自一项临床试验，该试验对一种在线自我管理干预措施进行了测试（N = 267）。通过患者报告结果测量信息系统（PROMIS）量表评估疲劳、社会参与和身体功能。采用欧洲五维度健康量表（EQ - 5D - 5L）评估生活质量。进行线性回归分析，以检验在控制相关协变量的情况下，基线疲劳与16周后的功能和生活质量结果之间的关系。使用PROMIS量表测量在管理症状、日常活动、药物和治疗、情绪及社交互动方面的自我效能。
基线时的疲劳显著预测了16周后的社会参与情况；但未预测身体功能或生活质量。自我效能变量未调节疲劳与社会参与之间的关联。
疲劳严重程度可预测系统性硬化症患者社会参与度的降低。针对疲劳的干预措施应包括支持患者维持社会角色和活动的参与度。自我效能报告水平并未改变疲劳与社会参与度下降之间关联的强度，这表明除自我管理外，可能还有其他治疗疲劳干预的靶点。
NCT02494401。
