Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Disabil Rehabil. 2024 Aug;46(17):3878-3886. doi: 10.1080/09638288.2023.2258333. Epub 2023 Sep 21.
Despite efficient biological disease-modifying antirheumatic drugs (bDMARDs) Rheumatoid Arthritis (RA) patients still suffer from high fatigue. This study aims to further our knowledge by assessing severity levels of the various fatigue dimensions and their associations with pain, sleep quality, and psychological well-being in bDMARDs treated RA patients.
The sample consisted of 146 RA patients (84.9% females; mean age 56.6 ± 13.6 years), who completed the MFI-20, SF-36, PSQI, GAD-7 and PHQ-9. Correlation analyses and multiple linear regressions were used to analyse the data.
General fatigue was the highest reported type of fatigue, followed by physical fatigue dimensions. In the final regression model, pain and disability were significantly associated with physical fatigue ( ≤ 0.001, ≤ 0.05, respectively) and reduced activity ( ≤ 0.01, ≤ 0.05, respectively). Anxiety was significantly associated with mental fatigue ( ≤ 0.05) and reduced motivation ( ≤ 0.01). Regression analyses showed no significant associations between depression, sleep quality, and fatigue in any of the final models.
Our findings indicate that effectively addressing fatigue in RA patients requires an individualized approach. This approach should acknowledge the varying degrees of fatigue across different fatigue dimensions (physical or mental), while also taking into account the patient's mental health problems, pain levels, and disability levels.
尽管生物性疾病修饰抗风湿药物（bDMARDs）治疗效果显著，类风湿关节炎（RA）患者仍深受疲劳困扰。本研究旨在通过评估不同疲劳维度的严重程度及其与 bDMARDs 治疗的 RA 患者疼痛、睡眠质量和心理健康的关联，进一步了解这一问题。
该样本包括 146 名 RA 患者（84.9%为女性；平均年龄 56.6±13.6 岁），他们完成了 MFI-20、SF-36、PSQI、GAD-7 和 PHQ-9 量表。采用相关分析和多元线性回归分析数据。
报告的最高类型疲劳是一般疲劳，其次是身体疲劳维度。在最终的回归模型中，疼痛和残疾与身体疲劳（ ≤ 0.001， ≤ 0.05）和活动减少（ ≤ 0.01， ≤ 0.05）显著相关。焦虑与精神疲劳（ ≤ 0.05）和动机降低（ ≤ 0.01）显著相关。回归分析显示，在任何最终模型中，抑郁、睡眠质量与疲劳之间均无显著关联。
我们的研究结果表明，要有效解决 RA 患者的疲劳问题，需要采取个体化的方法。这种方法应考虑到不同疲劳维度（身体或精神）的不同疲劳程度，同时还应考虑到患者的心理健康问题、疼痛程度和残疾程度。
