Aglan Loay, Kamal Mohammed, Mokhtar Mona, Abdelrahman Eman Kamel, Gaafar Sherine M
Rheumatology and Rehabilitation Department, Aswan University, Egypt.
Rheumatology and Rehabilitation Department Al-Azhar University, Egypt.
Curr Rheumatol Rev. 2024 Jun 28. doi: 10.2174/0115733971292438240620064231.
Clinically relevant fatigue in rheumatoid arthritis (RA) patients significantly affects their quality of life. Almost all studies have assessed fatigue in this population using non-specific scales. The present multi-centric study aimed to assess the validity, reliability, and clinical significance of the Arabic version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ).
The present cross-sectional multicentric study was conducted at Aswan, Mansoura, Port Said, and Al-Azhar University Hospitals over a 6-month duration. The study included 311 patients with RA diagnosed according to the 2010 criteria of the American College of Rheumatology. The Arabic version of BRAF-MDQ was developed to assess fatigue in these patients. All patients were subjected to careful history taking, thorough clinical assessment, and standard laboratory work-up. The obtained Arabic BRAF-MDQ was tested for construct validity, internal consistency, testretest reproducibility, and criterion validity. Construct validity was evaluated using factor analysis with the Kaiser Meyer Olkin tool of sampling adequacy and Bartlett's sphericity test. Internal consistency of subscales was assessed using Cronbach's alpha. Test-retest reproducibility was assessed after a 1-week interval using the intraclass correlation coefficient. Pearson's correlation coefficient was used to correlate numerical variables. Predictors of fatigue were identified using binary logistic regression analysis.
The present study included 311 RA patients. Construct validity assessment showed a high loading of questionnaire items within the proposed construct subscales with a KMO measure of sphericity of 0.927 and Bartlett's test of sphericity p-value < 0.001. Internal consistency assessment showed adequate Cronbach's alpha of Arabic BRAF-MDQ subscales. Total Arabic BRAFMDQ had excellent criterion validity, as indicated by the high correlations with MAFS (r=0.95, p < 0.001) and SF-36 vitality subscale (r=-0.91, p < 0.001). Clinically significant fatigue was identified in 214 patients (68.8%). Multivariate logistic regression analysis revealed age (OR (95% CI): 1.07 (1.02-1.12), p < 0.001), disease duration (OR (95% CI): 1.82 (1.43-2.33), p < 0.001), DAS28CRP (OR (95% CI): 8.62 (4.63-16.02), p < 0.001), and mHAQ (OR (95% CI): 3.85 (1.07-13.9), p = 0 .039) as significant predictors of fatigue development in the studied patients.
The Arabic version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire is a valid, consistent, and reliable tool for the assessment of fatigue in Egyptian rheumatoid arthritis patients. Clinically significant fatigue was identified in 214 patients (68.8%). Further, risk factors for fatigue included older age, longer disease duration, and higher disease activity.
类风湿关节炎（RA）患者临床上相关的疲劳会显著影响其生活质量。几乎所有研究都使用非特异性量表评估该人群的疲劳情况。本多中心研究旨在评估阿拉伯语版布里斯托尔类风湿关节炎疲劳多维问卷（BRAF-MDQ）的有效性、可靠性和临床意义。
本横断面多中心研究在阿斯旺、曼苏拉、塞得港和爱资哈尔大学医院进行，为期6个月。研究纳入了311例根据2010年美国风湿病学会标准诊断的RA患者。开发阿拉伯语版BRAF-MDQ以评估这些患者的疲劳情况。所有患者均接受详细的病史采集、全面的临床评估和标准实验室检查。对获得的阿拉伯语BRAF-MDQ进行结构效度、内部一致性、重测信度和效标效度测试。使用Kaiser Meyer Olkin抽样适当性工具和Bartlett球形检验通过因子分析评估结构效度。使用Cronbach's alpha评估分量表的内部一致性。使用组内相关系数在间隔1周后评估重测信度。使用Pearson相关系数关联数值变量。使用二元逻辑回归分析确定疲劳的预测因素。
本研究纳入了311例RA患者。结构效度评估显示问卷项目在所提出的结构分量表中有较高的载荷，球形度的KMO测量值为0.927，Bartlett球形检验p值<0.001。内部一致性评估显示阿拉伯语BRAF-MDQ分量表的Cronbach's alpha适当。总的阿拉伯语BRAF-MDQ具有出色的效标效度，与MAFS（r = 0.95，p < 0.001）和SF-36活力分量表（r = -0.91，p < 0.001）高度相关表明了这一点。在214例患者（68.8%）中发现有临床意义的疲劳。多因素逻辑回归分析显示年龄（OR（95%CI）：1.07（1.02 - 1.12），p < 0.001）、病程（OR（95%CI）：1.82（1.43 - 2.33），p < 0.001）、DAS28CRP（OR（95%CI）：8.62（4.63 - 16.02），p < 0.001）和mHAQ（OR（95%CI）：3.85（1.07 - 13.9），p = 0.039）是所研究患者疲劳发生的显著预测因素。
阿拉伯语版布里斯托尔类风湿关节炎疲劳多维问卷是评估埃及类风湿关节炎患者疲劳情况的有效、一致且可靠的工具。在214例患者（68.8%）中发现有临床意义的疲劳。此外，疲劳的危险因素包括年龄较大、病程较长和疾病活动度较高。
