Hsiao I-Yu, Livneh Hanoch, Yen Chieh-Tsung, Lu Ming-Chi, Chen Wei-Jen, Tsai Tzung-Yi
Department of Nursing, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan.
Rehabilitation Counseling Program, Portland State University, Portland, OR 97207-0751, USA.
Medicina (Kaunas). 2025 May 29;61(6):1013. doi: 10.3390/medicina61061013.
: Extant research on the relationship between fatigue and depression in people with rheumatic diseases portrays a divergent picture. While caring for persons with this medical condition, one issue that represents individual confidence in carrying out specific tasks, namely self-efficacy level, has attracted significant attention. Yet, the information regarding whether self-efficacy may pose a clue linking these two major symptoms is still unknown. The aim of this study, therefore, is to examine whether self-efficacy mediates the association between fatigue and depressive symptoms among persons with rheumatoid arthritis (RA). : A cross-sectional study of 224 females with RA from a hospital in Taiwan was conducted between January and October 2023. We then distributed anonymous self-reported questionnaires instructing participants to provide information on their demographic characteristics, levels of fatigue, self-efficacy, and depressive symptoms. The bootstrap via PROCESS macro in SPSS was executed to analyze if self-efficacy would mediate the effect of fatigue on emergence of depressive symptoms. : For those participants captured at baseline, a negative association was noted between fatigue and self-efficacy, as well as between self-efficacy and depressive symptoms. Results of the mediation analysis revealed a remarkable indirect effect of fatigue on depressive symptoms through self-efficacy, with a regression coefficient of 0.21 (95% confidence intervals: 0.06-0.37). : This work extends current understanding of the roles that fatigue and self-efficacy play in predicting depression among people with RA and further clarified the potential mediating role of self-efficacy in buffering against depressive symptomatology. Interventions that extend from the management of fatigue and further incorporate the improvement of self-efficacy sense into the stereotypical therapy should greatly mitigate the distressing symptoms for patients with RA.
关于风湿性疾病患者疲劳与抑郁之间关系的现有研究呈现出不同的情况。在照顾患有这种疾病的患者时，一个代表个体执行特定任务信心的问题，即自我效能水平，受到了极大关注。然而，关于自我效能是否可能成为连接这两种主要症状的线索的信息仍然未知。因此，本研究的目的是检验自我效能是否在类风湿关节炎（RA）患者的疲劳与抑郁症状之间起中介作用。
2023年1月至10月，对台湾一家医院的224名患有RA的女性进行了横断面研究。然后我们分发了匿名的自我报告问卷，指导参与者提供有关其人口统计学特征、疲劳水平、自我效能和抑郁症状的信息。通过SPSS中的PROCESS宏执行自抽样程序，以分析自我效能是否会介导疲劳对抑郁症状出现的影响。
对于那些在基线时被纳入的参与者，疲劳与自我效能之间以及自我效能与抑郁症状之间存在负相关。中介分析结果显示，疲劳通过自我效能对抑郁症状有显著的间接影响，回归系数为0.21（95%置信区间：0.06 - 0.37）。
这项工作扩展了我们目前对疲劳和自我效能在预测RA患者抑郁中所起作用的理解，并进一步阐明了自我效能在缓冲抑郁症状方面的潜在中介作用。从疲劳管理延伸并进一步将自我效能感的改善纳入传统治疗的干预措施，应能极大地减轻RA患者的痛苦症状。
