Riemsma R P, Rasker J J, Taal E, Griep E N, Wouters J M, Wiegman O
Department of Psychology, University of Twente, Enschede, The Netherlands.
Br J Rheumatol. 1998 Oct;37(10):1042-6. doi: 10.1093/rheumatology/37.10.1042.
To examine the relationship of fatigue in people with rheumatoid arthritis (RA) with self-efficacy, positive and problematic aspects of social support, and demographic and disease-related variables.
Out-patients with at least 5 yr RA were studied. Fatigue was measured with a visual analogue scale. Other variables included were: positive social support [Social Support List-Interactions (SSL12-I)] and problematic social support; self-efficacy towards coping with RA and towards mobilizing support; health status (Dutch-AIMS2); and laboratory tests: erythrocyte sedimentation rate (ESR), haemoglobin (Hb) and rheumatoid factor (RF); and disease duration.
A total of 229 out-patients were included. Fatigue correlated with all scales of the Dutch-AIMS2: with pain, physical function and affect (P < 0.001). There was no significant correlation with social support, but there was a highly significant correlation of fatigue with problematic social support (P < 0.001). Both forms of self-efficacy correlated strongly with fatigue: patients with high self-efficacy expectations towards coping with RA, and towards mobilizing the social network (P < 0.001), had less fatigue. In the regression analysis to explain the variation in fatigue, only pain, self-efficacy expectations towards coping with RA, and towards asking for help and problematic social support remained significant.
Fatigue can to a large extent (37%) be explained by pain, self-efficacy towards coping with RA, and towards asking for help and problematic social support. It is known that self-efficacy can be enhanced by self-management courses and it may thus be possible to improve fatigue.
探讨类风湿关节炎（RA）患者疲劳与自我效能、社会支持的积极和问题方面以及人口统计学和疾病相关变量之间的关系。
对至少患RA 5年的门诊患者进行研究。采用视觉模拟量表测量疲劳程度。其他纳入变量包括：积极社会支持[社会支持清单-互动（SSL12-I）]和问题性社会支持；应对RA及调动支持的自我效能；健康状况（荷兰版AIMS2）；实验室检查：红细胞沉降率（ESR）、血红蛋白（Hb）和类风湿因子（RF）；以及疾病持续时间。
共纳入229名门诊患者。疲劳与荷兰版AIMS2的所有量表均相关：与疼痛、身体功能和情感相关（P<0.001）。与社会支持无显著相关性，但疲劳与问题性社会支持高度相关（P<0.001）。两种形式的自我效能均与疲劳密切相关：对应对RA及调动社交网络有高自我效能期望的患者（P<0.001）疲劳程度较低。在解释疲劳变化的回归分析中，只有疼痛、应对RA的自我效能期望、寻求帮助和问题性社会支持仍然显著。
疲劳在很大程度上（37%）可由疼痛、应对RA的自我效能、寻求帮助和问题性社会支持来解释。已知自我管理课程可提高自我效能，因此有可能改善疲劳状况。
