TITLE:
Pain and fatigue in adult patients with rheumatoid arthritis: Association with body awareness, demographic, disease-related, emotional and psychosocial factors
AUTHORS:
Helena Lööf, Unn-Britt Johansson, Elisabet Welin Henriksson, Staffan Lindblad, Fredrik Saboonchi
KEYWORDS:
Pain; Fatigue; Emotional; Psychosocial; Rheumatoid Arthritis
JOURNAL NAME:
Open Journal of Nursing,
Vol.3 No.2,
June
13,
2013
ABSTRACT: Background:
Patients and clinicians report pain and fatigue as key outcome measures in rheumatoid
arthritis. Fatigue and pain are a major concern to patients. Aim: The objective
of this study was to examine fatigue and pain in adult patients with rheumatoid
arthritis (RA) and to investigate the association between pain and fatigue with
body awareness, demographic, disease-related, emotional and psychosocial factors.
Method: Data were collected from a sample of patients with RA (n = 120) recruited
from a Rheumatology clinic in a large university hospital in Stockholm, Sweden. Eligible for inclusion were patients
between 20 -80 years of age and with a confirmed diagnosis of RA. Fatigue
was measured using the Multidimensional Assessment of Fatigue (MAF) scale, while
the Visual Analogue Scale (VAS) was used to assess components of pain. A multiple
stepwise regression analysis was performed to evaluate factors related to fatigue
and pain. In the first step a univariate analysis of variance (ANOVA) was used for
all relevant independent factors. In the next step backwards stepwise regression
was applied. Result: Fatigue
was significantly associated with the Disease Activity
Score 28-joints (DAS 28) (p =
0.049), the Body Awareness Questionnaire (BAQ) (p = 0.006), the Positive Affect (PA) scale (p = 0.008) and no smoking (p = 0.021). Pain was significantly associated
with the EuroQol EQ-5D (p =
0.008) and the DAS 28 (p =
0.001). The adjusted R-square was 28.6% for fatigue and 50.0% for pain. Conclusion:
This study clearly demonstrates that fatigue and pain in patients with RA
appear to be associated with disease-related factors. Furthermore, fatigue was
related to body awareness and emotional factors, and pain was related to health
related quality of life.