Patients' perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored
Patients' perceptions of fatigue in rheumatoid arthritis: Overwhelming, uncontrollable, ignored
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DOI：
10.1002/art.21450
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发表时间：
2005-10-15
期刊：
影响因子：
--
通讯作者：
Hehir, M
中科院分区：
文献类型：
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作者：
Hewlett, S;Cockshott, Z;Hehir, M
objective.疲劳是类风湿性关节炎（RA）患者的常见症状，但很少作为治疗目标。本研究的目的是探讨RA患者所经历的疲劳的概念。15例RA和疲劳（>= 7在10厘米的视觉模拟量表）进行了单独采访，并询问有关描述，原因，后果和管理的疲劳。由两名研究人员独立地对转录本进行系统分析，对相关短语进行编码，并检查早期转录本中出现的代码。对分析的随机样本进行了独立审查。从数据中产生的191个代码被分为46个类别和总体主题。生动的描述反映了两种类型的疲劳：严重的疲劳和戏剧性的压倒性疲劳。类风湿性关节炎疲劳不同于正常的疲劳，因为它是极端的，通常不是应得的，并且无法解决。参与者描述了身体、认知和情感的组成部分，并将疲劳归因于炎症、关节工作更辛苦和睡眠不清新。参与者描述了对身体活动，情感，关系以及社会和家庭角色的深远影响。参与者使用自我管理策略，但成功有限。大多数人没有与临床医生讨论疲劳，但当他们这样做时，他们觉得这是被驳回的。参与者对疲劳的管理持否定态度。数据显示，RA疲劳是重要的，侵入性的，压倒性的，患者很难独自管理它。这些关于疲劳体验复杂性的数据将有助于临床医生设计措施，干预措施和自我管理指导。
Objective. Fatigue is commonly reported by patients with rheumatoid arthritis (RA) but is rarely a treatment target. The aim of this study was to explore the concept of fatigue as experienced by patients with RA.Methods. Fifteen patients with RA and fatigue (>= 7 on a 10-cm visual analog scale) were individually interviewed and asked about the description, cause, consequence, and management of fatigue. Transcripts were systematically analyzed by 2 researchers independently, relevant phrases were coded, and earlier transcripts were checked for the emerging codes. A random sample of analyses were independently reviewed. A total of 191 codes arising from the data were grouped into 46 categories and overarching themes.Results. Vivid descriptions reflect 2 types of fatigue: severe weariness and dramatic overwhelming fatigue. RA fatigue is different from normal tiredness because it is extreme, often not earned, and unresolving. Participants described physical, cognitive, and emotional components and attributed fatigue to inflammation, working the joints harder, and unrefreshing sleep. Participants described far-reaching effects on physical activities, emotions, relationships, and social and family roles. Participants used self-management strategies but with limited success. Most did not discuss fatigue with clinicians but when they did, they felt it was dismissed. Participants held negative views on the management of fatigue.Conclusion. The data show that RA fatigue is important, intrusive, and overwhelming, and patients struggle to manage it alone. These data on the complexity of fatigue experiences will help clinicians design measures, interventions, and self-managment guidance.