The British Journal of Rheumatology, Vol 37, 1042-1046, Copyright © 1998 by British Society for Rheumatology
RP Riemsma, JJ Rasker, E Taal, EN Griep, JM Wouters and O Wiegman
OBJECTIVE: 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. METHOD:
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. RESULTS: 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. CONCLUSIONS: 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.
ORIGINAL PAPERS
Fatigue in rheumatoid arthritis: the role of self-efficacy and problematic social support
Department of Psychology, University of Twente, Enschede, The Netherlands.
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