Impact of Fatigue on Quality of Life in Patients with Rheumatoid Arthritis

Objective: This study was performed to evaluate fatigue by multidimensional approach and to determine the impact of fatigue on the quality of life in patients with rheumatoid arthritis. Metarial and Methods: 37 patients diagnosed with rheumatoid arthritis were included in the study. Disease activity was measured using DAS28. Quality of life, fatigue, depressive symptoms and sleep disturbances were evaluated by Rheumatoid Arthritis Quality of Life questionnaire, Multidimensional Fatigue Symptom Inventory-Short Form, Zung Depression Scale and Pittsburgh Sleep Quality Index, respectively. Results: Fatigue, sleep disturbances and depressive symptoms were present in all patients, 83.4% and 32.4% of patients, respectively. Quality of life correlated significantly with fatigue, depressive symptoms and sleep disturbances. It was observed that the best predictor of quality of life was fatigue in the multiple regression analysis (beta= 0.290, p= 0.000, 95% CI 0.188-0.393) (r(2)= 0.484). For the subgroups of fatigue, the best predictor of quality of life was emotional fatigue (beta= 0.988, p= 0.000, 95% Cl 0.628-1.348) (r(2)= 0.470). Conclusion: Assessment of fatigue with the multidimensional approach provided comprehensive description of the patients who reported fatigue. The contribution of emotional fatigue to the patients' quality of life was considerably high. Fatigue, depressive symptoms and sleep disturbances, which negatively influenced the quality of life, should be considered in the assessment of the patients with rheumatoid arthritis.