The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis

Jette Primdahl*, Annette Hegelund, Annette Gøntha Lorenzen, Katrine Loeppenthin, Emma Dures, Bente Appel Esbensen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

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Abstract

OBJECTIVES: To identify, appraise and synthesise qualitative studies on the experience of living with rheumatoid arthritis (RA)-related fatigue.

METHODS: We conducted a qualitative metasynthesis encompassing a systematic literature search in February 2017, for studies published in the past 15 years, in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, SveMed, PsychINFO and Web of Science. To be included, the studies had to report the experience of living with fatigue among adults with RA. The analysis and synthesis followed Malterud's systematic text condensation.

RESULTS: Eight qualitative articles were included, based on 212 people with RA (69% women) and aged between 20 and 83 years old. The synthesis resulted in the overall theme 'A vicious circle of an unpredictable symptom'. In addition, the synthesis derived four subthemes: 'being alone with fatigue'; 'time as a challenge'; 'language as a tool for increased understanding' and 'strategies to manage fatigue'. Fatigue affects all areas of everyday life for people with RA. They strive to plan and prioritise, pace, relax and rest. Furthermore, they try to make use of a variety of words and metaphors to explain to other people that they experience that RA-related fatigue is different from normal tiredness. Despite this, people with RA-related fatigue experience feeling alone with their symptom and they develop their own strategies to manage fatigue in their everyday life.

CONCLUSIONS: The unpredictability of RA-related fatigue is dominant, pervasive and is experienced as a vicious circle, which can be described in relation to its physical, cognitive, emotional and social impact. It is important for health professionals to acknowledge and address the impact of fatigue on the patients' everyday lives. Support from health professionals to manage fatigue and develop strategies to increase physical activity and maintain work is important for people with RA-related fatigue.

Original languageEnglish
Article numbere024338
JournalBMJ Open
Volume9
Issue number3
Number of pages8
ISSN2044-6055
DOIs
Publication statusPublished - 20. Mar 2019

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Primdahl, J., Hegelund, A., Lorenzen, A. G., Loeppenthin, K., Dures, E., & Appel Esbensen, B. (2019). The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis. BMJ Open, 9(3), [e024338]. https://doi.org/10.1136/bmjopen-2018-024338
Primdahl, Jette ; Hegelund, Annette ; Lorenzen, Annette Gøntha ; Loeppenthin, Katrine ; Dures, Emma ; Appel Esbensen, Bente. / The Experience of people with rheumatoid arthritis living with fatigue : a qualitative metasynthesis. In: BMJ Open. 2019 ; Vol. 9, No. 3.
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title = "The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis",
abstract = "OBJECTIVES: To identify, appraise and synthesise qualitative studies on the experience of living with rheumatoid arthritis (RA)-related fatigue.METHODS: We conducted a qualitative metasynthesis encompassing a systematic literature search in February 2017, for studies published in the past 15 years, in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, SveMed, PsychINFO and Web of Science. To be included, the studies had to report the experience of living with fatigue among adults with RA. The analysis and synthesis followed Malterud's systematic text condensation.RESULTS: Eight qualitative articles were included, based on 212 people with RA (69{\%} women) and aged between 20 and 83 years old. The synthesis resulted in the overall theme 'A vicious circle of an unpredictable symptom'. In addition, the synthesis derived four subthemes: 'being alone with fatigue'; 'time as a challenge'; 'language as a tool for increased understanding' and 'strategies to manage fatigue'. Fatigue affects all areas of everyday life for people with RA. They strive to plan and prioritise, pace, relax and rest. Furthermore, they try to make use of a variety of words and metaphors to explain to other people that they experience that RA-related fatigue is different from normal tiredness. Despite this, people with RA-related fatigue experience feeling alone with their symptom and they develop their own strategies to manage fatigue in their everyday life.CONCLUSIONS: The unpredictability of RA-related fatigue is dominant, pervasive and is experienced as a vicious circle, which can be described in relation to its physical, cognitive, emotional and social impact. It is important for health professionals to acknowledge and address the impact of fatigue on the patients' everyday lives. Support from health professionals to manage fatigue and develop strategies to increase physical activity and maintain work is important for people with RA-related fatigue.",
author = "Jette Primdahl and Annette Hegelund and Lorenzen, {Annette G{\o}ntha} and Katrine Loeppenthin and Emma Dures and {Appel Esbensen}, Bente",
note = "{\circledC} Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.",
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Primdahl, J, Hegelund, A, Lorenzen, AG, Loeppenthin, K, Dures, E & Appel Esbensen, B 2019, 'The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis', BMJ Open, vol. 9, no. 3, e024338. https://doi.org/10.1136/bmjopen-2018-024338

The Experience of people with rheumatoid arthritis living with fatigue : a qualitative metasynthesis. / Primdahl, Jette; Hegelund, Annette; Lorenzen, Annette Gøntha; Loeppenthin, Katrine; Dures, Emma; Appel Esbensen, Bente.

In: BMJ Open, Vol. 9, No. 3, e024338, 20.03.2019.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - The Experience of people with rheumatoid arthritis living with fatigue

T2 - a qualitative metasynthesis

AU - Primdahl, Jette

AU - Hegelund, Annette

AU - Lorenzen, Annette Gøntha

AU - Loeppenthin, Katrine

AU - Dures, Emma

AU - Appel Esbensen, Bente

N1 - © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

PY - 2019/3/20

Y1 - 2019/3/20

N2 - OBJECTIVES: To identify, appraise and synthesise qualitative studies on the experience of living with rheumatoid arthritis (RA)-related fatigue.METHODS: We conducted a qualitative metasynthesis encompassing a systematic literature search in February 2017, for studies published in the past 15 years, in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, SveMed, PsychINFO and Web of Science. To be included, the studies had to report the experience of living with fatigue among adults with RA. The analysis and synthesis followed Malterud's systematic text condensation.RESULTS: Eight qualitative articles were included, based on 212 people with RA (69% women) and aged between 20 and 83 years old. The synthesis resulted in the overall theme 'A vicious circle of an unpredictable symptom'. In addition, the synthesis derived four subthemes: 'being alone with fatigue'; 'time as a challenge'; 'language as a tool for increased understanding' and 'strategies to manage fatigue'. Fatigue affects all areas of everyday life for people with RA. They strive to plan and prioritise, pace, relax and rest. Furthermore, they try to make use of a variety of words and metaphors to explain to other people that they experience that RA-related fatigue is different from normal tiredness. Despite this, people with RA-related fatigue experience feeling alone with their symptom and they develop their own strategies to manage fatigue in their everyday life.CONCLUSIONS: The unpredictability of RA-related fatigue is dominant, pervasive and is experienced as a vicious circle, which can be described in relation to its physical, cognitive, emotional and social impact. It is important for health professionals to acknowledge and address the impact of fatigue on the patients' everyday lives. Support from health professionals to manage fatigue and develop strategies to increase physical activity and maintain work is important for people with RA-related fatigue.

AB - OBJECTIVES: To identify, appraise and synthesise qualitative studies on the experience of living with rheumatoid arthritis (RA)-related fatigue.METHODS: We conducted a qualitative metasynthesis encompassing a systematic literature search in February 2017, for studies published in the past 15 years, in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, SveMed, PsychINFO and Web of Science. To be included, the studies had to report the experience of living with fatigue among adults with RA. The analysis and synthesis followed Malterud's systematic text condensation.RESULTS: Eight qualitative articles were included, based on 212 people with RA (69% women) and aged between 20 and 83 years old. The synthesis resulted in the overall theme 'A vicious circle of an unpredictable symptom'. In addition, the synthesis derived four subthemes: 'being alone with fatigue'; 'time as a challenge'; 'language as a tool for increased understanding' and 'strategies to manage fatigue'. Fatigue affects all areas of everyday life for people with RA. They strive to plan and prioritise, pace, relax and rest. Furthermore, they try to make use of a variety of words and metaphors to explain to other people that they experience that RA-related fatigue is different from normal tiredness. Despite this, people with RA-related fatigue experience feeling alone with their symptom and they develop their own strategies to manage fatigue in their everyday life.CONCLUSIONS: The unpredictability of RA-related fatigue is dominant, pervasive and is experienced as a vicious circle, which can be described in relation to its physical, cognitive, emotional and social impact. It is important for health professionals to acknowledge and address the impact of fatigue on the patients' everyday lives. Support from health professionals to manage fatigue and develop strategies to increase physical activity and maintain work is important for people with RA-related fatigue.

U2 - 10.1136/bmjopen-2018-024338

DO - 10.1136/bmjopen-2018-024338

M3 - Journal article

C2 - 30898808

VL - 9

JO - B M J Open

JF - B M J Open

SN - 2044-6055

IS - 3

M1 - e024338

ER -