Measuring Fatigue in Rheumatoid Arthritis' Patients with the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and the Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS): A Cross-Sectional Study

Suade Özlem Badak

doi:10.20515/otd.1027678

Research Article

Measuring Fatigue in Rheumatoid Arthritis' Patients with the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and the Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS): A Cross-Sectional Study

Year 2022, Volume: 44 Issue: 3, 353 - 359, 14.03.2022

Suade Özlem Badak

https://doi.org/10.20515/otd.1027678

Abstract

Fatigue is a common problem in Rheumatoid Arthritis (RA) and many factors are responsible for its etiology. The aim of this cross-sectional study was to investigate the current status of fatigue and to evaluate the factors related to fatigue by using the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS) developed specifically for RA in patients with RA. 64 patients with RA were included in the study. The Disease Activity Score (DAS28-CRP) of 28 joints was used to assess disease activity, and the Health Assessment Questionnaire (HAQ) was used to assess functional status. In addition, BRAF-MDQ and BRAF-NRS scales were used to assess fatigue, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were used to screen for psychiatric symptoms. All correlations between BRAF-MDQ, BRAF-NRS scales and DAS28-CRP, BAI, BDI were statistically significant (p<0.05, each other). BRAF-MDQ, BRAF-NRS scales were found to be unrelated to age, seropositivity, and drugs used. Considering the effect of disease activity, HAQ, anxiety and depressive symptoms on the BRAF-MDQ total, it was associated only with BAI (p<0.001, 95% CI 0.593-1.768). In this study, we showed the contribution of anxiety and depressive symptoms to fatigue as well as disease activity. We consider that effective interventions focusing on these symptoms can improve fatigue and reduce the burden of chronic disease.

Keywords

Anxiety, BRAF-MDQ, BRAF-NRS, Depression, Rheumatoid Arthritis

References

1. Hewlett S, Choy E, Kirwan J. Furthering Our Understanding Of Fatigue İn Rheumatoid Arthritis. J Rheumatol. 2012 Sep;39(9):1775-7. Doi: 10.3899/Jrheum.120724.
2. Overman CL, Kool MB, Da Silva JA, Geenen R. The Prevalence Of Severe Fatigue İn Rheumatic Diseases: An İnternational Study. Clin Rheumatol. 2016 Feb;35(2):409-15. Doi: 10.1007/S10067-015-3035-6.
3. Oude Voshaar MA, Ten Klooster PM, et al. Assessment Of Fatigue İn Rheumatoid Arthritis: A Psychometric Comparison Of Single-İtem, Multiitem, And Multidimensional Measures. J Rheumatol. 2015 Mar;42(3):413-20. Doi: 10.3899/Jrheum.140389.
4. Katz P. Causes And Consequences Of Fatigue İn Rheumatoid Arthritis. Curr Opin Rheumatol. 2017 May;29(3):269-276.
5. Pope JE. Management Of Fatigue İn Rheumatoid Arthritis. RMD Open. 2020 May;6(1):E001084. Doi: 10.1136/Rmdopen-2019-001084.
6. Hewlett S, Hehir M, Kirwan JR. Measuring Fatigue İn Rheumatoid Arthritis: A Systematic Review Of Scales İn Use. Arthritis Rheum. 2007 Apr 15;57(3):429-39. Doi: 10.1002/Art.22611.
7. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 Revised Criteria For The Classification Of Rheumatoid Arthritis. Arthritis Rheum. 1988 Mar;31(3):315-24. Doi: 10.1002/Art.1780310302.
8. Nicklin J, Cramp F, Kirwan J, et al. Measuring Fatigue İn Rheumatoid Arthritis: A Cross-Sectional Study To Evaluate The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Visual Analog Scales, And Numerical Rating Scales. Arthritis Care Res (Hoboken). 2010 Nov;62(11):1559-68. Doi: 10.1002/Acr.20282.
9. Hewlett S, Dures E, Almeida C. Measures of fatigue: BRAF MDQ, BRAF NRS for severity, effect, and CFQ, CIS20R and CIS8R, FSS, Fatigue (FACIT-F), MAF, MFI, PedsQL , ProF, SF-36 VT, VAS. Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S263-86. doi: 10.1002/acr.20579. PMID: 22588750.
10. Sari F, Oskay D, Tufan A. Reliability, Validity, And Cross-Cultural Adaptation Of The Turkish Version Of The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire. Clin Rheumatol. 2018 Jun;37(6):1465-1470. Doi: 10.1007/S10067-018-4008-3.
11. Fries JF, Spitz P, Kraines RG, et al. Measurement Of Patient Outcome İn Arthritis. Arthritis Rheum. 1980; Feb;23(2):137-45. Doi: 10.1002/Art.1780230202.
12. Küçükdeveci AA, Sahin H, Ataman S, et al. Issues İn Cross-Cultural Validity: Example From The Adaptation, Reliability, And Validity Testing Of A Turkish Version Of The Stanford Health Assessment Questionnaire. Arthritis Rheum. 2004 Feb 15;51(1):14-9. Doi: 10.1002/Art.20091.
13. Steer RA, Beck AT. Beck Anxiety Inventory. In: Zalaquett CP, Wood RJ, Editors. Evaluating Stress: A Book Of Resource. Lanham: MD: Scarecrow Education; 1997;Pp. 23–40.
14. Ulusoy M, Hisli N., Erkmen H. Turkish Version Of The Beck Anxiety Inventory: Psychometric Properties. Journal Of Cognitive Psychotherapy: An International Quarterly 1998; 12.
15. Beck AT, Steer RA. Internal Consistencies Of The Original And Revised Beck Depression Inventory. J Clin Psychol. 1984 Nov;40(6):1365-7. Doi: 10.1002/1097-4679(198411)40:6<1365::Aid-Jclp2270400615>3.0.Co;2-D.
16. Hisli N. Validity And Reliability Study Of Beck Depression Inventory. Turk J Psychol. 1998;6:118–122.
17. Santos EJF, Duarte C, Da Silva JAP, et al. The İmpact Of Fatigue İn Rheumatoid Arthritis And The Challenges Of İts Assessment. Rheumatology (Oxford). 2019 Nov 1;58(Suppl 5): V3-V9. Doi:10.1093/Rheumatology/Kez351. PMID: 31435662; PMCID: PMC6827262.
18. Rupp I, Boshuizen HC, Jacobi CE, et al. Impact Of Fatigue On Health-Related Quality Of Life İn Rheumatoid Arthritis. Arthritis Rheum. 2004 Aug 15;51(4):578-85. Doi: 10.1002/Art.20539.
19. Olsen CL, Lie E, Kvien TK, et al. Predictors Of Fatigue İn Rheumatoid Arthritis Patients İn Remission Or İn A Low Disease Activity State. Arthritis Care Res (Hoboken). 2016; Jul;68(7):1043-8. Doi: 10.1002/Acr.22787.
20. Druce KL, Bhattacharya Y, Jones GT, et al. Most Patients Who Reach Disease Remission Following Anti-TNF Therapy Continue To Report Fatigue: Results From The British Society For Rheumatology Biologics Register For Rheumatoid Arthritis. Rheumatology (Oxford). 2016 Oct;55(10):1786-90. Doi:10.1093/Rheumatology/Kew241.
21. Stebbings S, Herbison P, Doyle TC, et al. Comparison Of Fatigue Correlates İn Rheumatoid Arthritis And Osteoarthritis: Disparity İn Associations With Disability, Anxiety And Sleep Disturbance. Rheumatology (Oxford). 2010 Feb;49(2):361-7. Doi: 10.1093/Rheumatology/Kep367.
22. Belza BL, Henke CJ, Yelin EH, Et al. Correlates Of Fatigue İn Older Adults With Rheumatoid Arthritis. Nurs Res 1993;42:93–9
23. Huyser BA, Parker JC, Thoreson R, Et al. Predictors Of Subjective Fatigueamong İndividuals With Rheumatoid Arthritis. Arthritis Rheum 1998;41:2230–7.
24. S. Nikolaus, C. Bode, E. Taal, M.A.et al. New İnsights İnto The Experience Of Fatigue Among Patients With Rheumatoid Arthritis: A Qualitative Study Ann Rheum Dis, 69 (2010), Pp. 895-897
25. Matcham F, Rayner L, Steer S, et al. The Prevalence Of Depression İn Rheumatoid Arthritis: A Systematic Review And Meta-Analysis. Rheumatology (Oxford). 2013 Dec;52(12):2136-48. Doi: 10.1093/Rheumatology/Ket169. Epub 2013 Sep 3.
26. Isik A, Koca SS, Ozturk A, et al. Anxiety And Depression İn Patients With Rheumatoid Arthritis. Clin Rheumatol 2007;26:872–8
27. Lok EY, Mok CC, Cheng CW, et al. Prevalence And Determinants Of Psychiatric Disorders İn Patients With Rheumatoid Arthritis. Psychosomatics 2010;51:338–E8
28. Pollard LC, Choy EH, Gonzalez J, et al. Fatigue İn Rheumatoid Arthritis Reflects Pain, Not Disease Activity, Rheumatology, 2006, Vol. 45 (Pg. 885-9)
29. Riemsma RP, Rasker JJ, Taal E, et al. Fatigue İn Rheumatoid Arthritis: The Role Of Self-Efficacy And Problematic Social Support, Br J Rheumatol, 1998, Vol. 37 (Pg. 1042-6)
30. Vandyke MM, Parker JC, Smarr KL, et al. Anxiety İn Rheumatoid Arthritis. Arthritis Rheum. 2004 Jun 15;51(3):408-12. Doi: 10.1002/Art.20474. PMID: 15188326
31. Treharne GJ, Lyons AC, Booth DA, et al. Psychological Well-Being Across 1 Year With Rheumatoid Arthritis: Coping Resources As Buffers Of Perceived Stress. Br J Health Psychol. 2007 Sep;12(Pt 3):323-45. Doi: 10.1348/135910706X109288. PMID: 17640

Romatoid Artrit Hastalarında Bristol Romatoid Artrit Yorgunluk Çok Boyutlu Anketi (BRAF-MDQ) ve Bristol Romatoid Artrit Yorgunluk Sayısal Derecelendirme Ölçeği (BRAF-NRS) ile Yorgunluğun Ölçülmesi: Kesitsel Bir Çalışma

Year 2022, Volume: 44 Issue: 3, 353 - 359, 14.03.2022

Suade Özlem Badak

https://doi.org/10.20515/otd.1027678

Abstract

Yorgunluk Romatoid Artrit'te (RA) sık görülen bir sorundur ve etiyolojisinden birçok faktör sorumludur. Bu kesitsel çalışmanın amacı, RA'lı hastalarda RA için özel olarak geliştirilen Bristol Romatoid Artrit Yorgunluk Çok Boyutlu Anketi (BRAF-MDQ) ve Bristol Romatoid Artrit Yorgunluk Sayısal Derecelendirme Ölçeği (BRAF-NRS) kullanılarak yorgunluğun mevcut durumunu araştırmak ve yorgunluk ile ilgili faktörleri değerlendirmektir. RA'lı 64 hasta çalışmaya dahil edildi. Hastalık aktivitesini değerlendirmek için 28 eklemin Hastalık Aktivite Skoru (DAS28-CRP), yorgunluğu değerlendirmek için BRAF-MDQ, BRAF-NRS ölçekleri, psikiyatrik semptomları taramak için Beck's Depresyon Envanteri (BDI), Beck's Anksiyete Envanteri (BAI), fonksiyonel durumu Değerlendirmek için Sağlık Değerlendirme Anketi (HAQ) kullanıldı. BRAF-MDQ, BRAF-NRS ölçekleri ile DAS28-CRP, BAI, BDI arasındaki tüm korelasyonlar istatistiksel olarak anlamlıydı (p<0.05, birbirİ). BRAF-MDQ, BRAF-NRS ölçeklerinin yaş, seropozitiflik ve kullanılan ilaçlarla ilişkisiz olduğu bulundu. Hastalık aktivitesi, HAQ, anksiyete ve depresif semptomların BRAF-MDQ toplamına etkisi dikkate alındığında sadece BAI ile ilişkili idi (p<0,001, %95 CI 0,593-1.768). Bu çalışmada, anksiyete ve depresif belirtilerin hastalık aktivitesinin yanı sıra yorgunluğa katkısını gösterdik. Bu semptomlara odaklanan etkili müdahalelerin yorgunluğu iyileştirebileceğini ve kronik hastalık yükünü azaltabileceğini düşünüyoruz.

Keywords

Anksiyete, bristol romatoid artrit yorgunluk çok boyutlu anketi, bristol romatoid artrit yorgunluk sayısal derecelendirme ölçeği

References

1. Hewlett S, Choy E, Kirwan J. Furthering Our Understanding Of Fatigue İn Rheumatoid Arthritis. J Rheumatol. 2012 Sep;39(9):1775-7. Doi: 10.3899/Jrheum.120724.
2. Overman CL, Kool MB, Da Silva JA, Geenen R. The Prevalence Of Severe Fatigue İn Rheumatic Diseases: An İnternational Study. Clin Rheumatol. 2016 Feb;35(2):409-15. Doi: 10.1007/S10067-015-3035-6.
3. Oude Voshaar MA, Ten Klooster PM, et al. Assessment Of Fatigue İn Rheumatoid Arthritis: A Psychometric Comparison Of Single-İtem, Multiitem, And Multidimensional Measures. J Rheumatol. 2015 Mar;42(3):413-20. Doi: 10.3899/Jrheum.140389.
4. Katz P. Causes And Consequences Of Fatigue İn Rheumatoid Arthritis. Curr Opin Rheumatol. 2017 May;29(3):269-276.
5. Pope JE. Management Of Fatigue İn Rheumatoid Arthritis. RMD Open. 2020 May;6(1):E001084. Doi: 10.1136/Rmdopen-2019-001084.
6. Hewlett S, Hehir M, Kirwan JR. Measuring Fatigue İn Rheumatoid Arthritis: A Systematic Review Of Scales İn Use. Arthritis Rheum. 2007 Apr 15;57(3):429-39. Doi: 10.1002/Art.22611.
7. Arnett FC, Edworthy SM, Bloch DA, et al. The American Rheumatism Association 1987 Revised Criteria For The Classification Of Rheumatoid Arthritis. Arthritis Rheum. 1988 Mar;31(3):315-24. Doi: 10.1002/Art.1780310302.
8. Nicklin J, Cramp F, Kirwan J, et al. Measuring Fatigue İn Rheumatoid Arthritis: A Cross-Sectional Study To Evaluate The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire, Visual Analog Scales, And Numerical Rating Scales. Arthritis Care Res (Hoboken). 2010 Nov;62(11):1559-68. Doi: 10.1002/Acr.20282.
9. Hewlett S, Dures E, Almeida C. Measures of fatigue: BRAF MDQ, BRAF NRS for severity, effect, and CFQ, CIS20R and CIS8R, FSS, Fatigue (FACIT-F), MAF, MFI, PedsQL , ProF, SF-36 VT, VAS. Arthritis Care Res (Hoboken). 2011 Nov;63 Suppl 11:S263-86. doi: 10.1002/acr.20579. PMID: 22588750.
10. Sari F, Oskay D, Tufan A. Reliability, Validity, And Cross-Cultural Adaptation Of The Turkish Version Of The Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire. Clin Rheumatol. 2018 Jun;37(6):1465-1470. Doi: 10.1007/S10067-018-4008-3.
11. Fries JF, Spitz P, Kraines RG, et al. Measurement Of Patient Outcome İn Arthritis. Arthritis Rheum. 1980; Feb;23(2):137-45. Doi: 10.1002/Art.1780230202.
12. Küçükdeveci AA, Sahin H, Ataman S, et al. Issues İn Cross-Cultural Validity: Example From The Adaptation, Reliability, And Validity Testing Of A Turkish Version Of The Stanford Health Assessment Questionnaire. Arthritis Rheum. 2004 Feb 15;51(1):14-9. Doi: 10.1002/Art.20091.
13. Steer RA, Beck AT. Beck Anxiety Inventory. In: Zalaquett CP, Wood RJ, Editors. Evaluating Stress: A Book Of Resource. Lanham: MD: Scarecrow Education; 1997;Pp. 23–40.
14. Ulusoy M, Hisli N., Erkmen H. Turkish Version Of The Beck Anxiety Inventory: Psychometric Properties. Journal Of Cognitive Psychotherapy: An International Quarterly 1998; 12.
15. Beck AT, Steer RA. Internal Consistencies Of The Original And Revised Beck Depression Inventory. J Clin Psychol. 1984 Nov;40(6):1365-7. Doi: 10.1002/1097-4679(198411)40:6<1365::Aid-Jclp2270400615>3.0.Co;2-D.
16. Hisli N. Validity And Reliability Study Of Beck Depression Inventory. Turk J Psychol. 1998;6:118–122.
17. Santos EJF, Duarte C, Da Silva JAP, et al. The İmpact Of Fatigue İn Rheumatoid Arthritis And The Challenges Of İts Assessment. Rheumatology (Oxford). 2019 Nov 1;58(Suppl 5): V3-V9. Doi:10.1093/Rheumatology/Kez351. PMID: 31435662; PMCID: PMC6827262.
18. Rupp I, Boshuizen HC, Jacobi CE, et al. Impact Of Fatigue On Health-Related Quality Of Life İn Rheumatoid Arthritis. Arthritis Rheum. 2004 Aug 15;51(4):578-85. Doi: 10.1002/Art.20539.
19. Olsen CL, Lie E, Kvien TK, et al. Predictors Of Fatigue İn Rheumatoid Arthritis Patients İn Remission Or İn A Low Disease Activity State. Arthritis Care Res (Hoboken). 2016; Jul;68(7):1043-8. Doi: 10.1002/Acr.22787.
20. Druce KL, Bhattacharya Y, Jones GT, et al. Most Patients Who Reach Disease Remission Following Anti-TNF Therapy Continue To Report Fatigue: Results From The British Society For Rheumatology Biologics Register For Rheumatoid Arthritis. Rheumatology (Oxford). 2016 Oct;55(10):1786-90. Doi:10.1093/Rheumatology/Kew241.
21. Stebbings S, Herbison P, Doyle TC, et al. Comparison Of Fatigue Correlates İn Rheumatoid Arthritis And Osteoarthritis: Disparity İn Associations With Disability, Anxiety And Sleep Disturbance. Rheumatology (Oxford). 2010 Feb;49(2):361-7. Doi: 10.1093/Rheumatology/Kep367.
22. Belza BL, Henke CJ, Yelin EH, Et al. Correlates Of Fatigue İn Older Adults With Rheumatoid Arthritis. Nurs Res 1993;42:93–9
23. Huyser BA, Parker JC, Thoreson R, Et al. Predictors Of Subjective Fatigueamong İndividuals With Rheumatoid Arthritis. Arthritis Rheum 1998;41:2230–7.
24. S. Nikolaus, C. Bode, E. Taal, M.A.et al. New İnsights İnto The Experience Of Fatigue Among Patients With Rheumatoid Arthritis: A Qualitative Study Ann Rheum Dis, 69 (2010), Pp. 895-897
25. Matcham F, Rayner L, Steer S, et al. The Prevalence Of Depression İn Rheumatoid Arthritis: A Systematic Review And Meta-Analysis. Rheumatology (Oxford). 2013 Dec;52(12):2136-48. Doi: 10.1093/Rheumatology/Ket169. Epub 2013 Sep 3.
26. Isik A, Koca SS, Ozturk A, et al. Anxiety And Depression İn Patients With Rheumatoid Arthritis. Clin Rheumatol 2007;26:872–8
27. Lok EY, Mok CC, Cheng CW, et al. Prevalence And Determinants Of Psychiatric Disorders İn Patients With Rheumatoid Arthritis. Psychosomatics 2010;51:338–E8
28. Pollard LC, Choy EH, Gonzalez J, et al. Fatigue İn Rheumatoid Arthritis Reflects Pain, Not Disease Activity, Rheumatology, 2006, Vol. 45 (Pg. 885-9)
29. Riemsma RP, Rasker JJ, Taal E, et al. Fatigue İn Rheumatoid Arthritis: The Role Of Self-Efficacy And Problematic Social Support, Br J Rheumatol, 1998, Vol. 37 (Pg. 1042-6)
30. Vandyke MM, Parker JC, Smarr KL, et al. Anxiety İn Rheumatoid Arthritis. Arthritis Rheum. 2004 Jun 15;51(3):408-12. Doi: 10.1002/Art.20474. PMID: 15188326
31. Treharne GJ, Lyons AC, Booth DA, et al. Psychological Well-Being Across 1 Year With Rheumatoid Arthritis: Coping Resources As Buffers Of Perceived Stress. Br J Health Psychol. 2007 Sep;12(Pt 3):323-45. Doi: 10.1348/135910706X109288. PMID: 17640

There are 31 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	ORİJİNAL MAKALE
Authors	Suade Özlem Badak 0000-0002-4661-787X
Publication Date	March 14, 2022
Published in Issue	Year 2022 Volume: 44 Issue: 3

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Vancouver	Badak SÖ. Measuring Fatigue in Rheumatoid Arthritis’ Patients with the Bristol Rheumatoid Arthritis Fatigue Multidimensional Questionnaire (BRAF-MDQ) and the Bristol Rheumatoid Arthritis Fatigue Numerical Rating Scale (BRAF-NRS): A Cross-Sectional Study. Osmangazi Tıp Dergisi. 2022;44(3):353-9.

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