Article Text

THU0462-HPR Cognitive processes for rating fatigue: What the numbers don’t tell us
  1. K.S. Miljeteig1,
  2. J. Harris2,
  3. A.K. Kongtorp3
  1. 1Institute of Nursing, Bergen University College, Bergen, Norway
  2. 2School of Health and Related Research (ScHARR), Sheffield University, Sheffield S1 4DA, United Kingdom
  3. 3Dep. of rheumatology, Diakonhjemmets Hospital, Oslo, Norway


Background Patient involvement has been an important part of the recent development of a validated instrument for rating RA fatigue. There has been no research, however, on the cognitive processes that patients use when they try to assign ratings for the severity of their condition. Quality of life researchers have noted this gap.

Objectives Our qualitative study explored the challenges for patients when using a Visual Analogue Scale.

Methods Semi-structured cognitive interviewing was used to explore participants’ thought processes as they tried to complete the rating scale. Interviews were transcribed and preliminary analysis was conducted by two of the authors. Emerging themes were translated into English and further analysed by all authors.

Results Four themes emerged: finding a common language, evaluating fatigue in context, trying to find a pattern, and fiddling with the numbers.

Conclusions Patients experienced difficulties is assigning a summary score for a condition that can vary hourly. When they arrived at an average score, they then compared their rating with the experiences of others, and in some cases adjusted their scores to conform what they perceived to be socially acceptable norms. Patients also noted that a commonly understood description for RA fatigue does not exist. Lack of a common terminology makes it difficult for patients, clinicians and researchers to rate the severity of fatigue. We suggest that the value of rating scales lies in their ability to trigger discussion about fatigue experiences, and that discussion as well as a fatigue score need to be considered by nurses when working with RA patients.

Disclosure of Interest None Declared

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