Background Patients with rheumatic diseases commonly experience fatigue and this fatigue has a substantial impact on patients' self-care activities and overall quality of life. Fatigue levels and the expression of fatigue may be modified by cultural differences as has been demonstrated for pain (1). However qualitative studies of fatigue in non-European cultures are lacking.

Objectives The objective of this qualitative study was to increase the understanding of the fatigue experience and characteristics among Egyptian patients with rheumatic diseases: rheumatoid arthritis (RA), fibromyalgia (FM) and axial spondyloarthritis (AxSpA).

Prospective monocentric qualitative study based on conventional qualitative content analysis, inductive reasoning, grounded theory. Consecutive patients with definite disease (either RA, FM or AxSpA) were invited to participate in 30-min interviews. Patients were asked about fatigue, its patterns, consequences and self-management. Interviews were recorded by audiotape, transcribed verbatim and all phrases were systematically coded until overarching themes appeared.

Methods Prospective monocentric qualitative study based on conventional qualitative content analysis, inductive reasoning, grounded theory. Consecutive patients with definite disease (either RA, FM or AxSpA) were invited to participate in 30-min interviews. Patients were asked about fatigue, its patterns, consequences and self-management. Interviews were recorded by audiotape, transcribed verbatim and all phrases were systematically coded until overarching themes appeared.

Results Of the 60 patients interviewed, 20 patients had each disease (RA, FM and AxSpA). Patients were mainly male (N=40, 66%), had 3 to 7 years (mean) of disease duration and had moderate disease activity. Fatigue was high with median fatigue visual analog scales (0-10) of 50 in RA, 70 in FM and 40 in AxSpA. Concept of fatigue: Fatigue was a difficult concept for patients; when clarified, RA and FM patients described fatigue as the need to rest more whereas AxSpA patients described fatigue as a freezing of the body. Consequences of fatigue: In all diseases, the participants stated that fatigue influenced and affected physical activity and work, whereas fatigue had a major impact on social and leisure activities only for RA and FM patients (AxSpA patients not stating such a limitation). Fatigue affected sexual activity markedly in all disease groups and this was a major concern of most of the participants. Self-management of fatigue: Patients felt their fatigue was ignored from medical staff and from families alike; however RA patients expressed getting more help from their family.

Conclusions This study gives insights into fatigue in rheumatic diseases in an Arabic and Muslim culture. We found that the characteristics of fatigue and its consequences had some differences from previously reported European studies; these differences may be attributed mainly to cultural reasons.

References

1. Yazici Y, Kautiainen H, Sokka T. Journal of Rheumatology.2007; 34(2):311–315

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1860