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New insights into the experience of fatigue among patients with rheumatoid arthritis: a qualitative study
  1. Stephanie Nikolaus1,*,
  2. Christina Bode1,
  3. Erik Taal1,
  4. Mart A F J van de Laar2
  1. 1 University of Twente, Netherlands;
  2. 2 University of Twente and Medical Spectrum Twente, Netherlands
  1. Correspondence to: Stephanie Nikolaus, Institute for Behavioural Research, University of Twente, Drienerlolaan 5, Enschede, 7500 AE, Netherlands; s.nikolaus{at}


Objectives: Patients with rheumatoid arthritis (RA) complain about fatigue. Aim of this study was to gain further insight into the experience of fatigue in RA.

Methods: Participants were 31 RA outpatients of the Medical Spectrum Twente, with all levels of fatigue. In-depth structured interviews on the patients’ experience of fatigue were conducted and analyzed using a bottom-up coding scheme, meaning that answers of patients were summarized and categorized.

Results: Patients’ mean fatigue severity score was 50 (VAS; theoretical range 0-100). Interviews showed inter-individual differences in the experience and impact of fatigue. Different patterns in emotions, consequences and management of fatigue were found. Especially younger women with multiple daily roles seemed to be vulnerable to the negative impact of RA fatigue. Patients also reported positive aspects of fatigue. Moreover, varying forms of fatigue were described.

Conclusions: Results point to the existence of differences in fatigue experience according to gender, age, and daily roles. This finding indicates a need for targeting advice and interventions to the individual situation of a patient. Furthermore, the positive aspects patients reported about their fatigue could facilitate an approach that is focused on remaining opportunities and not only on restrictions.

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