Fatigue is a symptom of arthritis that causes difficulty at work. An improved understanding of this symptom could assist its management in the work environment. The aim of this study was to explore people with rheumatic diseases’ experiences of fatigue in work. A qualitative descriptive design was used with semi-structured interviews and a constant comparative method of data analysis. There were 18 participants, the majority of them female with Rheumatoid Arthritis (RA) and working full-time. Three themes were identified: “Impact of fatigue on work performance” with cognition, mood and physical abilities being the main difficulties reported. In the second theme “Disclosure at Work” participants discussed disclosing their disease to employers but reported a lack of understanding of fatigue from colleagues. The final theme “work-based fatigue management strategies” included cognitive strategies and energy management techniques, which were mainly self-taught. In this study, fatigue was reported to impact on many areas of work performance with limited understanding from colleagues and employers. Interventions from health professionals to assist with development of work-related self-management skills are required to assist with symptom management in the work place. Such interventions should include education to employers and colleagues on the nature of fatigue in Rheumatic diseases.

Background. Fatigue is one of the most frequently reported symptoms by individuals with ankylosing spondylitis. However, it is often overlooked clinically and in research. Literature researching the impact of severe fatigue on occupational participation in ankylosing spondylitis is limited. Therefore, the aim of this research was to explore the impact of severe fatigue on occupational participation, disease activity, and quality of life in people with AS. Methods. A sequential exploratory mixed method study design was used in this study. Self-reported questionnaires gathered quantitative data which were analysed with descriptive and inferential statistics. Qualitative data were generated through semistructured interviews and analysed using a content analysis approach. Results. Fifty individuals with AS completed all study questionnaires. Participants had a mean age of 46.5 years; 72% were men with a mean disease duration of 14.5 years. High fatigue was reported by 38% of participants using the Multidimensional Assessment of Fatigue (MAF). Fatigue was significantly associated with lower occupational participation (p=0.018), higher disease activity (p<0.001), higher pain (p<0.001), reduced physical capacity (p=0.018), lower quality of life (p<0.001), and lower global well-being (p<0.001). There were significant differences between those with low and high fatigue levels for occupational participation (p=0.007), disease activity (p<0.001), physical capacity (p=0.015), pain (p<0.001), and quality of life (p<0.001). Participants discussed the impact of fatigue on productivity and leisure. They also discussed a range of strategies for managing their fatigue but reported a lack of education from health professionals on managing this symptom. Conclusion. Severe fatigue is a prevalent symptom for individuals with ankylosing spondylitis and results in reduced occupational participation in productivity and leisure. Early fatigue management interventions may reduce the occupational participation impact of this symptom for individuals with ankylosing spondylitis.

Background:Almost 65% of individuals with rheumatic diseases have severe fatigue with the majority of these reporting difficulties in work leading to absenteeism and early retirement. However, there is a lack of research investigating how different types of fatigue impact on work ability.Objectives:To identify the prevalence of different types of fatigue and explore the association between different types of fatigue and various demands involved in workMethods:A cross-sectional study was carried out with 234 individuals with rheumatic diseases currently in employment. Study measures examined demographics, different types of fatigue (general, physical reduced activity, reduced motivation and mental), ability to meet work demands, disease activity and quality of life.Results:The majority of participants were female (70%), had rheumatoid arthritis (42.7%), were between 41-50 years (30.3%) and worked full-time (70%). One hundred and twenty-eight participants (55%) had severe fatigue. Physical fatigue was the most prevalent category of fatigue (Table 1). Participants reported managing 50% of their work demands with physical demands being the most challenging (Table 1). All types of fatigue were significantly associated with the total WRF score (Table 2). Mental fatigue had the strongest association with the total WRF score (r=0.53, p<0.001). On examining the impact of different types of fatigue on meeting work demands, mental fatigue was the most significant predictor of difficulty meeting work demands (β =1.6, SE=0.37, p<0.001)Table 1.MFI and WRF total and category scoresWRF n=212Total mean (SD)Work Scheduling Demands mean (SD)Output demands mean (SD)Physical Demands mean (SD)Mental Demands mean (SD)Social Demands mean (SD)50.3% (19.0)44.6% (25.8)52.9% (22.1)43.3% (27.9)53.4% (22.5)62.4% (17.7)MFIn=220Totalmean (SD)Physical fatigue mean (SD)Reduced activity mean (SD)Reduced motivation mean (SD)Mental fatigue mean (SD)13.4 (2.8)12.5 (4.3)10.1 (4.2)10.2 (3.5)10.3 (4.2)Table 2.Correlations for WRF and MFI fatigue categoriesMFI CategoryCorrelations with total WRFp-valuesGeneral fatigue.53<0.001Mental fatigue.57<0.001Physical fatigue.48<0.001Reduced motivation.48<0.001Reduced activity levels.41<0.001Conclusion:Fatigue interferes with many aspects of work performance. However, this study identifies that mental fatigue is the greatest predictor of difficulty in managing work. Self-management interventions focusing on mental fatigue and work ability are required for individuals with rheumatic diseases to manage the demands of their work.Disclosure of Interests:None declared