Fatigue in Egyptian patients with rheumatic diseases: a qualitative study

Abstract

ObjectivesFatigue is frequent in rheumatic diseases. Fatigue expression and consequences may be modified by cultural differences. Our objective was to increase the understanding of the fatigue experience and characteristics among Egyptian, Muslim patients with rheumatic diseases.MethodsProspective monocentric qualitative study based on conventional qualitative content analysis, inductive reasoning, grounded theory. Egyptian patients with rheumatoid arthritis (RA), fibromyalgia or axial spondyloarthritis (AxSpA) were asked about fatigue, its patterns, consequences and self-management.ResultsOf the 60 patients interviewed, 20 patients had each disease (RA, fibromyalgia and AxSpA); median ages ranged from 34 to 40 years. Patients were mainly male (N = 40, 66 %), had 3 to 7 years (mean) of disease duration and had moderate disease activity. Some aspects of the patients’ experience of fatigue may be specific to the Egyptian and Muslim culture such as the description of fatigue as a physical more than a mental impact of the disease, the response to the effect of fatigue on sexual function and the gender specific (women more than men) limitation of social activities due to fatigue which was more obvious in our study than other previous studies. Other aspects of patients’ experience of fatigue like overlap between the patients’ perception of fatigue and pain and coping strategies were similar to the findings in previous studies.ConclusionThis study gives insights regarding fatigue in rheumatic diseases in an Arabic and Muslim culture. Similarities and differences with previous studies were noted and should be taken into account when assessing these patients.

Health Equity Considerations for Developing and Reporting Patient-reported Outcomes in Clinical Trials: A Report from the OMERACT Equity Special Interest Group

“…Therefore, the group agreed that testing PROM in diverse populations with representation from disadvantaged subgroups is essential as well as performing subgroup analyses, when appropriate. Table 2 20,32,33,34,35,36,37,38 presents examples of the effect of population characteristics and the potential effect on outcome identification and prioritization.…”

Perceptions of the Cause, Impact and Management of Persistent Fatigue in Patients with Rheumatoid Arthritis Following Tumour Necrosing Factor Inhibition Therapy

“…From a synthesis of these qualitative studies, similar descriptors and experiences related to the consequences and management of fatigue emerged (Feldthusen et al, ; Hewlett et al, ; Mortada et al, ; Nikolaus et al, ; Repping‐Wuts et al, ; Tack, ). Patients experienced fatigue as frustrating and overwhelming, different from normal tiredness, unearned and unpredictable (Hewlett et al, ; Mortada et al, ; Repping‐Wuts et al, ). One unique descriptor was reported by the Egyptian population studied, who described fatigue as a ‘toxin’ passing through their bodies (Mortada et al, ).…”

“…Ensuing work has focused on understanding the meaning of fatigue and the fatigue experience (Kirwan et al, ). Appropriately, qualitative research has been undertaken de novo (Feldthusen et al, ; Hewlett et al, ; Mortada et al, ; Nikolaus et al, ; Repping‐Wuts et al, ), which complements early seminal research (Tack, ). Together, these six qualitative studies, representing five discrete populations (USA, UK, Egypt, Switzerland, and two Dutch), provide insight into the fatigue experience as reported by patients.…”

“…Patients experienced fatigue as frustrating and overwhelming, different from normal tiredness, unearned and unpredictable (Hewlett et al, ; Mortada et al, ; Repping‐Wuts et al, ). One unique descriptor was reported by the Egyptian population studied, who described fatigue as a ‘toxin’ passing through their bodies (Mortada et al, ). All studies found the consequences of fatigue to include physical, emotional, and cognitive components that permeated every sphere of life, including roles and relationships, mood, mobility, activities and participation (Feldthusen et al, ; Hewlett et al, ; Mortada et al, ; Nikolaus et al, ; Repping‐Wuts et al, ; Tack, ).…”

“…One unique descriptor was reported by the Egyptian population studied, who described fatigue as a ‘toxin’ passing through their bodies (Mortada et al, ). All studies found the consequences of fatigue to include physical, emotional, and cognitive components that permeated every sphere of life, including roles and relationships, mood, mobility, activities and participation (Feldthusen et al, ; Hewlett et al, ; Mortada et al, ; Nikolaus et al, ; Repping‐Wuts et al, ; Tack, ). One exception to this was found among the one non‐Western culture patients, who emphasized more the physical impact of the disease as opposed to mental consequences (Mortada et al, ).…”