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Fatigue in patients with rheumatoid arthritis: British and Dutch nurses’ knowledge, attitudes and management

Authors

  • Han Repping-Wuts,

    1. Han Repping-Wuts MSc RN Nurse Scientist Radboud University Nijmegen Medical Centre, The Netherlands
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  • Sarah Hewlett,

    1. Sarah Hewlett MA PhD RN ARC Professor of Rheumatology and Nursing Faculty of Health and Life Sciences, School of Nursing, University of the West of England, Bristol Royal Infirmary, UK
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  • Piet Van Riel,

    1. Piet van Riel MD PhD Professor of Rheumatology Department Rheumatology, Radboud University Nijmegen Medical Centre, The Netherlands
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  • Theo Van Achterberg

    1. Theo van Achterberg PhD RN Professor of Nursing Science Department Quality of Care, Radboud University Nijmegen Medical Centre, The Netherlands
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H. Repping-Wuts: e-mail: j.repping@cis.umcn.nl

Abstract

Title. Fatigue in patients with rheumatoid arthritis: British and Dutch nurses’ knowledge, attitudes and management.

Aim.  This paper is a report of a study conducted to compare the knowledge, attitudes and current management of rheumatoid arthritis-related fatigue in British and Dutch rheumatology nurses.

Background.  After pain, fatigue is the most important symptom for patients with rheumatoid arthritis, but little is known about the current management of this fatigue by healthcare professionals.

Methods.  A questionnaire was mailed in 2007 to rheumatology nurses who were members of British Health Professionals in Rheumatology (N = 267) and the Dutch Society of Rheumatology Nurses (N = 227). Descriptive statistics, independent samples t-test and Pearson chi-square tests were used for statistical analysis.

Results.  A total of 494 nurses returned questionnaires (response rate 48%). In general, their knowledge about rheumatoid arthritis fatigue was in accordance with the literature and all indicated a positive attitude towards assessing and managing rheumatoid arthritis-related fatigue. However, respondents reported contradictory views about managing fatigue. Although they believed that other team members could help patients, they seldom referred patients on to other professionals. Although nurses believed that other advice besides pacing and balance between activity and rest might help, they did not offer this to patients. Despite acknowledging that there is poor communication about fatigue between patients and nurses, respondents reported that it is patients rather than nurses who raise the issue of fatigue in consultations.

Conclusion.  British and Dutch rheumatology nurses are sympathetic but do not know how to manage rheumatoid arthritis-related fatigue. Strategies to support self-management for this fatigue, and to increase communication between healthcare professionals and patients, should be initiated to help improve patient outcomes for rheumatoid arthritis-related fatigue.

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