Fatigue in adults with primary antiphospholipid syndrome: findings from a mixed-methods study, 2020, Bearne et al

[Andy]

Objective
This study aimed to explore the experience and impact of fatigue in adults with primary antiphospholipid syndrome (pAPS).

Methods
This sequential, explanatory mixed-methods study enrolled adults with a six-month or more history of pAPS. Consenting participants completed the Functional Assessment of Chronic Illness Therapy–Fatigue subscale (FS), Multi-Dimensional Perceived Social Support Scale, Patient Health Questionnaire (PHQ9), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQMETS). Relationships between FS and other variables were explored with multiple linear regression. Interviews were conducted with a subgroup of participants, and the data were analysed thematically.

Results
A total of 103 participants were recruited (Mage = 50.3 years; standard deviation = 10.1 years; 18 males). Of these, 62% reported severe fatigue. Greater fatigue was associated with lower mood, physical inactivity, poorer sleep quality and lower perceived social support. The best-fit model explained 56% of the variance in FS (adjusted R2 = 0.560, F(3, 74) = 33.65, p > 0.001) and included PHQ9 and IPAQMETS as significant predictors, and PSQI as a non-significant predictor. Twenty participants completed interviews. Three key themes were identified: characteristics of fatigue, impact on life and coping strategies.

Conclusion
Fatigue was a common symptom of pAPS and challenging to manage. Other factors, particularly mood and physical activity, influenced fatigue. Evidence-based self-management interventions are needed.

Paywall, https://journals.sagepub.com/doi/10.1177/0961203320928421
Sci hub, https://sci-hub.tw/10.1177/0961203320928421

 

[Peter T]

Am I missing something or did they fail to include an objective biological measure of the underlying pAPS?

So though this study was based on the hypothesis that variation in fatigue can not be explained by variation in the underlying medical condition, they have no way of knowing if that is the case in this sample. As with most studies of fatigue they go from correlations to causation without any evidence to back this.

 

[rvallee]

Other factors, particularly mood and physical activity, influenced fatigue

Right. Sure. The presence of heavy smoke influences the intensity of the fire. Smart. Give these people a knighthood, stat.