title: The role of psychological factors in the fatigue of primary biliary cirrhosis.
abstract: Fatigue impairs the quality of life of primary biliary cirrhosis (PBC) patients. In this study, we explored the psychological factors and coping strategies in fatigued PBC patients. Patients participated in a semi-structured interview examining thoughts regarding the impact of fatigue and coping strategies. All completed the disease-specific quality-of-life tool, PBC-40, the Penn State Worry Questionnaire (PSWQ) (degree of habitual worry) and Hospital Anxiety and Depression Scale (HADS) (current anxiety and depression). PBC patients were allocated into high (>38, n=10) and low-fatigue (<38, n=14) groups. No differences were seen between high-fatigue and low-fatigue groups regarding age, marital status, employment status, PBC stage, years with diagnosis and years experiencing fatigue. High-fatigue participants were significantly more anxious (P=0.008), more depressed (P<0.001), and more likely to worry (<0.05). High-fatigue participants had more frequent thoughts about the impact of fatigue (P<0.005) and lower self-efficacy scores (P<0.001). In conclusion, PBC patients can experience profound distress associated with fatigue. PBC patients with high levels of fatigue seem to be more vulnerable to emotional distress, more likely to perceive that their quality of life has been negatively affected and are less confident to engage in everyday activities compared with those with low levels of fatigue.
authors.affiliation: Department of Health Psychology, Royal Victoria Infirmary, Newcastle-upon-Tyne, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Blackburn
authors.forename: Mark
authors.initials: M
authors.lastname: Freeston
authors.forename: Christine R
authors.initials: CR
authors.lastname: Baker
authors.forename: David E J
authors.initials: DE
authors.lastname: Jones
authors.forename: Julia L
authors.initials: JL
authors.lastname: Newton
mesh_terms: D000223:Adaptation, Psychological; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000150:complications / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D020377:Self Efficacy