title: Impact of fatigue on psychological outcomes in adults living with rheumatoid arthritis.
abstract: BACKGROUND
  Fatigue has been shown to be a prevalent symptom in patients with rheumatoid arthritis, having a negative impact on health-related quality of life. However, aside from depression, related fatigue has not been linked to specific psychological outcomes and is not a common target in treatment programs.
  
  
  OBJECTIVE
  The aim of the study was to examine the unique influence of rheumatoid arthritis-related fatigue on three psychological outcomes: depressive symptoms, perceived health impairment, and satisfaction with abilities.
  
  
  METHODS
  In a large (n = 200) convenience sample of older adults who provided informed consent, multiple regression analyses were conducted to determine the direct and unique impact of demographic variables, functional impairment, pain, and fatigue on each of three psychological outcomes: depressive symptoms, perceived health impairment, and satisfaction with ability.
  
  
  RESULTS
  Fatigue significantly and uniquely contributed to each of the psychological outcomes, above and beyond pain and functional impairment. The variances of depressive symptoms, perceived health impairment, and satisfaction with ability accounted for by fatigue were highly significant.
  
  
  CONCLUSIONS
  The study indicates that rheumatoid arthritis-related fatigue contributes to diminished psychological well-being in older adults aging with rheumatoid arthritis and suggests the need for psychoeducational and management strategies that specifically target fatigue as part of an overall rheumatoid arthritis management program. Future research should attempt to obtain a larger sample of male and younger patients to determine if there are significant gender and age differences in the impact of fatigue on psychological outcomes.
authors.affiliation: Florida Institute of Technology, Melbourne, FL 32901, USA. ash.franklin01@gmail.com
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Franklin
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Harrell
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D012044:Regression Analysis; D057566:Self Report