title: Patient perspectives of managing fatigue in Ankylosing Spondylitis, and views on potential interventions: a qualitative study.
abstract: BACKGROUND
  Fatigue is a major component of living with ankylosing spondylitis (AS), though it has been largely over-looked, and currently there are no specific agreed management strategies.
  
  
  METHODS
  This qualitative exploratory study involved participants who are members of an existing population-based ankylosing spondylitis (PAS) cohort. Participants residing in South West Wales were invited to participate in a focus group to discuss; (1) effects of fatigue, (2) self-management strategies and (3) potential future interventions. The focus groups were audio-recorded and the transcripts were analysed using thematic analysis.
  
  
  RESULTS
  Participants consisted of 3 males/4 females (group 1) and 4 males/3 females (group 2), aged between 35 and 73 years (mean age 53 years). Three main themes were identified: (1) The effects of fatigue were multi-dimensional with participants expressing feelings of being 'drained' (physical), 'upset' (emotional) and experiencing 'low-mood' (psychological); (2) The most commonly reported self-management strategy for fatigue was a balanced combination of activity (exercise) and rest. Medication was reluctantly taken due to side-effects and worries over dependency; (3) Participants expressed a preference for psychological therapies rather than pharmacological for managing fatigue. Information on Mindfulness-Based Stress Reduction (MBSR) was received with interest, with recommendations for delivery in a group format with the option of distance-based delivery for people who were not able to attend a group course.
  
  
  CONCLUSIONS
  Patients frequently try and manage their fatigue without any formal guidance or support. Our research indicates there is a need for future research to focus on psychological interventions to address the multi-faceted aspects of fatigue in AS.
authors: College of Medicine, Swansea University, Swansea, South Wales, UK. h.davies@swansea.ac.uk
authors: Helen
authors: H
authors: Davies
authors: Sinead
authors: S
authors: Brophy
authors: Michael
authors: M
authors: Dennis
authors: Roxanne
authors: R
authors: Cooksey
authors: Elizabeth
authors: E
authors: Irvine
authors: Stefan
authors: S
authors: Siebert
mesh_terms: D000328:Adult; D000368:Aged; D019468:Disease Management; D005221:Fatigue / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D057240:Patient Preference; D011613:Psychotherapy; D012648:Self Care; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000523:psychology / Q000628:therapy*
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