Disease Activity, Occupational Participation, and Quality of Life for Individuals with and without Severe Fatigue in Ankylosing Spondylitis

Fatigueisoneofthemostfrequentlyreportedsymptomsbyindividualswithankylosingspondylitis.However,itis oftenoverlookedclinicallyandinresearch.Literatureresearchingtheimpactofseverefatigueonoccupationalparticipationin ankylosingspondylitisislimited.Therefore,theaimofthisresearchwastoexploretheimpactofseverefatigueonoccupational participation,diseaseactivity,andqualityoflifeinpeoplewithAS.Methods.Asequentialexploratorymixedmethodstudy designwasusedinthisstudy.Self-reportedquestionnairesgatheredquantitativedatawhichwereanalysedwithdescriptiveand inferentialstatistics.Qualitativedataweregeneratedthroughsemistructuredinterviewsandanalysedusingacontentanalysis approach.Results.FiftyindividualswithAScompletedallstudyquestionnaires.Participantshadameanageof46.5years;72% weremenwithameandiseasedurationof14.5years.Highfatiguewasreportedby38%ofparticipantsusingthe MultidimensionalAssessmentofFatigue(MAF).Fatiguewassignificantlyassociatedwithloweroccupationalparticipation (p=0018),higherdiseaseactivity(p<0001),higherpain(p<0001),reducedphysicalcapacity(p=0018),lowerqualityoflife (p<0001),andlowerglobalwell-being(p<0001).Thereweresignificantdifferencesbetweenthosewithlowandhighfatigue levelsforoccupationalparticipation(p=0007),diseaseactivity(p<0001),physicalcapacity(p=0015),pain(p<0001),and qualityoflife(p<0001).Participantsdiscussedtheimpactoffatigueonproductivityandleisure.Theyalsodiscussedarangeof strategiesformanagingtheirfatiguebutreportedalackofeducationfromhealthprofessionalsonmanagingthissymptom. Conclusion.Severefatigueisaprevalentsymptomforindividualswithankylosingspondylitisandresultsinreduced occupationalparticipationinproductivityandleisure.Earlyfatiguemanagementinterventionsmayreducetheoccupational participationimpactofthissymptomforindividualswithankylosingspondylitis.