{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:50:34Z","timestamp":1790459434293,"version":"4.1.0"},"reference-count":76,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2020,1,7]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Fatigue is frequently reported in inflammatory bowel disease (IBD) and impacts on health-related quality of life (HRQoL). HRQoL has not been systematically reviewed in IBD fatigue.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To investigate what impact IBD fatigue has on HRQoL in adults with IBD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Systematic searches (CINAHL, EMBASE, PsychINFO, Medline) were conducted on 25 September 2018, restricted to \u2018human\u2019, \u2018adult\u2019, \u2018primary research\u2019 and \u2018English language\u2019. Search terms encompassed concepts of \u2018fatigue\u2019, \u2018IBD\u2019 and \u2018HRQoL\u2019. A 5-year time limit (2013\u20132018) was set to include the most relevant publications. Publications were screened, data extracted and quality appraised by two authors. A narrative synthesis was conducted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Eleven studies were included, presenting data from 2823 participants. Fatigue experiences were significantly related to three HRQoL areas: symptom acceptance, psychosocial well-being and physical activity. Patients reporting high fatigue levels had low symptom acceptance. Psychosocial factors were strongly associated with both fatigue and HRQoL. Higher social support levels were associated with higher HRQoL. Physical activity was impaired by higher fatigue levels, lowering HRQoL, but it was also used as a means of reducing fatigue and improving HRQoL. Quality appraisal revealed methodological shortcomings in a number of studies. Notably, use of multiple measures, comparison without statistical adjustment and fatigue and HRQoL assessment using the same tool were some of the methodological shortcomings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Psychosocial factors, symptom management and acceptance and physical activity levels have significant impact on HRQoL. Results support application of psychosocial or exercise interventions for fatigue management. Further exploration of HRQoL factors in IBD fatigue is required, using validated fatigue and HRQoL measures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42018110005.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/flgastro-2019-101355","type":"journal-article","created":{"date-parts":[[2020,1,24]],"date-time":"2020-01-24T17:15:53Z","timestamp":1579886153000},"page":"11-21","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":52,"title":["Systematic review: the impact of inflammatory bowel disease-related fatigue on health-related quality of life"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2226-0810","authenticated-orcid":false,"given":"Shellie Jean","family":"Radford","sequence":"first","affiliation":[{"name":"Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"McGing","sequence":"additional","affiliation":[{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wladyslawa","family":"Czuber-Dochan","sequence":"additional","affiliation":[{"name":"Florence Nightingale school of Nursing, Midwifery and Pallative care, King\"s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Moran","sequence":"additional","affiliation":[{"name":"Nottingham Digestive Diseases Centre, University of Nottingham, University Park Campus, Nottingham, UK"},{"name":"NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,24]]},"reference":[{"key":"2025090708270937000_12.1.11.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(03)00371-4"},{"key":"2025090708270937000_12.1.11.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2012.04.004"},{"key":"2025090708270937000_12.1.11.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6931.763"},{"key":"2025090708270937000_12.1.11.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckp113"},{"key":"2025090708270937000_12.1.11.5","doi-asserted-by":"crossref","first-page":"834","DOI":"10.7326\/M15-0443","article-title":"Diagnostic methods for myalgic Encephalomyelitis\/Chronic fatigue syndrome: a systematic review for a national Institutes of health pathways to prevention workshop","volume":"162","author":"Haney","year":"2015","journal-title":"Ann Intern Med"},{"key":"2025090708270937000_12.1.11.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1042\/cs0990001","article-title":"Fatigue in chronic disease","volume":"99","author":"Swain","year":"2000","journal-title":"Clin Sci"},{"key":"2025090708270937000_12.1.11.7","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12060"},{"key":"2025090708270937000_12.1.11.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2010.04347.x"},{"key":"2025090708270937000_12.1.11.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9270(01)02440-6"},{"key":"2025090708270937000_12.1.11.10","doi-asserted-by":"publisher","DOI":"10.1007\/BF01538073"},{"key":"2025090708270937000_12.1.11.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0753-3322(01)80006-8"},{"key":"2025090708270937000_12.1.11.12","first-page":"353","article-title":"Identification of research priorities for inflammatory bowel disease nursing in Europe: a Nurses-European Crohn\"s and colitis organisation Delphi survey","volume":"11","author":"Dibley","year":"2017","journal-title":"J Crohns Colitis"},{"key":"2025090708270937000_12.1.11.13","doi-asserted-by":"publisher","DOI":"10.3109\/00365521003734141"},{"key":"2025090708270937000_12.1.11.14","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12205"},{"key":"2025090708270937000_12.1.11.15","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw144"},{"key":"2025090708270937000_12.1.11.16","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.224154"},{"key":"2025090708270937000_12.1.11.17","unstructured":"The world Health organization quality of life assessment (WHOQOL): position paper from the world Health organization. Soc. Sci. Med 1995."},{"key":"2025090708270937000_12.1.11.18","doi-asserted-by":"crossref","unstructured":"Lipscomb J , Gotay CC , Snyder C , eds. Definitions and conceptual models of quality of life. Outcomes assessment in cancer: Measures, methods, and applications . Cambridge University Press, 2005.","DOI":"10.1017\/CBO9780511545856"},{"key":"2025090708270937000_12.1.11.19","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01323.x"},{"key":"2025090708270937000_12.1.11.20","doi-asserted-by":"publisher","DOI":"10.1159\/000320403"},{"key":"2025090708270937000_12.1.11.21","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-017-0644-y","article-title":"Optimal database combinations for literature searches in systematic reviews: a prospective exploratory study","volume":"6","author":"Bramer","year":"2017","journal-title":"Syst Rev"},{"key":"2025090708270937000_12.1.11.22","unstructured":"Booth A , Papaioannou D , Sutton A . The literature review: its role within research. in Systematic Approaches to a Successful Literature Review 1\u201316 2012."},{"key":"2025090708270937000_12.1.11.23","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1002\/jrsm.1127","article-title":"Reporting standards for literature searches and report inclusion criteria: making research syntheses more transparent and easy to replicate","volume":"6","author":"Atkinson","year":"2015","journal-title":"Res Synth Methods"},{"key":"2025090708270937000_12.1.11.24","first-page":"1","article-title":"Doing a literature search","volume":"1","author":"Hart","year":"2001","journal-title":"SAGE London"},{"key":"2025090708270937000_12.1.11.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7967(03)00146-3"},{"key":"2025090708270937000_12.1.11.26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2702.2004.00955.x"},{"key":"2025090708270937000_12.1.11.27","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-008-9362-1"},{"key":"2025090708270937000_12.1.11.28","unstructured":"Joanna Briggs Institute and The university of Adelaide . Critical Appraisal Tools - JBI. Available: http:\/\/joannabriggs.org\/research\/critical-appraisal-tools.html [Accessed 23 Sep 2018]."},{"key":"2025090708270937000_12.1.11.29","unstructured":"Zhang Y , Wildemuth BM . Qualitative Analysis of Content. in Applications of Social Research Methods to Questions in Information and Library Scienc 2009."},{"key":"2025090708270937000_12.1.11.30","first-page":"365","article-title":"Qualitative metasynthesis: issues and techniques","volume":"8","author":"Walsh","year":"2002","journal-title":"Qual Health Res"},{"key":"2025090708270937000_12.1.11.31","unstructured":"Pope C , Mays N , Popay J . Synthesizing qualitative and quantitative health evidence : a guide to methods. Open University Press, McGraw Hill Education, 2007."},{"key":"2025090708270937000_12.1.11.32","unstructured":"Viazis N et al . Inflammatory bowel disease: Greek patients\u2019 perspective on quality of life, information on the disease, work productivity and family support. Ann. Gastroenterol 2013."},{"key":"2025090708270937000_12.1.11.33","doi-asserted-by":"crossref","unstructured":"Devlen J et al . The burden of inflammatory bowel disease: a patient-reported qualitative analysis and development of a conceptual model. Inflamm. Bowel Dis 2014.","DOI":"10.1097\/01.MIB.0000440983.86659.81"},{"key":"2025090708270937000_12.1.11.34","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/HNP.0000000000000189","article-title":"Tolerance limits, self-understanding, and stress resilience in integrative recovery of inflammatory bowel disease","volume":"31","author":"Skrautvol","year":"2017","journal-title":"Holist Nurs Pract"},{"key":"2025090708270937000_12.1.11.35","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12659"},{"key":"2025090708270937000_12.1.11.36","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0181435","article-title":"Fatigue in out-patients with inflammatory bowel disease: prevalence and predictive factors","volume":"12","author":"Villoria","year":"2017","journal-title":"PLoS One"},{"key":"2025090708270937000_12.1.11.37","doi-asserted-by":"publisher","DOI":"10.1097\/01.MIB.0000437614.91258.70"},{"key":"2025090708270937000_12.1.11.38","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-013-0508-4"},{"key":"2025090708270937000_12.1.11.39","doi-asserted-by":"publisher","DOI":"10.4321\/S1130-01082013000300005"},{"key":"2025090708270937000_12.1.11.40","doi-asserted-by":"crossref","unstructured":"Artom M , Czuber-Dochan W , Sturt J , et al . The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: a cross-sectional study. Aliment Pharmacol Ther 2017.","DOI":"10.1111\/apt.13870"},{"key":"2025090708270937000_12.1.11.41","first-page":"104","article-title":"Quality of life in inflammatory bowel disease patients: a cross-sectional study","volume":"22","author":"Habibi","year":"2017","journal-title":"J. Res. Med. Sci"},{"key":"2025090708270937000_12.1.11.42","doi-asserted-by":"publisher","DOI":"10.1111\/apt.12659"},{"key":"2025090708270937000_12.1.11.43","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2009.11.011"},{"key":"2025090708270937000_12.1.11.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.08.019"},{"key":"2025090708270937000_12.1.11.45","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-121-12-199412150-00009"},{"key":"2025090708270937000_12.1.11.46","doi-asserted-by":"crossref","unstructured":"Armes J , Krishnasamy M , Higginson I . Fatigue in cancer. Oxford University Press, 2004.","DOI":"10.1093\/oso\/9780192630940.001.0001"},{"key":"2025090708270937000_12.1.11.47","doi-asserted-by":"crossref","unstructured":"Wessely S , Nimnuan C , Sharpe M . Functional somatic syndromes: one or many? Lancet 1999.","DOI":"10.1016\/S0140-6736(98)08320-2"},{"key":"2025090708270937000_12.1.11.48","doi-asserted-by":"crossref","unstructured":"Power JD , Badley EM , French MR , et al . Fatigue in osteoarthritis: a qualitative study. BMC Musculoskelet Disord 2008;9.doi:10.1186\/1471-2474-9-63","DOI":"10.1186\/1471-2474-9-63"},{"key":"2025090708270937000_12.1.11.49","doi-asserted-by":"crossref","unstructured":"White JH et al . Exploring the experience of post-stroke fatigue in community dwelling stroke survivors: a prospective qualitative study. Disabil. Rehabil 2012.","DOI":"10.3109\/09638288.2011.645111"},{"key":"2025090708270937000_12.1.11.50","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/55.6.P362"},{"key":"2025090708270937000_12.1.11.51","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7489(03)00010-5"},{"key":"2025090708270937000_12.1.11.52","doi-asserted-by":"crossref","first-page":"649","DOI":"10.12968\/bjon.2016.25.12.649","article-title":"Identifying disease-specific distress in patients with inflammatory bowel disease","volume":"25","author":"Woodward","year":"2016","journal-title":"Br J Nurs"},{"key":"2025090708270937000_12.1.11.53","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1590\/S0004-28032014000300005","article-title":"Quality of life in patients with inflammatory bowel disease: importance of clinical, demographic and psychosocial factors","volume":"51","author":"Magalh\u00e3es","year":"2014","journal-title":"Arq Gastroenterol"},{"key":"2025090708270937000_12.1.11.54","first-page":"173","article-title":"Psychosocial factors contributing to inflammatory bowel disease activity and health-related quality of life","volume":"8","author":"Faust","year":"2012","journal-title":"Gastroenterol. Hepatol."},{"key":"2025090708270937000_12.1.11.55","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2003.07414.x"},{"key":"2025090708270937000_12.1.11.56","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21285"},{"key":"2025090708270937000_12.1.11.57","first-page":"1","article-title":"Biopsychosocial predictors of fatigue in quiescent and mild ulcerative colitis: an explorative study","volume":"2","author":"H\u00e4user","year":"2005","journal-title":"GMS Psycho-Social-Medicine"},{"key":"2025090708270937000_12.1.11.58","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2005.02380.x"},{"key":"2025090708270937000_12.1.11.59","doi-asserted-by":"crossref","first-page":"3055","DOI":"10.3748\/wjg.v24.i28.3055","article-title":"Non-Pharmacological therapies for inflammatory bowel disease: recommendations for self-care and physician guidance","volume":"24","author":"Duff","year":"2018","journal-title":"WJG"},{"key":"2025090708270937000_12.1.11.60","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.325.7362.480"},{"key":"2025090708270937000_12.1.11.61","doi-asserted-by":"crossref","unstructured":"Todorovic V . Providing holistic support for patients with inflammatory bowel disease. Br. J. Community Nurs 2012.","DOI":"10.12968\/bjcn.2012.17.10.466"},{"key":"2025090708270937000_12.1.11.62","doi-asserted-by":"crossref","first-page":"2659","DOI":"10.1111\/jocn.12892","article-title":"The lived experience of adults with ulcerative colitis","volume":"24","author":"Sammut","year":"2015","journal-title":"J Clin Nurs"},{"key":"2025090708270937000_12.1.11.63","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.20864"},{"key":"2025090708270937000_12.1.11.64","doi-asserted-by":"publisher","DOI":"10.1037\/\/0033-295X.96.4.608"},{"key":"2025090708270937000_12.1.11.65","doi-asserted-by":"crossref","unstructured":"Hilbert RA et al . Social stigma: the psychology of marked relationships. Contemp Sociol 1985.doi:10.2307\/2071381","DOI":"10.2307\/2071381"},{"key":"2025090708270937000_12.1.11.66","doi-asserted-by":"crossref","DOI":"10.2307\/2676360","article-title":"The dimensionality of stigma: a comparison of its impact on the self of persons with HIV\/AIDS and cancer","volume":"41","author":"Fife","year":"2000","journal-title":"J Health Soc Behav"},{"key":"2025090708270937000_12.1.11.67","doi-asserted-by":"crossref","first-page":"717","DOI":"10.2217\/14796694.4.5.717","article-title":"Stigma in cancer patients whose behavior may have contributed to their disease","volume":"4","author":"Lebel","year":"2008","journal-title":"Future Oncology"},{"key":"2025090708270937000_12.1.11.68","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-011-9883-x"},{"key":"2025090708270937000_12.1.11.69","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1111\/j.1365-2702.2009.03020.x","article-title":"Assessing health-related quality of life in patients with inflammatory bowel disease in Zhejiang, China","volume":"19","author":"Zhou","year":"2010","journal-title":"J Clin Nurs"},{"key":"2025090708270937000_12.1.11.70","doi-asserted-by":"publisher","DOI":"10.1177\/0022146510383501"},{"key":"2025090708270937000_12.1.11.71","doi-asserted-by":"publisher","DOI":"10.1097\/01.PSY.0000074757.11682.96"},{"key":"2025090708270937000_12.1.11.72","doi-asserted-by":"publisher","DOI":"10.1016\/j.gcb.2009.08.015"},{"key":"2025090708270937000_12.1.11.73","doi-asserted-by":"crossref","first-page":"39","DOI":"10.12968\/gasn.2016.14.8.39","article-title":"The effect of increasing physical activity and\/or omega-3 supplementation on fatigue in inflammatory bowel disease","volume":"14","author":"McNelly","year":"2016","journal-title":"Gastrointestinal Nursing"},{"key":"2025090708270937000_12.1.11.74","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90169-4"},{"key":"2025090708270937000_12.1.11.75","doi-asserted-by":"crossref","unstructured":"Cramp F , Byron-Daniel J , Cochrane Pain, Palliative and Supportive Care Group . Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev 2012;339.doi:10.1002\/14651858.CD006145.pub3","DOI":"10.1002\/14651858.CD006145.pub3"},{"key":"2025090708270937000_12.1.11.76","doi-asserted-by":"publisher","DOI":"10.1177\/0269215507082283"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2019-101355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:27:33Z","timestamp":1757258853000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2019-101355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,24]]},"references-count":76,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12,9]]},"published-print":{"date-parts":[[2021,1]]}},"alternative-id":["10.1136\/flgastro-2019-101355"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2019-101355","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"value":"2041-4137","type":"print"},{"value":"2041-4145","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,24]]}}}