{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T08:55:21Z","timestamp":1762073721027,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010438","name":"Poznan University of Medical Sciences","doi-asserted-by":"publisher","award":["502-14-04407637-10441"],"award-info":[{"award-number":["502-14-04407637-10441"]}],"id":[{"id":"10.13039\/501100010438","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Rheumatoid arthritis (RA) is a chronic systemic disease of connective tissue with periods of exacerbation and remission. Fatigue is excessive strain throughout the body that is disproportionate or unrelated to an activity or lifestyle. Fatigue is an integral part of RA in most patients. The study aimed to assess the level of fatigue in RA patients and establish the relationship between fatigue and demographic and clinical factors. The study group consisted of 128 RA patients according to European League Against Rheumatism (EULAR) criteria. The Functional Assessment of Chronic Illness Therapy-Fatigue and -Medical Outcomes Study Short Form 36 (SF-36) vitality scores were used to assess the severity of fatigue symptoms. The analyzed variables were gender, age, disease duration, education, marital status, place of residence, work and residence status, pharmacological treatment, pain, morning stiffness, hemoglobin, C-reactive protein (CRP), rheumatoid factor (RF), compression soreness, Richie Articular Index, and DAS28 disease activity. The examined patients experience chronic fatigue\u2014the mean value on the FACIT-F scale was 24.1 \u00b1 9.1 points and on the SF-36 Vitality score was 14.2 \u00b1 1.8 points. There is a relationship between the level of fatigue and pain, long-lasting morning stiffness, active disease, increased soreness of joints, and low hemoglobin values. When analyzing the symptom of fatigue, each patient should be approached individually, using the existing questionnaires or asking key questions to recognize the situation. The presence of fatigue symptoms should be considered during therapy and patient care by searching for and eliminating additional, intensifying stimuli and increasing its level.<\/jats:p>","DOI":"10.3390\/ijerph192214681","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T02:34:52Z","timestamp":1667961292000},"page":"14681","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The Link between the Demographic and Clinical Factors and Fatigue Symptoms among Rheumatoid Arthritis Patients"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6575-8312","authenticated-orcid":false,"given":"Katarzyna Anna","family":"Koz\u0142owska","sequence":"first","affiliation":[{"name":"Department of Nursing Practices, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6691-3863","authenticated-orcid":false,"given":"Dorota","family":"Formanowicz","sequence":"additional","affiliation":[{"name":"Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8919-5729","authenticated-orcid":false,"given":"Gra\u017cyna","family":"B\u0105czyk","sequence":"additional","affiliation":[{"name":"Department of Nursing Practices, Poznan University of Medical Sciences, 61-701 Poznan, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"ref_1","first-page":"111","article-title":"Stanowisko Zespo\u0142u Ekspert\u00f3w Konsultanta Krajowego ds. Reumatologii w sprawie diagnostyki i terapii reumatoidalnego zapalenia staw\u00f3w","volume":"46","author":"Brzosko","year":"2008","journal-title":"Reumatologia"},{"key":"ref_2","first-page":"455","article-title":"Rheumatoid arthritis: Common questions about diagnosis and management","volume":"97","author":"Wasserman","year":"2018","journal-title":"Am. Fam. Physician"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Lin, Y.J., Anzaghe, M., and Sch\u00fclke, S. (2020). Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid arthritis. Cells, 9.","DOI":"10.3390\/cells9040880"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1136\/annrheumdis-2021-220750","article-title":"Fatigue in patients with early rheumatoid arthritis undergoing treat-to-target therapy: Predictors and response to treatment","volume":"81","author":"Holten","year":"2022","journal-title":"Ann. Rheum. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.3899\/jrheum.120724","article-title":"Furthering Our Understanding of Fatigue in Rheumatoid Arthritis","volume":"39","author":"Hewlett","year":"2012","journal-title":"J. Rheumatol."},{"key":"ref_6","first-page":"2629","article-title":"The Enigma of Fatigue","volume":"36","author":"Rasker","year":"2016","journal-title":"J. Rheumatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.tins.2013.10.003","article-title":"The Neuroimmune Basis of Fatigue","volume":"37","author":"Dantzer","year":"2014","journal-title":"Trends Neurosci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1093\/rheumatology\/kez351","article-title":"The impact of fatigue in rheumatoid arthritis and the challenges of its assessment","volume":"58","author":"Santos","year":"2019","journal-title":"Rheumatology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1093\/rheumatology\/keq282","article-title":"Fatigue in rheumatoid arthritis: Time for a conceptual model","volume":"50","author":"Hewlett","year":"2011","journal-title":"Rheumatology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1580","DOI":"10.1136\/ard.2010.138461","article-title":"2010 rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"69","author":"Aletaha","year":"2010","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1477-7525-1-79","article-title":"The functional assessment of chronic illness therapy (FACIT) measurement system: Properties, applications and interpretation","volume":"1","author":"Webster","year":"2003","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_12","first-page":"1166","article-title":"Kwestionariusz oceny jako\u015bci \u017cycia SF-36\u2014wersja polska","volume":"67","author":"Tylka","year":"2009","journal-title":"Kardiol. Pol."},{"key":"ref_13","unstructured":"(2022, June 01). Available online: https:\/\/www.das-score.nl\/das28\/DAScalculators\/DAS28_CRP_3VAR.html."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1093\/rheumatology\/keu390","article-title":"Patients receiving anti-TNF therapies experience clinically important improvements in RA-related fatigue: Results from the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis","volume":"54","author":"Druce","year":"2015","journal-title":"Rheumatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.reuma.2018.07.010","article-title":"Fatigue in Rheumatoid Arthritis Patients: Association With Sleep Quality, Mood Status, and Disease Activity","volume":"16","author":"Hammam","year":"2020","journal-title":"Reumatol. Clin."},{"key":"ref_16","first-page":"1773","article-title":"Associated factors of different fatigue dimensions in elderly patients with rheumatoid arthritis","volume":"100","author":"Lao","year":"2020","journal-title":"Zhonghua Yi Xue Za Zhi."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"178","DOI":"10.4103\/1110-161X.168158","article-title":"Assessment of fatigue in rheumatoid arthritis and its relation to pain and disease activity measures","volume":"42","author":"Lotfi","year":"2015","journal-title":"Egypt Rheumatol Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.12669\/pjms.37.4.3602","article-title":"Fatigue assessment by FACIT-F scale in Pakistani cohort with Rheumatoid Arthritis (FAF-RA) study","volume":"37","author":"Wagan","year":"2021","journal-title":"Pak. J. Med. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1007\/s40266-018-0589-4","article-title":"Treating Fatigue in Rheumatoid Arthritis: Does Patient Age Matter?","volume":"35","author":"Uhlig","year":"2018","journal-title":"Drugs Aging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"469","DOI":"10.2340\/16501977-2090","article-title":"Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study","volume":"48","author":"Feldthusen","year":"2016","journal-title":"J. Rehabil. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1002\/acr.22577","article-title":"Role of Sleep Disturbance, Depression, Obesity, and Physical Inactivity in Fatigue in Rheumatoid Arthritis","volume":"68","author":"Katz","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1111\/1756-185X.13897","article-title":"Fatigue and associated factors in a multi-ethnic cohort of rheumatoid arthritis patients","volume":"23","author":"Lee","year":"2020","journal-title":"Int. J. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.rbr.2017.04.004","article-title":"Measuring fatigue with multiple instruments in a Brazilian cohort of early rheumatoid arthritis patients","volume":"57","author":"Diniz","year":"2017","journal-title":"Rev. Bras. Reumatol. Engl. Ed."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"65","DOI":"10.5114\/reum.2017.67600","article-title":"Fatigue and sleep quality in rheumatoid arthritis patients during hospital admission","volume":"55","author":"Szady","year":"2017","journal-title":"Reumatologia"},{"key":"ref_25","first-page":"e000041","article-title":"Fatigue in rheumatoid arthritis; a persistent problem: A large longitudinal study","volume":"4","author":"Tsonaka","year":"2015","journal-title":"RMD Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1080\/03009742.2020.1726449","article-title":"Predictors of fatigue and persistent fatigue in early rheumatoid arthritis: A longitudinal observational study, data from the ESPOIR cohort","volume":"49","author":"Combe","year":"2020","journal-title":"Scand J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1002\/acr.22787","article-title":"Predictors of Fatigue in Rheumatoid Arthritis Patients in Remission or in a Low Disease Activity State","volume":"68","author":"Olsen","year":"2016","journal-title":"Arthritis Care Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Engberg, I., Segerstedt, J., Waller, G., Wennberg, P., and Eliasson, M. (2017). Fatigue in the general population-associations to age, sex, socioeconomic status, physical activity, sitting time and self-rated health: The northern Sweden MONICA study 2014. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4623-y"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"255","DOI":"10.3109\/03009742.2015.1095943","article-title":"Correlations between fatigue and disease duration, disease activity, and pain in patients with rheumatoid arthritis: A systematic review","volume":"45","author":"Madsen","year":"2016","journal-title":"Scand J. Rheumatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s41687-019-0105-6","article-title":"PROMIS Fatigue short forms are reliable and valid in adults with rheumatoid arthritis","volume":"21","author":"Bingham","year":"2019","journal-title":"J. Patient Rep. Outcomes"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/art.41499","article-title":"Improvements in Fatigue Lag Behind Disease Remission in Early Rheumatoid Arthritis: Results From the Canadian Early Arthritis Cohort","volume":"73","author":"Holdren","year":"2021","journal-title":"Arthritis Rheum."},{"key":"ref_32","first-page":"58","article-title":"Is improvement of fatigue in rheumatoid arthritis a proper effect of biologics?","volume":"59","author":"Ines","year":"2021","journal-title":"Rom. J. Intern. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"181","DOI":"10.2147\/OARRR.S142411","article-title":"Adalimumab impact on fatigue measured by FACIT-F: A study of rheumatoid arthritis patients in Saudi Arabia","volume":"17","author":"Janoudi","year":"2017","journal-title":"Open Access Rheumatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1136\/annrheumdis-2017-211259","article-title":"Patient-reported outcomes from a phase 3 study of baricitinib versus placebo or adalimumab in rheumatoid arthritis: Secondary analyses from the RA-BEAM study","volume":"76","author":"Keystone","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s40744-019-0164-4","article-title":"Relative Impact of Pain and Fatigue on Work Productivity in Patients with Rheumatoid Arthritis from the RA-BEAM Baricitinib Trial","volume":"6","author":"Michaud","year":"2019","journal-title":"Rheumatol. Ther."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e15947","DOI":"10.1097\/MD.0000000000015947","article-title":"Correlation of fatigue with other disease related and psychosocial factors in patients with rheumatoid arthritis treated with tocilizumab: ACT-AXIS study","volume":"98","author":"Corominas","year":"2019","journal-title":"Medicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3031","DOI":"10.1007\/s00296-013-2825-x","article-title":"A comparison of impact of fatigue on cognitive, physical, and psychosocial status in patients with fibromyalgia and rheumatoid arthritis","volume":"33","author":"Kuran","year":"2013","journal-title":"Rheumatol. Int."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1290","DOI":"10.1080\/07420528.2021.1927069","article-title":"Time-of-day effects on the postural control and symptoms in women with rheumatoid arthritis","volume":"38","author":"Bouchaala","year":"2021","journal-title":"Chronobiol. Int."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e12996","DOI":"10.1111\/ijn.12996","article-title":"Current status and influencing factors of fatigue in patients with rheumatoid arthritis: A cross-sectional study in China","volume":"28","author":"Gao","year":"2022","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Feldthusen, C., Grimby-Ekman, A., Forsblad-d\u2019Elia, H., Jacobsson, L., and Mannerkorpi, K. (2016). Seasonal variations in fatigue in persons with rheumatoid arthritis: A longitudinal study. BMC Musculoskelet. Disord., 17.","DOI":"10.1186\/s12891-016-0911-4"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e6771","DOI":"10.7717\/peerj.6771","article-title":"Patient-reported fatigue in patients with rheumatoid arthritis who commence biologic therapy: A longitudinal study","volume":"17","author":"Rinke","year":"2019","journal-title":"PeerJ"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"3737","DOI":"10.1093\/rheumatology\/keab947","article-title":"Fatigue in early rheumatoid arthritis: Data from the Early Rheumatoid Arthritis Network","volume":"61","author":"Ifesemen","year":"2022","journal-title":"Rheumatology"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/14681\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:12:54Z","timestamp":1760145174000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/22\/14681"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":42,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["ijerph192214681"],"URL":"https:\/\/doi.org\/10.3390\/ijerph192214681","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,11,9]]}}}