C Chavarría1, M J Casanova1, M Chaparro1, M Barreiro-de Acosta2, E Ezquiaga1,3, L Bujanda4, M Rivero5, F Argüelles-Arias6, M D Martín-Arranz7, M P Martínez-Montiel8, M Valls9, R Ferreiro-Iglesias2, J Llaó10, I Moraleja-Yudego11, F Casellas12, B Antolín-Melero13, X Cortés14, R Plaza15, J R Pineda16, M Navarro-Llavat17, S García-López18, P Robledo-Andrés19, I Marín-Jiménez20, V García-Sánchez21, O Merino22, A Algaba23, M R Arribas-López24, J M Banales4, B Castro5, L Castro-Laria6, R Honrubia7, P Almela9, J P Gisbert1. 1. Department of Gastroenterology, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Madrid, Spain. 2. Department of Gastroenterology, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain. 3. Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa [IIS-IP] and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas [CIBEREHD], Madrid, Spain. 4. Department of Gastroenterology, Instituto Biodonostia, Universidad del País Vasco [UPV/EHU] and CIBEREHD, San Sebastián, Spain. 5. Hospital Universitario Marqués de Valdecilla and Instituto de Investigación Marqués de Valdecilla [IDIVAL], Santander, Spain. 6. Department of Gastroenterology, Hospital Universitario Virgen Macarena, Sevilla, Spain. 7. Department of Gastroenterology, Hospital Universitario La Paz, Madrid, Spain. 8. Department of Gastroenterology, Hospital Universitario 12 de Octubre, Madrid, Spain. 9. Hospital General Universitario de Castellón, Castellón, Spain. 10. Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. 11. Department of Gastroenterology, Hospital Galdakao-Usansolo, Galdakao, Spain. 12. Department of Gastroenterology, Hospital Universitari Vall d'Hebron and CIBEREHD, Barcelona, Spain. 13. Department of Gastroenterology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 14. Department of Gastroenterology, Hospital de Sagunto, Valencia, Spain. 15. Department of Gastroenterology, Hospital Universitario Infanta Leonor, Madrid, Spain. 16. Department of Gastroenterology, Complejo Hospitalario Universitario de Vigo, Vigo, Spain. 17. Department of Gastroenterology, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain. 18. Department of Gastroenterology, Hospital Universitario Miguel Servet and CIBEREHD, Zaragoza, Spain. 19. Department of Gastroenterology, Hospital San Pedro de Alcántara, Cáceres, Spain. 20. Department of Gastroenterology, Hospital General Universitario Gregorio Marañón and CIBEREHD, Madrid, Spain. 21. Department of Gastroenterology, Hospital Universitario Reina Sofía, Córdoba, Spain. 22. Department of Gastroenterology, Hospital Universitario de Cruces, Bilbao, Spain. 23. Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Madrid, Spain. 24. Department of Gastroenterology, Hospital Universitario Infanta Sofía, Madrid, Spain.
Abstract
BACKGROUND AND AIMS: The aims of this study were to determine the prevalence of fatigue in patients with inflammatory bowel disease [IBD], to identify the factors associated with fatigue and its severity, to assess the impact of fatigue on quality of life [QoL], and to evaluate the relationship between fatigue and sleep disorders. METHODS: This was a prospective multicentre study conducted at 22 Spanish centres. Consecutive patients followed at IBD Units were included. Fatigue was evaluated with the Fatigue Severity Scale [FSS] and the Fatigue Impact Scale [FIS]. Quality of life and sleep quality were assessed using the IBD Questionnaire-Short Form [IBDQ-9] and the Pittsburgh Sleep Quality Index [PSQI], respectively. RESULTS: A total of 544 consecutive adult IBD patients were included [50% women, mean age 44 years, 61% Crohn's disease]. The prevalence of fatigue was 41% (95% confidence interval [CI] = 37-45%). The variables associated with an increased risk of fatigue were: anxiety [OR = 2.5, 95% CI = 1.6-3.7], depression [OR = 2.4, 95% CI = 1.4-3.8], presence of extraintestinal manifestations [EIMs] [OR = 1.7, 95% CI = 1.1-2.6], and treatment with systemic steroids [OR = 2.8, 95% CI = 1.4-5.7]. The presence of EIMs [regression coefficient, RC = 8.2, 95% CI = 2.3-14.2], anxiety [RC = 25.8, 95% CI = 20.0-31.5], depression [RC = 30.6, 95% CI = 24.3-37.0], and sleep disturbances [RC = 15.0, 95% CI = 9.3-20.8] were associated with severity of fatigue. Patients with fatigue had a significantly decreased IBDQ-9 score [p < 0.001]. CONCLUSIONS: The prevalence of fatigue in IBD patients is remarkably high and has a negative impact on QoL. Therapy with systemic steroids is associated with an increased risk of fatigue. The severity of fatigue is associated with anxiety, depression, sleep disorders, and the presence of EIMs. Fatigue was not associated with anaemia, disease activity or anti-TNF therapy.
BACKGROUND AND AIMS: The aims of this study were to determine the prevalence of fatigue in patients with inflammatory bowel disease [IBD], to identify the factors associated with fatigue and its severity, to assess the impact of fatigue on quality of life [QoL], and to evaluate the relationship between fatigue and sleep disorders. METHODS: This was a prospective multicentre study conducted at 22 Spanish centres. Consecutive patients followed at IBD Units were included. Fatigue was evaluated with the Fatigue Severity Scale [FSS] and the Fatigue Impact Scale [FIS]. Quality of life and sleep quality were assessed using the IBD Questionnaire-Short Form [IBDQ-9] and the Pittsburgh Sleep Quality Index [PSQI], respectively. RESULTS: A total of 544 consecutive adult IBD patients were included [50% women, mean age 44 years, 61% Crohn's disease]. The prevalence of fatigue was 41% (95% confidence interval [CI] = 37-45%). The variables associated with an increased risk of fatigue were: anxiety [OR = 2.5, 95% CI = 1.6-3.7], depression [OR = 2.4, 95% CI = 1.4-3.8], presence of extraintestinal manifestations [EIMs] [OR = 1.7, 95% CI = 1.1-2.6], and treatment with systemic steroids [OR = 2.8, 95% CI = 1.4-5.7]. The presence of EIMs [regression coefficient, RC = 8.2, 95% CI = 2.3-14.2], anxiety [RC = 25.8, 95% CI = 20.0-31.5], depression [RC = 30.6, 95% CI = 24.3-37.0], and sleep disturbances [RC = 15.0, 95% CI = 9.3-20.8] were associated with severity of fatigue. Patients with fatigue had a significantly decreased IBDQ-9 score [p < 0.001]. CONCLUSIONS: The prevalence of fatigue in IBD patients is remarkably high and has a negative impact on QoL. Therapy with systemic steroids is associated with an increased risk of fatigue. The severity of fatigue is associated with anxiety, depression, sleep disorders, and the presence of EIMs. Fatigue was not associated with anaemia, disease activity or anti-TNF therapy.
Authors: Kendra Kamp; Sharon Dudley-Brown; Margaret Heitkemper; Gwen Wyatt; Barbara Given Journal: Res Nurs Health Date: 2019-10-10 Impact factor: 2.228
Authors: Suja P Davis; Ding-Geng Chen; Patricia B Crane; Linda P Bolin; Lee Ann Johnson; Millie D Long Journal: Nurs Res Date: 2021 Jul-Aug 01 Impact factor: 2.381