Evaluation of person-centred care at rheumatic disease
Short description
Treatment for rheumatoid arthritis (RA) has improved and has contributed to better control of the disease. Despite this, fatigue is a prominent symptom with significant consequences in everyday life. The experience of fatigue is individual and has physical, cognitive and emotional components affecting everyday tasks and social roles.
Physical activity is the non-pharmacological treatment with greatest evidence to reduce fatigue in people with RA. But being able to exercise is difficult for those who are tired.
The purpose of the research project was to search for deeper knowledge about fatigue in people with RA and to design a person-centred treatment to alleviate fatigue and its consequences. The project included qualitative interview studies, quantitative observational studies over time and a randomized controlled treatment study.
Short description of main results
The studies showed significant consequences on fatigue for people with RA. Fatigue varied over time and was most severe during the winter. Pain and depressive symptoms were important for the variation of fatigue.
We developed a person-centred physiotherapy treatment with focus on health-enhancing physical activity and balance in everyday life.
A randomised controlled trial showed significant and lasting effects with reduced fatigue and improved physical function and health. The participants in the intervention expressed that physical activity was important in managing fatigue, but this insight could only be achieved through personal experience.
Publications
Feldthusen C, Mannerkorpi K. Factors of importance for reducing fatigue in persons with rheumatoid arthritis: a qualitative interview study. BMJ Open. 2019;9(5) https://gup.ub.gu.se/publications/show/282024
Feldthusen C, Dean E, Forsblad-d'Elia H, Mannerkorpi K. Effects of Person-Centered Physical Therapy on Fatigue-Related Variables in Persons With Rheumatoid Arthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2016;97:26-36. https://gup.ub.gu.se/publications/show/227891
Feldthusen C, Grimby-Ekman A, Forsblad-d'Elia H, Jacobsson L, Mannerkorpi K. Explanatory factors and predictors of fatigue in persons with rheumatoid arthritis: A longitudinal study. J Rehabil Med. 2016;(Apr):15. https://gup.ub.gu.se/publications/show/237415
Feldthusen C, Grimby-Ekman A, Forsblad-d’Elia H, Jacobsson L, Mannerkorpi K. Seasonal variations in fatigue in persons with rheumatoid arthritis: a longitudinal study. BMC Musculoskeletal Disorders 2016;17:59. https://gup.ub.gu.se/publications/show/233536
Feldthusen C, Björk M, Forsblad-d’Elia H, Mannerkorpi K. Perception, consequences, communication, and strategies for handling fatigue in persons with rheumatoid arthritis of working age—a focus group study. Clinical Rheumatology 2013;32(5):557-66. https://gup.ub.gu.se/publications/show/171837
Researchers
Caroline Feldthusen, PhD, physiotherapist.
Kaisa Mannerkorpi, professor, physiotherapist. Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, University of Gothenburg.
Helena Forsblad-d’Elia, professor, MD. Institute of Medicine, Department of Rheumatology and Inflammationresearch, Sahlgrenska Academy, University of Gothenburg.
Elizabeth Dean, professor, physical therapist. Department of Physical Therapy, University of British Columbia, Canada
Mathilda Björk, professor, occupational therapist. Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping