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Rheumatoid arthritis RA: more than an inflammatory disorder? A systematic review

Szotek, Ninja (2010) Rheumatoid arthritis RA: more than an inflammatory disorder? A systematic review.

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Abstract:Rheumatoid arthritis is a chronic inflammatory disorder which affects the joints by destroying body tissues. Thereby, pain and fatigue are very common and often reported symptoms. But rheumatoid arthritis is not only connected to devastating bodily ailment but also to restrictive mental problems. The aim of this study was to analyze the progress of pain and fatigue in rheumatoid arthritis and the overall relation with problematic moods (depression/anxiety), psychosocial resources (social support, selfefficacy) and burdens (social distress, problematic social support). The design which is utilized is a Cochrane Systematic Review. A broad search of literature which report on the relations in demand is applied in four electronic databases. The methodological quality of the included studies was assessed and data extracted, based on pain and fatigue as primary outcomes, depression and anxiety as secondary outcomes and social burdens/resources were extracted as third outcomes. The results of 7 adequate articles for fatigue, 13 for fatigue and pain and 23 for pain summarized partly opposing results. Through the different studies, pain and fatigue seemed to fluctuate in different directions over a period of 10 years. Most of the studies show considerable relations of pain/fatigue with anxiety and depression. Partly, that mood influenced pain/fatigue, partly that pain/fatigue led to mood problems. Some papers failed to confirm any relation. The psychosocial resources/burdens were all related to pain/fatigue: self-efficacy and the amount of social support negatively and social distress and problematic social support positively. Further, social distress mediated positively and self-efficacy mediated negatively the relation between problematic moods and pain/fatigue. These data suggest on the one hand a need for further high qualitative research for describing the progress of pain and fatigue as well as the causality between pain, fatigue, mood problems and psychosocial resources/burdens on the field of rheumatoid arthritis but on the other hand also that psychological aspects, as tutoring in self-management and support in mood problems, should play a greater role in treating RA.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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