Resilience and positive affect are related to the experience of fatigue in patients with a rheumatic disease.

Background. Fatigue is a common symptom in patients with a rheumatic disease. Resilience, the ability to bounce back or recover from stress, has been found to be related to lower fatigue in patients with cancer, traumatic brain injury, cardiac disease and fibromyalgia (see e.g. [1])
Objectives. To study the relationships of resilience and the resilience related factors positive affect, acceptance and engaged living with fatigue in patients with rheumatic diseases.
Methods. 57 patients with a rheumatic disease (rheumatoid arthritis, 70%; osteoarthritis, 11%; others, 9 %) completed an online questionnaire. Fatigue was assessed with SF-36 vitality scale; pain with a VAS; Resilience with BRS and resilience related factors with PANAS (positive affect), AAQ-II (Acceptance) and ELS (engaged living). Data were analysed with hierarchical multiple regression analyses.
Results. Resilience, positive affect, acceptance and engaged living were multivariate significantly related to fatigue (R2 = 0.54; P≤ 0.001). Resilience (β= 0.29; P≤0.05) and positive affect (β= 0.39; P≤ 0.01) were significant individual predictors of lower fatigue in multiple regression analysis. Acceptance and engaged living were not significantly related with fatigue in the multivariate model. The relationship between resilience and fatigue was partially mediated by positive affect. When pain was included in the model the relations of resilience (β= 0.27; P≤0.05) and positive affect (β= 0.34; P≤ 0.05) with fatigue remained significant.
Conclusions. Resilience and positive affect may be predictors of decreased fatigue in rheumatic patients. Further longitudinal studies are needed to examine the causality of these relationships.
References
[1] Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: Assessing the ability to bounce back. Int J Behav Med 2008;15(3):194-200.