Fatigue in Egyptian patients with rheumatic diseases: a qualitative study

OBJECTIVES Fatigue is frequent in rheumatic diseases. Fatigue expression and consequences may be modified by cultural differences. Our objective was to increase the understanding of the fatigue experience and characteristics among Egyptian, Muslim patients with rheumatic diseases. METHODS Prospective monocentric qualitative study based on conventional qualitative content analysis, inductive reasoning, grounded theory. Egyptian patients with rheumatoid arthritis (RA), fibromyalgia or axial spondyloarthritis (AxSpA) were asked about fatigue, its patterns, consequences and self-management. RESULTS Of the 60 patients interviewed, 20 patients had each disease (RA, fibromyalgia and AxSpA); median ages ranged from 34 to 40 years. Patients were mainly male (N = 40, 66%), had 3 to 7 years (mean) of disease duration and had moderate disease activity. Some aspects of the patients' experience of fatigue may be specific to the Egyptian and Muslim culture such as the description of fatigue as a physical more than a mental impact of the disease, the response to the effect of fatigue on sexual function and the gender specific (women more than men) limitation of social activities due to fatigue which was more obvious in our study than other previous studies. Other aspects of patients' experience of fatigue like overlap between the patients' perception of fatigue and pain and coping strategies were similar to the findings in previous studies. CONCLUSION This study gives insights regarding fatigue in rheumatic diseases in an Arabic and Muslim culture. Similarities and differences with previous studies were noted and should be taken into account when assessing these patients.