Cognitive response to symptoms in women with rheumatoid arthritis.

Abstract

The purpose of this study was to advance knowledge and understanding related to the cognitive response evoked by symptoms in women with rheumatoid arthritis. The mechanisms to achieve this purpose were through: (1) psychometric evaluation of a newly developed instrument: Chronic Fatigue Index (CFI), (2) examining the relationship among the symptoms of RA and components of quality of life for women with RA, and (3) exploring the mechanism by which learned resourcefulness affects the relationship between symptoms and quality of life. The Chronic Fatigue Index (CFI) was evaluated and met minimal levels of reliability and validity. Cronbach alpha reliability estimate for the CFI was.87. Convergent validity was tested through factor analysis. The CFI was found to be a multi-dimensional scale with two distinct factors: chronicity and interference. The factor analytical strategies revealed 46% of the variance in chronic fatigue was supported by these two components. Moderate to strong relationships were found among the symptoms of chronic pain, chronic fatigue, disturbed sleep, and disease flare. To evaluate quality of life in this population a common factor was created through factor analysis. The results of factor analysis revealed three indicators explaining 69% of the variance in quality of life for this population. Chronic pain explained fourteen percent of the variance in learned resourcefulness. The other symptoms and multiplicative terms did not meet the entry criteria. Learned resourcefulness was a weak mediator between the disturbance of chronic pain and quality of life, but successfully moderated the adverse effect of disturbed sleep. Fifty eight percent of the variance in quality of life was explained by the direct path of chronic pain and disturbed sleep on quality of life and the interaction of disturbed sleep and learned resourcefulness. Model respecification suggested that the inclusion of additional variables in the model would increase the explanatory power of the model. The self-regulation framework for symptom appraisal was supported by the findings of this study. Nursing interventions should focus on assisting clients with enhancing their level of learned resourcefulness as it will buffer the adverse effects of the disease process.