Relationship of Fatigue, Pain Interference, and Physical Disability in Children Newly Diagnosed With Juvenile Idiopathic Arthritis

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-05-20 DOI:10.1002/acr.25377
Naomi Choong, Michelle Batthish, Roberta A. Berard, Gaëlle Chédeville, Brian M. Feldman, Kristin M. Houghton, Adam M. Huber, Sarah James, Jean-Philippe Proulx-Gauthier, Dax G. Rumsey, Heinrike Schmeling, Karine Toupin-April, Jaime Guzman, for the CAPRI Registry Investigators
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Abstract

Objective

Our objectives were to quantify the relationships among fatigue, pain interference, and physical disability in children with juvenile idiopathic arthritis (JIA) and to test whether fatigue mediates the relationship between pain interference and physical disability in JIA.

Methods

Patients enrolled within three months of JIA diagnosis in the Canadian Alliance of Pediatric Rheumatology Investigators (CAPRI) Registry between February 2017 and May 2023 were included. Their parents completed the Patient-Reported Outcomes Measurement Information System fatigue and pain interference short proxy questionnaires and the Childhood Health Assessment Questionnaire disability index at registry enrollment. Associations were assessed using Pearson correlations and multiple linear regression. Structural equation modeling (SEM) was used to test if fatigue mediates the relationship between pain interference and physical disability.

Results

Among 855 patients (61.4% female, 44.1% with oligoarthritis), most reported fatigue and pain interference scores similar to those in the reference population, but 15.6% reported severe fatigue and 7.3% reported severe pain interference, with wide variation across JIA categories. Fatigue was strongly correlated with pain interference (r = 0.72, P < 0.001) and with physical disability (r = 0.60, P < 0.001). Pain interference (β = 0.027, P < 0.001) and fatigue (β = 0.013, P < 0.001) were both associated with physical disability after controlling for each other and potential confounders. SEM supported our hypothesis that fatigue partially mediates the relationship between pain interference and physical disability.

Conclusion

Our findings suggest both fatigue and pain interference are independently associated with physical disability in children newly diagnosed with JIA, and the effect of pain interference may be partly mediated by fatigue.

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新诊断为幼年特发性关节炎的儿童疲劳、疼痛干扰和身体残疾之间的关系。
目标:我们的目标是量化 JIA 儿童疲劳、疼痛干扰和身体残疾之间的关系,并检验疲劳是否介导了 JIA 儿童疼痛干扰和身体残疾之间的关系:我们的目标是量化JIA患儿疲劳、疼痛干扰和肢体残疾之间的关系,并检验疲劳是否介导了JIA疼痛干扰和肢体残疾之间的关系:方法:纳入2017年2月至2023年5月期间在加拿大儿童风湿病学研究者联盟(CAPRI)登记处确诊JIA后3个月内登记的患者。他们的父母在注册登记时填写了PROMIS疲劳和疼痛干扰简易代理问卷以及CHAQ残疾指数。采用皮尔逊相关性和多元线性回归评估两者之间的关联。结构方程模型(SEM)用于检验疲劳是否介导了疼痛干扰和身体残疾之间的关系:在 855 名患者(61.4% 为女性,44.1% 患有少关节炎)中,大多数人的疲劳和疼痛干扰评分与参照人群相似,但有 15.6% 的人报告有严重疲劳,7.3% 的人报告有严重疼痛干扰,而且不同 JIA 类别之间的差异很大。疲劳与疼痛干扰(r = 0.72,p < 0.001)和身体残疾(r = 0.60,p < 0.001)密切相关。疼痛干扰(b = 0.027,p < 0.001)和疲劳(b = 0.013,p < 0.001)在控制了彼此和潜在的混杂因素后,均与身体残疾相关。SEM 支持我们的假设,即疲劳在一定程度上介导了疼痛干扰与身体残疾之间的关系:我们的研究结果表明,在新诊断为JIA的儿童中,疲劳和疼痛干扰均与肢体残疾独立相关,疼痛干扰的影响可能部分由疲劳介导。
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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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