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Fatigue in adults with primary Antiphospholipid Syndrome: findings from a mixed methods study

Research output: Contribution to journalArticle

Lindsay M Bearne, Julie Bieles, Sofia Georgopoulou, Josie Andrews, Amy Tully, Katrine Stolarchuk-Prowting , Thomas Williamson, Beatriz Santana Suarez, Louise Nel, David D'Cruz, Heidi Lempp

Original languageEnglish
Pages (from-to)924-933
Number of pages10
Issue number8
Early online date5 Jun 2020
Accepted/In press30 Apr 2020
E-pub ahead of print5 Jun 2020
Published1 Jul 2020


King's Authors


Objective: This study aimed to explore the experience and impact of fatigue in adults with primary antiphospholipid syndrome (pAPS). Methods: This sequential, explanatory mixed-methods study enrolled adults with a six-month or more history of pAPS. Consenting participants completed the Functional Assessment of Chronic Illness Therapy–Fatigue subscale (FS), Multi-Dimensional Perceived Social Support Scale, Patient Health Questionnaire (PHQ9), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQMETS). Relationships between FS and other variables were explored with multiple linear regression. Interviews were conducted with a subgroup of participants, and the data were analysed thematically. Results: A total of 103 participants were recruited (M age = 50.3 years; standard deviation = 10.1 years; 18 males). Of these, 62% reported severe fatigue. Greater fatigue was associated with lower mood, physical inactivity, poorer sleep quality and lower perceived social support. The best-fit model explained 56% of the variance in FS (adjusted R 2 = 0.560, F(3, 74) = 33.65, p > 0.001) and included PHQ9 and IPAQMETS as significant predictors, and PSQI as a non-significant predictor. Twenty participants completed interviews. Three key themes were identified: characteristics of fatigue, impact on life and coping strategies. Conclusion: Fatigue was a common symptom of pAPS and challenging to manage. Other factors, particularly mood and physical activity, influenced fatigue. Evidence-based self-management interventions are needed.

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