Introduction: Fatigue is a well-established symptom in systemic lupus erythematosus. Depression and anxiety can develop at different stages of systemic lupus erythematosus and their severity can range from mild symptoms to more serious disorders. Patients with systemic lupus erythematosus may consider fatigue to be a symptom that is more severe than pain, depression, or anxiety. Objectives: To describe fatigue in patients with systemic lupus erythematosus and identify the best predictive model for fatigue in these patients. Methods: Multicenter cross-sectional cohort studies. Eighty-eight patients with systemic lupus erythematosus from different regions of Spain will be included in the studies. The primary variable will be fatigue (Fatigue Assessment Scale), with anxiety (State-Trait Anxiety Inventory) as the dependent variable. The secondary variables will be perceived quality of life (Lupus Quality of Life and 36-Item Short Form Survey Instrument), level of physical activity (International Physical Activity Questionnaire), and the main clinical, sociodemographic, and anthropometric variables. Expected results: To describe fatigue in patients with systemic lupus erythematosus, as well as the predictive model for fatigue in these patients.
Study Type
OBSERVATIONAL
Enrollment
884
Universidad de Oviedo
Almería, Andalusia, Spain
Assessment of fatigue at baseline
Fatigue will be assessed using the Fatigue Assessment Scale. This tool provides information on the physical and psychological aspects of fatigue. This scale is highly reliable. This self-reported questionnaire consists of 10 items with a 5-point Likert response scale. Five items reflect the physical component and five reflect the psychological component. The score range of the scale is 10-50 (the higher the score, the greater the degree of fatigue).
Time frame: Baseline
Assessment of anxiety symptoms at baseline
The State-Trait Anxiety Inventory will be used to measure the presence and severity of anxiety symptoms in patients with systemic lupus erythematosus. There are two subscales within this measure: state and trait. The state anxiety scale assesses the current state of anxiety, while the trait anxiety scale assesses relatively stable aspects of the propensity for anxiety. This scale has 40 items, 20 assigned to each of the subscales, with a range of 1 to 4 points (the higher the score, the higher the level of anxiety).
Time frame: Baseline
Assessment of quality of life at baseline
Quality of life in patients with systemic lupus erythematosus will be measured using the Spanish version of the Lupus Quality of Life (LupusQoL) questionnaire. This questionnaire consists of 34 items in 8 domains (physical health, emotional health, body image, pain, planning, fatigue, intimate relationships, and burden on others). The questionnaire scores range from 0 (worst quality of life) to 100 (best quality of life).
Time frame: Baseline
Assessment of health-related quality of life at baseline
The Spanish version of the Short Form-36 Health Survey (SF-36) questionnaire will be used to measure health-related quality of life. It consists of 36 items that investigate eight dimensions (physical function, physical role, bodily pain, general health, vitality, social function, emotional role, and mental health, including a health transition item). The score ranges from 0 to 100 (better perception of quality of life).
Time frame: Baseline
Assessment of physical activity level at baseline
Physical activity level will be assessed using the International Physical Activity Questionnaire (IPAQ). This tool consists of seven questions that inquire about the frequency, duration, and intensity of physical activity performed in the last week. It also assesses the time spent walking and sitting. The results are classified into three categories: low, moderate, and high activity, identifying whether individuals meet the WHO activity recommendations. The unit of measurement is the metabolic equivalent of task (METS), where a higher number of METS indicates greater physical activity.
Time frame: Baseline
Assessment of lupus activity index at baseline
The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) is a widely used tool in the evaluation of systemic lupus erythematosus. This global index assesses disease activity over the last 10 days and consists of 24 items that collect specific manifestations in 9 organs or systems. The SLEDAI score ranges from 0 to 105, with higher scores indicating greater disease activity.
Time frame: Baseline
Assessment of cumulative damage in lupus at baseline
The assessment of cumulative damage in patients with systemic lupus erythematosus will be performed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC/ACR). The tool includes 12 organ systems and measures irreversible damage from the onset of the disease, regardless of its activity, adverse effects due to treatment, or comorbidities. For damage to be considered, it must have been present for at least six months, thus avoiding confusion with active inflammatory processes. The total index score ranges from 0 to 46, with a higher score indicating a greater degree of cumulative damage.
Time frame: Baseline
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