Mediating Role of Self-Efficacy in the Association Between Fatigue and Depressive Symptoms in Females with Rheumatoid Arthritis.

Background and

Objectives

Extant research on the relationship between fatigue and depression in people with rheumatic diseases portrays a divergent picture. While caring for persons with this medical condition, one issue that represents individual confidence in carrying out specific tasks, namely self-efficacy level, has attracted significant attention. Yet, the information regarding whether self-efficacy may pose a clue linking these two major symptoms is still unknown. The aim of this study, therefore, is to examine whether self-efficacy mediates the association between fatigue and depressive symptoms among persons with rheumatoid arthritis (RA). Materials and Method: A cross-sectional study of 224 females with RA from a hospital in Taiwan was conducted between January and October 2023. We then distributed anonymous self-reported questionnaires instructing participants to provide information on their demographic characteristics, levels of fatigue, self-efficacy, and depressive symptoms. The bootstrap via PROCESS macro in SPSS was executed to analyze if self-efficacy would mediate the effect of fatigue on emergence of depressive symptoms.

Results

For those participants captured at baseline, a negative association was noted between fatigue and self-efficacy, as well as between self-efficacy and depressive symptoms. Results of the mediation analysis revealed a remarkable indirect effect of fatigue on depressive symptoms through self-efficacy, with a regression coefficient of 0.21 (95% confidence intervals: 0.06-0.37).

Conclusions

This work extends current understanding of the roles that fatigue and self-efficacy play in predicting depression among people with RA and further clarified the potential mediating role of self-efficacy in buffering against depressive symptomatology. Interventions that extend from the management of fatigue and further incorporate the improvement of self-efficacy sense into the stereotypical therapy should greatly mitigate the distressing symptoms for patients with RA.