THE EXPERIENCE OF RHEUMATOID-ARTHRITIS PAIN AND FATIGUE - EXAMINING MOMENTARY REPORTS AND CORRELATES OVER ONE WEEK

Objective. To evaluate the daily experience of patients with rheumatoi d arthritis (RA) in an ecologically valid manner; Ecological Momentary Assessment (EMA) was employed. Diurnal cycles and within-day variatio n of self-reported pain and fatigue were examined as were relationship s between pain, fatigue, daily stressful events, and sleep. Methods. T hirty-five patients with RA were alerted with an electronic beep 7 tim es per day for 7 consecutive days. Assessments were recorded at each b eep, Upon awakening each day, sleep information was reported. Results. There were large individual differences in variation of pain and fati gue. Stressors were associated with increased pain but not fatigue. Su bjects with poor sleep had higher levels of pain and fatigue. Diurnal cycles of pain and fatigue were found, yet were observed for only some patients (37% and 34%, respectively), Conclusion. The use of EMA deep ens our understanding of the pain and fatigue experienced by RA patien ts. This method may help identify subgroups of patients who are highly ''psychoreactive'' to environmental stimuli and/or who have diurnal p atterns to their symptoms. It may also be used to improve existing ins truments.