A better self-efficacy is predictive of lower fatigue in systemic lupus erythematosus patients: Data from a Almenara Lupus Cohort

Objectives: To determine the possible predictive value of self-efficacy on fatigue in SLE patients. Methods: SLE patients from a single-center prevalent cohort were included. Self-efficacy was ascertained with the five instruments of the Patient-Reported Outcomes Measurement Information System® (PROMIS®) Self-efficacy for Managing Chronic Conditions plus the PROMIS general self-efficacy. For PROMIS instruments, a score of 50 is the average for a clinical population (people with a chronic condition), the higher score, the greater self-efficacy. Fatigue was ascertained with the Functional Assessment of Chronic Illness Therapy – Fatigue (FACIT-F), the higher score, the lower fatigue. Generalized estimating equations were performed, using as outcome the FACIT-F in the subsequent visit, and the self-efficacy instrument in the previous visit; multivariable models were adjusted for possible confounders. All the confounders were measured in the same visit than the self-efficacy instrument. Results: A total of 209 patients and 563 visits were included. At baseline, FACIT-F was 33.0 (10.2), mean general self-efficacy was 47.2 (10.4), self-efficacy for managing emotions was 44.6 (8.0), for managing symptoms was 47.7 (8.2), for managing daily activities was 45.5 (7.5) for managing social interactions was 42.9 (7.9) and for managing medications and treatment was 43.9 (7.0). In the multivariable models a lower fatigue was predicted by self-efficacy for managing symptoms and managing activities. Conclusion: A better self-efficacy is predictive of a subsequent lower fatigue, even after adjustment for possible confounders. Strategies to improve self-efficacy in SLE patients should be encouraged.