Abstract
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.