The Effect of Pain in Patients with Ankylosing Spondylitis on Sleep Disturbance: Focusing on the Mediating Effect of Fatigue

강직성 척추염 환자의 통증이 수면장애에 미치는 영향: 피로의 매개효과를 중심으로

  • Cho, Ok-Hee (Department of Nursing, College of Nursing and Health, Kongju National University) ;
  • Lim, Jong Mi (Department of Nursing, College of Nursing and Health, Kongju National University) ;
  • Hwang, Kyung-Hye (Department of Nursing, Suwon Science College)
  • 조옥희 (공주대학교 간호학과) ;
  • 임종미 (공주대학교 대학원 간호학과) ;
  • 황경혜 (수원과학대학교 간호학과)
  • Received : 2018.04.25
  • Accepted : 2018.07.11
  • Published : 2018.08.31


Purpose: The purpose of this study was to investigate the mediating effect of fatigue on the relationship between pain and sleep disturbance in patients with ankylosing spondylitis. Methods: The subjects of this study were 109 patients with ankylosing spondylitis who visited the rheumatology department in a university hospital. Subjects completed structured questionnaires measuring pain, sleep disturbance, and fatigue. Data were analyzed using t-test, Pearson's correlation coefficients, and 3-step regression analysis. Results: Pain was positively correlated with fatigue (r=.60, p<.001) and sleep disturbance (r=.45, p<.001). Fatigue was positively correlated with sleep disturbance (r=.55, p<.001) and had a mediating effect on the relationship between pain and sleep disturbance. Conclusion: The findings confirm that pain in patients with ankylosing spondylitis affects fatigue and its accumulation has a mediating effect on increasing the level of sleep disturbance. In clinical practice, education on symptom management for patients with ankylosing spondylitis needs to be provided for encouraging proper exercise and rest. Patient education should also include strategies to reduce fatigue and promote sleep in daily lives in addition to pain management.


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