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Author ORCID Identifier


Campus-Only Access for Five (5) Years

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Jeungok Choi

Second Advisor

Cynthia Jacelon

Third Advisor

Christopher Martell

Subject Categories

Family Practice Nursing | Geriatric Nursing | Other Medicine and Health Sciences | Other Nursing | Other Psychiatry and Psychology | Psychiatric and Mental Health Nursing | Psychological Phenomena and Processes | Public Health Education and Promotion


Background: Arthritis is a leading cause of long-term disability in older adults. Fatigue is a prevalent symptom occurring in up to 80% of arthritis patients. Finding solutions to improve long-term symptom severity amongst is a critical need.

Purpose: To improve long-term arthritis fatigue symptoms by encouraging simple walking using a tablet-based cognitive behavioral group intervention, called Tab-G. Tab-G encourages simple walking through group participant engagement and goal setting.

Methods: Using an experimental, longitudinal pre and posttest repeated measures design, older adults with arthritis fatigue (n = 40) were randomized the Tab-G (intervention group, n = 18) or the control group (n = 22). The two groups were compared on four outcomes: daily step counts, level of fatigue, self-efficacy, and perceived quality of life (QOL) across four time points (baseline, week 4 (end of Tab-G intervention), week 8 (follow-up #1), week 10 (follow-up #2).

Results: Results of the RM-ANOVA show significant mean differences (Tab-G vs. Control), in daily step counts, F(1, 36), = 4.180, p < .001, with Tab-G participants reporting higher steps, however there were no statistically significant time differences in daily step counts at the four time points. Significant mean differences in fatigue scores F(1, 36), = 9.971, p = .003, were observed with Tab-G participants reporting lower fatigue. Significant mean score differences in fatigue scores at the four time points, F(3, 108), = 5.430, p = .002, were also seen. Tab-G participants reported higher self-efficacy with significant group mean score increase, F(1,28), = 4.645, p = .04, when compared to the control group. Significant mean score differences were noted at the four time points for self-efficacy as well. Significant mean differences in QOL-RA scores between the two groups, F(1, 29), = 6.147, p = .019, with Tab-G participants reporting higher QOL, as well as significant mean score differences in the QOL scores at the four time points, F(3,87), = 3.673, p = .015.

Conclusion: The long-term effectiveness of Tab-G is one solution for self-management of arthritis fatigue. For more persuasive evidence, a trajectory of future research should include G-CBI for arthritis fatigue, including feasibility and duration of effectiveness.


Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Available for download on Sunday, May 26, 2024