Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study

What we know about fatigue self-management programs for people living with chronic conditions: A scoping review

OBJECTIVE

The significant impact of fatigue on the lives of patients with chronic conditions has demanded a response. One response has been the development and testing of self-management programs. Little is known about what these programs have in common or how they differ. This scoping review compared the key components of fatigue self-management programs.

METHODS

Scoping review methodology was employed. Databases of CINAHL, Academic Search Premier, PsycINFO, Cochrane and Medline were searched to identify relevant sources.

RESULTS

Included fatigue programs were compared using a three-component framework: 1) self-management strategies; 2) active patient participation; and 3) self-management support. Although all programs included some aspects of these components, the extent varied with only a few domains of these components found across all programs.

CONCLUSION

The three self-management components employed in this study showed potential benefits in identifying similarities and differences across fatigue programs with comparable and distinct underlying theories. This three-component framework could facilitate identification of domains associated with positive outcomes.

PRACTICE IMPLICATIONS

It is essential that authors of programs provide detailed descriptions to enable inter-program comparison. The three-component framework chosen for this review was capable of describing and comparing fatigue self-management programs, paving the way for more effective interventions.

Lived experiences in daily life with myalgic encephalomyelitis

Introduction

Myalgic encephalomyelitis is a complex systemic condition, causing severe symptoms that limit the quality of life of the people living with it. This study examined changes in life, coping strategies, and the ability to obtain a successful occupational adaptation in people with myalgic encephalomyelitis in Denmark, viewed from the perspective of the model of human occupation.

Method

In-depth qualitative interviews with seven persons with myalgic encephalomyelitis aged 31–61 years were analysed with qualitative content analysis.

Results

The participants experienced severe changes in their lives leading to impaired occupational competences which affected their occupational identity and made them lonely. Pacing and environmental changes were the preferred coping strategies in their attempt to adapt to the new circumstances.

Conclusion

The participants experienced major changes in everyday life with the onset of myalgic encephalomyelitis. Pacing and environmental changes were not sufficient strategies to secure a successful occupational adaptation. Thus, people living with myalgic encephalomyelitis need assistance to enable a successful occupational adaptation and preserve hope. Access to occupational therapy within the Danish programme for people living with myalgic encephalomyelitis may support more effective occupational adaptation in the population.

Effectiveness of a group-based self-management program for people with chronic fatigue syndrome: a randomized controlled trial

OBJECTIVE

To evaluate the effectiveness of a group-based self-management program for people with chronic fatigue syndrome.

DESIGN

A randomized controlled trial.

SETTING

Four mid-sized towns in southern Norway and two suburbs of Oslo.

SUBJECTS

A total of 137 adults with chronic fatigue syndrome.

INTERVENTION

A self-management program including eight biweekly meetings of 2.5 hours duration. The control group received usual care.

MAIN MEASURES

Primary outcome measure: Medical Outcomes Study-Short Form-36 physical functioning subscale.

SECONDARY OUTCOME MEASURES

Fatigue severity scale, self-efficacy scale, physical and mental component summary of the Short Form-36, and the illness cognition questionnaire (acceptance subscale). Assessments were performed at baseline, and at six-month and one-year follow-ups.

RESULTS

At the six-month follow-up, a significant difference between the two groups was found concerning fatigue severity ( p = 0.039) in favor of the control group, and concerning self-efficacy in favor of the intervention group ( p = 0.039). These significant differences were not sustained at the one-year follow-up. No significant differences were found between the groups concerning physical functioning, acceptance, and health status at any of the measure points. The drop-out rate was 13.9% and the median number of sessions attended was seven (out of eight).

CONCLUSIONS

The evaluated self-management program did not have any sustained effect, as compared with receiving usual care.

Fatigue in rheumatic diseases

Fatigue is a common and important problem in many diseases including rheumatologic illnesses, and it has a negative impact on health-related quality of life. Fatigue is described as having an impact on multiple aspects of a patient's life. There is a need for knowledge about causes of and treatments for fatigue to ensure that patient outcomes are improved. There are several effective treatment strategies available for fatigue including pharmacological and non-pharmacological therapies. We aim to provide an overview of fatigue in rheumatologic disorders and some recommendations on its optimal management.