The Interactive, Fatigue Self-Management Resource: The Road from Development to Testing to Hope for a Potential New Fatigue Management Tool
Symptom management is an essential component of patient care. In addition to medical, nursing and rehabilitative interventions and strategies, self-management initiatives can be very effective adjunct tools for managing symptoms. Self-management, helping patients understand the central role they play in managing their illness, may be a valuable initiative in addressing fatigue. Fatigue impacts 70-90% of persons with MS. While many available fatigue management interventions do support self-management, they usually require involvement in a structured program. These programs may not be accessible or consistent with patients' preferred learning styles or the particular factors contributing to their fatigue. An interactive, self-guided fatigue management resource has the potential to address this problem. Our team developed such a resource, which allows people with MS to take a personalized and active approach to learning about and managing their fatigue.
A pilot study was undertaken to evaluate the utility and feasibility of this resource.
Based on research literature, an interactive Microsoft PowerPoint® presentation was created, allowing persons with MS to gain knowledge about MS fatigue, learn how to assess and track their own fatigue, discover factors that may be contributing to their particular fatigue (i.e.; depression, poor sleep, medication side-effects, lack of physical activity, and mental exertion), and explore practical and evidence-based strategies for managing fatigue. The pilot study recruited persons with MS from two sites in Canada (N=35). The primary criterion for eligibility was a Fatigue Severity Scale score of 2.0-5.4 (i.e., mild to moderate fatigue). Data were collected at baseline, 3-weeks and 3-months, using the Modified Fatigue Impact Scale (MFIS), Lorig Self-management Efficacy Scale (SMSE), and Perceived Deficits Questionnaire (PDQ). Paired t-tests were used to evaluate changes over time. Qualitative data were also collected via semi-structured interviews and analysed using interpretive description analysis.
Participants reported significantly lower MFIS overall fatigue (t=2.64, p=0.012), cognitive (t=2.89, p=0.00) and psychosocial (t=2.83, p=0.008) fatigue, as well as fewer PDQ cognitive difficulties (t=2.68, p=0.011). Positive trends were found in regards to the MFIS physical fatigue sub-scale and SMSE. Qualitative analyses reflected positive changes in fatigue knowledge, expectations, and behaviors, as well as overall improved quality of life, increased self-confidence, and better communication with others.
The results suggest this resource holds strong potential to be an effective and valuable fatigue self-management support tool for persons with MS. Self-guided fatigue management tools such as our resource can aid to achieve successful outcomes when added to established treatment strategies for MS fatigue.