Using the Flinders Program to Develop a Self-Management Program for Patients with Fatigue
Available literature highlights that less than a quarter of patients with MS are using any self-management strategies to address fatigue and that pharmacologic agents are as of yet not a replacement for self-management strategies (in part due to an absence of FDA-approved medications for the management of fatigue). Thus, patients may be in great need of viable self-management programs that can be adopted within the clinics at which they receive their care. However, a gold standard self-management program has yet to be identified in the literature on MS-related fatigue. Many of the ones that have been piloted in research are not yet promising and are subject to design flaws that restrict them from being truly self-management based. For example, many of these programs involved other- rather than self-imposed goals, incorporated interventions that were not accessible to the patients once participation in the program was concluded, or were not easily integrated into the patient’s daily lives (e.g., the strategies were too novel to the patients). Such fatigue management programs may incidentally promote learned helplessness by supporting the patient’s perception that he/she lacks external resources necessary for managing fatigue and by not accessing the patient’s own internally-derived motivation for applying the individual’s internal and external resources to manage fatigue.
Objectives: As a result of these identified issues, our objective is to introduce a patient directed self-management program following the Flinders Program for self-management of chronic conditions developed by the Flinders Human Behavior and Health Research Unit of Flinders University.
Methods: This model is a patient centered approach in which patients collaborate with a health “coach” to decide on factors that contribute to their identified health problem and develop a care plan to follow that utilizes concrete action-based goals that patients set for themselves. Patients rate themselves on a variety of 12 domains related to managing their health condition and are interviewed by their coach, who also rates them, according to these domains. Consensus ratings determine areas in which the patient is experiencing problems that form the basis of patient-derived intervention. Follow-up is provided at selected intervals to promote accountability, goal refinement and achievement.
Conclusions: This poster will report on how the Flinders Program is being adapted for use in an MS patient population to promote self-management of fatigue and may exist as a potential gold-standard solution for addressing MS-related fatigue in the future.