Feasibility of an inpatient fatigue education study

Weise, Andrea and Kool, Jan and Barbero, Marco and Michel, Gisela and Hersche-Cupelli, Ruth (2018) Feasibility of an inpatient fatigue education study. 23rd Annual Conference of Rehabilitation in Multiple Sclerosis(EuRims).

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RIMS Poster Feasibility 20180511.pdf

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Abstract

Background: Outpatient fatigue management education by occupational therapists in persons with MS (pwMS) is efficient, but no program is available for the inpatient setting. To close this gap an inpatient energy management education (IEME) was developed. Aim: To evaluate the feasibility of a RCT study-protocol and to explore the effect of IEME on self-efficacy and fatigue Methods: Design: RCT. Sampling: Persons with MS-related fatigue during a three-week inpatient rehabilitation at Rehabilitation Centre Valens. Interventions: Six IEME or progressive muscle relaxation (PMR) group sessions as part of a personalized rehabilitation program. Data-collection: Evaluation of recruitment and assessment procedures, drop-out and follow-up rate, treatment fidelity, compliance with therapy and six telephone-interviews with IEME-participants after returning home. Outcomes were fatigue impact, self-efficacy, quality of life and occupational performance at baseline, discharge and 16 weeks follow-up. Results: Between July and November 2017, 47/83 pwMS were included and randomized (IEME:24/PMR:23). Reasons for discontinued participation were preliminary discharge and insufficient energy for the strenuous rehabilitation program (IEME:2/PMR:4). Treatment fidelity was high and 89% of all tasks were completed. SF 36 at discharge (T1) was not suitable as questions relate to everyday situations in the usual environment not fitting with changed routines during inpatient-stay. At T1 there were no differences in fatigue between groups, but a significant difference in self-efficacy applying energy conservation strategies, and a reduced demand for individual OT-sessions in the IEME group. At the follow-up, participants at home reported the exchange in the IEME groups as being positive, they were more aware of energy management and had introduced changes in daily routine. Data analysis from the 4-month follow-up until March 2018 will depict the effect of IEME on self-efficacy in everyday life. Conclusion: The feasibility of the study protocol was confirmed and preliminary effects of IEME are promising.

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