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AB1244-HPR Guided self-management for patients with rheumatic inflammatory diseases and fatigue – a pilot project
  1. E Fjerstad1,
  2. RH Moe2,3,
  3. S Nymo4,
  4. T Berge5
  1. 1Enhet for psykiske helsetjenester i somatikken, Diakonhjemmet Hospital, Oslo, Norway
  2. 2Rheumatology, NKRR, Diakonhjemmet Hospital, Oslo, Norway
  3. 3Rheumatology, NBRR, Diakonhjemmet Hospital, Oslo, Norway, Oslo
  4. 4Drammen Hospital, Dronninggata 28, 3004 Drammen, Drammen
  5. 5Enhet for psykiske helsetjenester i somatikken, Diakonhjemmet Hospital, Oslo, Norway

Abstract

Background Fatigue is reported to be a common symptom in people with inflammatory rheumatic diseases. It is a complex symptom, characterized by an individual interplay of biopsychosocial factors that has been associated with factors like inflammation, deconditioning, sleep problems, decreased function, pain and psychosocial factors like depression.

Objectives The main objective was to contribute to improved coping and quality of life in people with inflammatory rheumatic disease and fatigue. Cognitive therapy is one of the common psychological interventions used in the rehabilitation of people with rheumatic diseases and fatigue. The current intervention was developed as a supplement to medical treatment to strengthen coping and quality of life, and reducing fatigue, depression and pain.

Methods People with inflammatory rheumatic diseases and fatigue were recruited for 6–9 sessions of cognitive therapy sessions, in addition to treatment as usual at a rheumatology outpatient clinic in Norway. The intervention aimed at reducing fatigue, depression and pain, consisted of four main elements; understanding fatigue, assessment and activity planning, mental and cognitive self-help skills. The project was developed, and data collected at the rheumatology outpatient clinic at Diakonhjemmet Hospital in 2014–2016.

Results This pilot project recruited 40 people with inflammatory rheumatic disease from a rheumatologic outpatient clinic in Norway. Participants had a disease duration of mean 14 years, they were mainly women (n=36) with a mean age of 45 (Standard Deviation =10) years (Table 1). Repeated ANOVA analyses and Paired t-tests showed promising statistically significant changes on a group level for fatigue and depression, not for pain (Table 2).

Table 1.

Demographic data of included patients (n=40)

Table 2.

Self-reported fatigue and depression at baseline, after treatment and at 6 months follow-up

Conclusions This pilot project supports the idea of conducting a trial on the effectiveness of a brief cognitive therapy intervention for people with inflammatory rheumatic diseases and fatigue. ANOVA analyses and Paired t-tests showed promising statistically significant changes on a group level for fatigue and depression, but not for pain, whether these changes are clinically meaningful, and if there is a difference, compared to treatment as usual remains to be explored.

Acknowledgements This project would not have been possible without the support from the national patient organization, through a grant from the Norwegian ExtraFoundation for Health and Rehabilitation. We acknowledge patients who contributed to this project and the staff at the rheumatological outpatient clinic at Diakonhjemmet Hospital.

Disclosure of Interest None declared

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