Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions

Abstract

Purpose: To evaluate effectiveness of a face-to-face and an online fatigue self-management programme and to compare these to two control groups (information-only and no-intervention) in a sample of adults (n = 115) with neurological conditions reporting extreme fatigue. Method: Non-equivalent pre-test post-test control group design using the Fatigue Impact Scale, Personal Wellbeing Index and Activity Card Sort as primary outcome measures. Results: Participants in the two intervention groups and the information-only group showed clinically significant improvements in fatigue over time (p < 0.05). When compared to the no-intervention group, face-to-face participants showed significantly greater improvement in overall and cognitive fatigue, while participants in the online group showed significant improvement in self-efficacy and stress. Conclusion: Participation in either the online or face-to-face programme appears to result in improved self-management, however, with different potency depending on outcomes. The improvement in the online information only group further complicates the understanding of the results. With few other comparisons of online and face-to-face self-management protocols available, further research is needed to understand differential impacts which may be related to the delivery format, the rural versus urban split of participants or other unknown factors.

Implications for Rehabilitation

• The fatigue self-management programme supports people to self-manage extreme fatigue, a common side effect of neurological conditions.

• Both online and face-to-face versions are available.

• In comparison to a no-intervention group, participants in the face-to-face version had decreased fatigue levels while those in the online version were better able to self-manage depression and stress and to improve their self-efficacy.

• Online programmes may reach people with poorer baseline scores, partially explaining the difference in outcomes.

Keywords::

• Fatigue
• internet
• self-management

Acknowledgement

The authors acknowledge the Iranian Ministry of Health and Medical Education who awarded the first author a PhD scholarship to undertake this work. The authors also acknowledge the Multiple Sclerosis Society of Western Australia for both their financial support and their continued enthusiasm for new ideas. We also thank all Multiple Sclerosis Societies across Australia for support and assistance during the recruitment stage.

Declaration of interest: The authors report no conflicts of interest.