Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study

Abstract:

OBJECTIVE: The aim of the study was to develop a group-based self-management programme for individuals with chronic fatigue syndrome (CFS) by using the participants’ experiences with the initial version of the programme, which intends to promote coping with the illness in a primary healthcare setting.

METHODS: An initial programme was developed, based on self-efficacy theory and the concepts of client-centred practice and empowerment. Subsequently, the programme was tested and further developed by drawing on the participants’ experiences with the programme. Focus-group interviews were applied. The interviews were analysed using thematic analysis.

RESULTS: The initial programme was found to be feasible, although several modifications regarding the content and practical organization of the programme were proposed.

CONCLUSION: In line with the participants’ experiences, the final self-management programme was developed, which includes short presentations of eight topics, exchange of experiences among participants, goal-setting, construction of action plans, and relaxation exercises, in addition to a meeting for relatives. The programme will be provided in eight biweekly sessions and be led by juxtaposed peer counsellors and occupational therapists. The effects of the final programme will be evaluated in a randomized controlled trial.

 

Source: Pinxsterhuis I, Hellum LL, Aannestad HH, Sveen U. Development of a group-based self-management programme for individuals with chronic fatigue syndrome: a pilot study. Scand J Occup Ther. 2015 Mar;22(2):117-25. doi: 10.3109/11038128.2014.985608. Epub 2015 Jan 12. https://www.ncbi.nlm.nih.gov/pubmed/25581161

 

Predictors of response to treatment for chronic fatigue syndrome

Abstract:

BACKGROUND: Controlled trials have shown that psychological interventions designed to encourage graded exercise can facilitate recovery from chronic fatigue syndrome.

AIMS: To identify predictors of response to psychological treatment for chronic fatigue syndrome.

METHOD: Of 114 patients assigned to equally effective treatment conditions in a randomised, controlled trial, 95 completed follow-up assessments. Relationships between variables measured prior to randomisation and changes in physical functioning and subjective handicap at 1 year were evaluated by multiple regression.

RESULTS: Poor outcome was predicted by membership of a self-help group, being in receipt of sickness benefit at the start of treatment, and dysphoria as measured by the Hospital Anxiety and Depression scale. Severity of symptoms and duration of illness were not predictors of response.

CONCLUSIONS: Poor outcome in the psychological treatment of chronic fatigue syndrome is predicted by variables that indicate resistance to accepting the therapeutic rationale, poor motivation to treatment adherence or secondary gains from illness.

 

Source: Bentall RP, Powell P, Nye FJ, Edwards RH. Predictors of response to treatment for chronic fatigue syndrome. Br J Psychiatry. 2002 Sep;181:248-52. http://bjp.rcpsych.org/content/181/3/248.long (Full article)

 

Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care

Abstract:

OBJECTIVE: To evaluate the attributions of patients with chronic fatigue syndrome (CFS) and fibromyalgia (FM) consulting at a university fatigue and pain clinic.

METHODS: Consecutive attenders (n = 192) who met the CFS criteria (n = 95) or FM criteria (n = 56) or who had medically unexplained chronic pain and/or fatigue without meeting both criteria (CPF) (n = 41) were evaluated. All subjects completed an extended form of the Cause of Illness Inventory. Descriptive statistics, frequency analyses, chi-square tests, one-way analysis of variance, and sequential Fisher least significant difference tests were performed.

RESULTS: In total, 48 patients reported physical causes only and 10 patients psychosocial causes only; the majority (70%) mentioned both types of causes. With regard to the contents, “a chemical imbalance in my body” (61%), “a virus” (51%), “stress” (61%), and “emotional confusion” (40%) were reported most frequently. The diagnostic label did not have a significant influence on number and type of attributions. Small to moderate effect sizes were registered concerning the association of specific attributions and diagnosis, sex, duration of the symptoms, contact with a self-help group, and premorbid depression.

CONCLUSION: The majority of patients with CFS, FM, and CPF reported a great diversity of attributions open to a preferably personalized cognitive behavioral approach. Special attention should be paid to patients with symptoms existing for more than one year and those who had previous contacts with a self-help group. They particularly show external, stable, and global attributions that may compromise feelings of self-efficacy in dealing with the illness.

 

Source: Neerinckx E, Van Houdenhove B, Lysens R, Vertommen H, Onghena P. Attributions in chronic fatigue syndrome and fibromyalgia syndrome in tertiary care. J Rheumatol. 2000 Apr;27(4):1051-5. http://www.ncbi.nlm.nih.gov/pubmed/10782836