Berry Alice, Bridgewater Susan, Abbott Bryan, Adams Jo, Dures Emma
School of Health and Social Wellbeing, Faculty of Health and Applied Sciences, University of the West of England.
Academic Rheumatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol.
Rheumatol Adv Pract. 2022 Aug 16;6(2):rkac064. doi: 10.1093/rap/rkac064. eCollection 2022.
We developed a brief cognitive behavioural, one-to-one intervention to reduce fatigue impact for patients with inflammatory arthritis. This qualitative process evaluation explored intervention acceptability and potential refinements from the perspective of patients who attended sessions and rheumatology health professionals (RHPs) who delivered the intervention.
Interviews were conducted with patients and RHPs from five National Health Service (NHS) sites. Data were analysed using inductive thematic analysis.
Twenty-two patients and 11 RHPs participated.
Collaborative, non-judgemental consultations: patients valued having space to reflect, where their fatigue was validated. Relevant content, but not ground-breaking: patients appreciated the opportunity to tailor content to individual priorities. Daily diaries were useful to visualize fatigue. Self-awareness: patients reported increased acceptance, sense of control, and confidence to manage fatigue. Degrees of openness to change: sessions prompted patients to engage in behaviour change. For some, complicated lives made it difficult to plan for change.
Engagement with intervention: RHPs liked training face to face, and sessions were more enjoyable with experience of delivery. Research clinical practice: RHPs expressed concern about fitting sessions into NHS clinic appointments. It was difficult to offer follow-up sessions within 2 weeks. Collaborating with patients: RHPs reported that patients engaged with the tools and strategies. Some RHPs followed the manual in a linear way, whereas others used it flexibly.
There is potential for this brief fatigue intervention to benefit patients. Future research will focus on flexibility to fit with local services and creating educational resources to use in a range of contexts.
我们开发了一种简短的认知行为一对一干预措施，以减轻炎症性关节炎患者的疲劳影响。这项定性过程评估从参加干预课程的患者以及提供干预的风湿病健康专业人员（RHP）的角度，探讨了干预措施的可接受性和潜在的改进之处。
对来自五个国民保健服务（NHS）机构的患者和RHP进行了访谈。使用归纳主题分析法对数据进行了分析。
22名患者和11名RHP参与了研究。
协作性、非评判性咨询：患者重视有反思的空间，在这个空间里他们的疲劳得到了认可。内容相关，但并非开创性：患者赞赏有机会根据个人优先事项调整内容。日常日记有助于直观呈现疲劳情况。自我意识：患者报告称，他们对疲劳的接受度、掌控感和管理疲劳的信心有所增强。对改变的开放程度：课程促使患者参与行为改变。对一些人来说，复杂的生活使得制定改变计划变得困难。
RHP主题：参与干预：RHP喜欢面对面培训，随着授课经验的增加，课程也更有趣。研究与临床实践：RHP对将课程纳入NHS诊所预约表示担忧。很难在两周内提供后续课程。与患者合作：RHP报告称患者参与了工具和策略的使用。一些RHP以线性方式遵循手册，而另一些则灵活使用。
这种简短的疲劳干预措施有使患者受益的潜力。未来的研究将侧重于灵活性，以适应当地服务，并创建可在多种情况下使用的教育资源。
