Situation:
This is a fatigue management programme over 6 weekly session for patients with a diagnosis of stroke or neurological disorder. We originally planned to run the group face-to-face, but due to the pandemic we were unable to do this so planned to start it virtually. The format of the group is on Microsoft Teams as this was recommended by the Trust and we were unable to use our Attend Anywhere platform for group therapy. We needed to adapt resources to enable us to use them virtually and ensure patients had the required technology available.
Actions:
Objectives
- To run a 6 week virtual fatigue management programme for patients with stroke or neurological diagnosis;
- To compare pre and post group outcomes measures including the Modified Fatigue Impact Scale (MFIS) and the Fatigue Severity Scale (FSS);
- To determine if this is a feasible method of delivery for fatigue management and whether it improves timely discharge from the service.
Predictions
- It will be feasible to run a fatigue management programme virtually using Microsoft Teams and embed it into future practice;
- We predict that we will be able to discharge 90% of patients who attend the course within 1 month post completion;
- Patients’ fatigue will be reduced and they will improve their skills in self-management of fatigue.
Questions
Who?
Suitable patient target group:
- People with a diagnosis of a stroke or neurological condition in which fatigue is a limiting factor to engagement in occupation;
- Considered able to cope with and willing to engage in a 6 week programme and participate in homework based exercises;
- Able to travel and attend group setting with or without carer OR able to participate in video consultations or virtual group;
- Proficient English;
- Able to read PowerPoint display.
Exclusion criteria:
- Those with cognitive and language difficulties that would be unable to engage in the group setting, using resources or would be disruptive in the group situation (in this situation consider if use of resources on a 1:1 basis is appropriate);
- People with visual impairments where resources cannot be adapted to suit needs.
What?
A 6 week fatigue management programme completed virtually. The content is as follows:
Session 1: Introduction and what is fatigue
- Aims and objectives of programme
- General introduction & types of fatigue
- Information gathering including outcome measures
- Action before next session: Issuing fatigue diaries and energy measure
Session 2: Your energy levels
- Review of activity diaries and identification or fatigue triggers
- Introduction to fatigue management toolbox
- Sleep, sleep questionnaire and sleep hygiene
- Relaxation
- Prioritisation
- Homework: prioritisation and relaxation practice