FOCUS IS IMPORTANT,but sometimes difficult

School of PsychologyFlorida Institute of Technology

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A persistent feeling of tiredness and lack of energy related to chronic illness

Experienced as unearned, unpredictable, and non-responsive to rest or sleep

Affects large percentages of individuals with autoimmune disorders; including RA, fibromyalgia, MS, Crohn’s disease, chronic fatigue syndrome, and some cancers

CHRONIC ILLNESS-RELATED FATIGUE AND STRATEGIES FOR

FATIGUE SELF-MANAGMENT

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THE FATIGUE MANAGEMENT INSTITUTE

The FMI integrates emerging research findings with techniques for day-to-day management of fatigue

Conducts research on chronic fatigue and fatigue management interventions

Provides fatigue management training in the local community

Disseminates research and empirically-based patient information related to fatigue and its management in chronic medical conditions

Provides students training in behavioral health care and self-management, the development of integrated community service and research programs as well as experience in the process and logistics of providing community-based services and opportunities to facilitate self-management training groups.

The Behavioral Healthcare Team is the advanced practicum associated with the FMI clinical training programs.

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STUDENT INVOLVEMENT

The FMI is largely managed by the students, who may participate as research assistants, self-management training facilitators, DRP students, or a combination of these roles.

The team currently has 13 student members, four of whom have taken our programs in new directions based on their personal interests and initiative.

Currently, six students are working on DRPs related to FMI programs.

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CURRENT PROGRAMSRheumatic Disorders Fatigue Self-Management Training Program

Developed by former student Randi Johnson and initially facilitated by Randi and Isaac Levinsky, this program has provided training to over 100 patients. Effectiveness studies from the program have resulted in numerous completed DRPs.

Breast Cancer Fatigue Self-Management Training ProgramThis program was developed by a team of several students and has been provided in the community for the past two years. Two DRPs using data for this project are in progress.

National Chronic Fatigue SurveyCorinne Russell and I developed the online survey and collected data in 2009-2010 from over 1500 individuals with chronic illness-related fatigue. Several DRPs based on data from the survey have been completed

Self-Management Training for Teens with DiabetesTory Sank led a team of students who developed this community program.

Survey of Parents of Children with Chronic IllnessThis survey is currently in progress. We are looking at parenting stress, parenting self-efficacy, and parent coping strategies; as well as chronically ill child behaviors and sibling interaction.

A Cognitive Behavioral Intervention to Manage Fatigue

Developed and Sponsored by The Fatigue Management InstituteSchool of Psychology Florida Tech

Life after Breast Cancer

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HOW DO YOU EXPERIENCE FATIGUE?

Physical weakness Mental exhaustion Lack of vitality Inability to complete

everyday tasks Difficulty

concentrating Memory difficulties Feeling unusually

lazy Feeling depressed

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KEEPING A REGULAR SLEEP SCHEDULE

Make a “bedtime routine” Go to bed at the same

time each night Don’t sleep in! The truth about sleep

cycles and the 8 hour myth

Bedside Notepad Napping properly

Power naps Napping too much No evening naps

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RESTORATIVE ACTIVITIES

Prioritize and ensure time for valued & pleasurable activity Try to spend at least 1-

2 hours each day doing something you enjoy in order to maintain your activity level and positive mental health.

Massage/Spa Relaxation & guided

imagery Spiritual Wellness

Fatigue Management Training Effectiveness Research

This involves a two-group design, with one group receiving only their usual medical treatment (UMT), and a second group, which in addition to UMT receives FMT.

To what degree is Fatigue Management Training effective when provided to community patients, relative to their usual medical treatment?

Because patients for the two groups actively chose to participate in FMT or were only provided the option to continue UMT, assignment to groups was not random.

Design Considerations I

Additionally, patients were not required to be free from other medical conditions.Due to these factors, the study is not a randomized clinical trial (RCT). However, it does represent a comparative effectiveness study, where findings are considered to represent the utility of the treatment when applied by practitioners in the general community.

IV = Fatigue Management Training (FMT)Tx Effectiveness Measure = Self-efficacyDVs = Fatigue Levels

Functional Impairment

Patients in the two groups were matched statistically via the use of propensity scores, to reduce the selection bias inherent in nonrandom assignment to groups.

Disclaimer: Propensity procedures were conducted by professionals under controlled conditions. Do not attempt these at home.

Design Considerations II

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