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Therapists’ experiences of remotely delivering cognitive-behavioural or graded-exercise interventions for fatigue: A qualitative evaluation

Bennett, Sarah E.; Almeida, Celia; Bachmair, Eva-Maria; Gray, Stuart R; Lovell, Karina; Paul, Lorna; Wearden, Alison; Macfarlane, Gary J; Basu, Neil; Dures, Emma

Therapists’ experiences of remotely delivering cognitive-behavioural or graded-exercise interventions for fatigue: A qualitative evaluation Thumbnail


Authors

Sarah E. Bennett

Eva-Maria Bachmair

Stuart R Gray

Karina Lovell

Lorna Paul

Alison Wearden

Gary J Macfarlane

Neil Basu

Emma Dures Emma2.Dures@uwe.ac.uk
Professor in Rheumatology and Self-management



Abstract

Objective: Fatigue is a challenging feature of all inflammatory rheumatic diseases. LIFT (Lessening the Impact of Fatigue in inflammatory rheumatic diseases: a randomized Trial) included remotely delivered personalized exercise programme (PEP) or cognitive-behavioural approach (CBA) interventions. The aim of this nested qualitative evaluation was to understand rheumatology health professionals' (therapists') perspectives of delivering the interventions in the LIFT trial. Methods: A subgroup of therapists who had delivered the personalized exercise programme (PEP) and cognitive-behavioural approach (CBA) interventions took part in semi-structured telephone interviews. Results: Seventeen therapists (13 women and 4 men) who delivered PEP (n = 8) or CBA (n = 9) interventions participated. Five themes were identified. In 'The benefits of informative, structured training', therapists described how they were able to practice their skills, and the convenience of having the LIFT manual for reference. When 'Getting into the swing of it', supporting patients gave therapists the confidence to tailor the content of the manual to each patient. Clinical supervision supported therapists to gain feedback and request assistance when required. In 'Delivering the intervention', therapists reported that patients valued the opportunity to talk about their fatigue and challenge their beliefs. In 'Challenges in delivering the LIFT intervention', therapists struggled to work in partnership with patients who lacked motivation or stopped engaging. Finally, in 'LIFT developing clinical skills', therapists gained confidence and professional satisfaction, seeing patients' fatigue improve over time. Conclusion: The findings support the provision of training for rheumatology health professionals to remotely deliver fatigue-management interventions. Insights from these trials can be used to better improve clinical practice and service provision.

Citation

Bennett, S. E., Almeida, C., Bachmair, E., Gray, S. R., Lovell, K., Paul, L., …Dures, E. (2022). Therapists’ experiences of remotely delivering cognitive-behavioural or graded-exercise interventions for fatigue: A qualitative evaluation. Rheumatology Advances in Practice, 6(3), Article rkac083. https://doi.org/10.1093/rap/rkac083

Journal Article Type Article
Acceptance Date Oct 4, 2022
Online Publication Date Oct 17, 2022
Publication Date Nov 2, 2022
Deposit Date Nov 1, 2022
Publicly Available Date Nov 1, 2022
Journal Rheumatology Advances in Practice
Print ISSN 2514-1775
Electronic ISSN 2514-1775
Publisher Oxford University Press
Peer Reviewed Peer Reviewed
Volume 6
Issue 3
Article Number rkac083
DOI https://doi.org/10.1093/rap/rkac083
Keywords Rheumatology, Fatigue, Qualitative, Exercise, Cognitive-behavioural approaches, Rheumatic diseases
Public URL https://uwe-repository.worktribe.com/output/10109146
Publisher URL https://academic.oup.com/rheumap/advance-article/doi/10.1093/rap/rkac083/6762094?login=false
Related Public URLs https://academic.oup.com/rheumap/article/6/3/rkac083/6762094#supplementary-data

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