Marcia Finlayson, Katharine Preissner, Chi Cho; Outcome Moderators of a Fatigue Management Program for People With Multiple Sclerosis. Am J Occup Ther 2012;66(2):187-197. doi: 10.5014/ajot.2012.003160.
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OBJECTIVE. We determined whether age, gender, work status, or impairment moderated fatigue management program outcomes for people with multiple sclerosis (MS).
METHOD. We conducted a secondary analysis of longitudinal data from a randomized controlled trial using mixed-effects models (N = 181) and examined outcomes of fatigue impact, mental health, physical health, and self-efficacy. Measures were collected before and immediately after intervention and at 6 wk, 3 mo, and 6 mo postintervention.
RESULTS. Younger participants experienced greater reductions in fatigue impact and greater improvements in self-efficacy over time than did older participants, but we found no age differences in physical or mental health. Participants with less impairment experienced greater mental health gains and were more likely to retain these gains over time than were participants with greater impairment. Although women experienced greater fatigue impact benefits, men experienced greater mental health benefits. Work status did not moderate outcomes.
CONCLUSION. Fatigue management program outcomes for people with MS are moderated by age, gender, and impairment.
For younger clients with MS, therapists should consider writing more ambitious energy management goals (e.g., greater decline in fatigue impact, strategy use across a wider range of occupations).
For older clients with MS, therapists should consider writing goals that focus on identifying, refining, and generalizing energy management strategies that clients are already using.
Therapists who are delivering group-based energy management education should consider creating homogeneous groups of clients, because doing so may facilitate social learning and peer mentoring among group participants.
Follow-up visits to reinforce learning from energy management education should be considered at 3 mo, because this appears to be the point at which program benefits begin to wane.
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