Background:
Fatigue is a disabling symptom in people with MS (pwMS). Energy Management Education (EME) aims to enhance self-management skills for managing energy and maintaining a meaningful routine despite fatigue. Participants in EME learn to use strategies like pacing, planning, prioritizing activities, and optimizing communication and the environment. EME has been shown to reduce fatigue's impact and improve quality of life. However, research is limited on which strategies are easiest to implement and which factors influence engagement in self-management behaviors.
Objective:
To explore how behavior changes become stable habits after EME and identify factors influencing fatigue self-management behaviors.
Methods:
Forty-nine pwMS participated in a 3-week multidisciplinary inpatient rehabilitation program, including EME. Sociodemographic and outcome data (fatigue, self-efficacy, quality of life) were collected at baseline, post-intervention, and follow-up. Changes in strategy use, perceived effectiveness, and ease of implementation were assessed at 4 and 6 months via an online questionnaire. Multiple regression and path analyses were conducted.
Results:
The number of energy management strategies increased by 22% at post-intervention and remained at 16% at 6 months. Strategies with the largest increase were "communicate needs" "use adaptive equipment," and "set priorities." The most effective strategies were "take breaks," "delegate activities," and "balanced day”. Environmental adaptations were the easiest to implement. EDSS had a direct effect on strategy use (β: 0.0597; 95% CI), with self-efficacy acting as a significant mediator (β: 0.0182; 95% CI).
Conclusion / Contribution to OT:
This study demonstrates that EME improves fatigue management and offers OTs valuable insights into factors, influencing behavior change, which should guide personalized interventions.