Defining a Treatment Model for Self-Management of Fatigue in Rehabilitation of Acquired Brain Injury Using the Rehabilitation Treatment Specification System

Frederik Lehman Dornonville de la Cour*, Anne Norup, Tonny Elmose Andersen, Trine Schow

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Abstract

Systematic treatment descriptions to standardize and evaluate management of fatigue after acquired brain injury (ABI) are lacking. The purpose of this multi-phase qualitative study was to formulate a treatment model for promoting self-management of fatigue in rehabilitation of ABI based on practice-based understandings and routines. The study was conducted in a community-based rehabilitation center in Denmark. The model was defined using the Rehabilitation Treatment Specification System. Phase 1 comprised co-production workshops with five service providers (occupational therapists, physiotherapists, and a neuropsychologist) to elicit preliminary treatment theories. In Phase 2, four case studies were conducted on management of fatigue in vocational rehabilitation. Interviews (n = 8) and treatment log entries (n = 76) were analyzed thematically to specify treatment targets and active ingredients. The treatment model comprised five main components: (i) Knowledge and understanding of fatigue, (ii) Interoceptive attention of fatigue, (iii) Acceptance of fatigue, (iv) Activity management, and (v) Self-management of fatigue. For each component, lists of targets and active ingredients are outlined. In conclusion, management of fatigue includes multiple treatment components addressing skills, habits, and mental representations such as knowledge and attitudes. The model articulates treatment theories, which may guide clinical reasoning and facilitate future theory-driven evaluation research.

OriginalsprogEngelsk
Artikelnummer3192
TidsskriftJournal of Clinical Medicine
Vol/bind12
Udgave nummer9
Antal sider13
ISSN2077-0383
DOI
StatusUdgivet - apr. 2023

Bibliografisk note

Funding Information:
This research was funded by Helsefonden, grant number 19-B-0313, and TrygFonden, grant number 124663. The APC was funded by Neurorehabilitation Research and Knowledge Centre, Rigshospitalet.

Publisher Copyright:
© 2023 by the authors.

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