Targeting persistent fatigue with tailored versus generic self-management strategies in adolescents and young adults with a fatigue syndrome or rheumatic condition: A randomized crossover trial

Abstract

Objectives: To evaluate the use of two self-management intervention strategies for persistent fatigue in adolescents and young adults with a fatigue syndrome or rheumatic condition. Design: A randomized crossover trial administering tailored lifestyle advice and generic dietary advice, each 12 weeks, with a four-week washout period between. Methods: Sixty participants (aged 12–29) were included. Tailoring was achieved through the PROfeel method. Dietary guidelines were conceptualized by the Netherlands Nutrition Centre. Questionnaires were used pre–post-interventions to measure primary outcome ‘fatigue severity’ (Checklist Individual Strength-8) and secondary outcomes ‘self-efficacy’ (Self-Efficacy Scale-28) and ‘quality of life’ (QoL) (Paediatric Quality of Life Inventory 4.0). Feasibility and adherence were self-rated on a scale of 1 to 10 (low to high). Linear mixed modelling was used to assess change over time, compare strategy effectiveness and study the impact of intervention order. Results: Fatigue severity, self-efficacy and QoL regarding ‘physical’ and ‘emotional’ functioning improved significantly over time (all p