Evaluation of the efficiency of the nurse follow-up programsupported with web-based education in managing fatigue inpatients with multiple sclerosis

Introduction: Although fatigue is common in MS patients, interventions on the evaluation and management of this symptom are inadequate. Purpose: This study was carried out to examine the effect of the nurse follow-up program supported by web-based training on the patients' fatigue, sleep, quality of life and daily step counts. Method: This study, which was carried out using a quasi-experimental research design with a pretest-posttest single group, was conducted with 30 patients. All patients were in remission. A patient information form, fatigue severity scale, Pittsburgh sleep quality index, EQ-5D-3L quality of life scale were applied to all patients, and step counts were measured. After the measurements were made, the measurements of the patients who were followed up with standard care were repeated at the end of the 5-week period. The same patient group was then included in a 5-week nurse follow-up program. The patients' measurements were repeated immediately at the end of the program and at the end of 3 months. Results: The mean age of the cohort participating in the study was 34.3±8.1 years, 80% of whom were women. 56.7% of the patients had a bachelor's degree, 56.7% were unemployed, 66.7% were married and 56.7% had children. 23.3% of the patients were using antidepressants. While there was no statistically significant difference in fatigue, quality of life, sleep quality and step count measurements at the end of the control period compared to baseline, there was a significant decrease in fatigue levels at the end of the education program (3rd measurement) and at the 3rd month (4th measurement) (p=0.040, p=0.002). However, post-intervention analysis demonstrated a significant reduction in fatigue levels at the post-training assessment (third measurement) and at the three-month follow-up (fourth measurement), with p-values of 0,040 and 0,002, respectively. An increase in step count was also observed, presenting significant differences when compared to baseline at both the post-training (p=0.001) and three-month follow-up points (p=0.001). Fatigue levels showed a statistically significant decrease in women compared to men, in unemployed people compared to employed people, in those with sufficient income compared to those with low or high income, in married people compared to single people, in non-smokers compared to users, and in non-users of antidepressants compared to users (p=0.005, p=0.008, p=0.003, p=0.035, p=0.006, p=0.016). The intervention was beneficial to 66.6% of the patients. Gender, marital status, presence of children, age, duration of diagnosis, EDSS, smoking, and antidepressant use did not make a difference in terms of benefiting from education. Conclusion: In the management of fatigue in MS patients, the nurse-led program supported by web-based education did not make a difference on the quality of life and sleep quality, but significantly reduced fatigue and increased the number of steps compared to standard care. Therefore, web-based training programs should be developed for fatigue management in MS patients and patients should be motivated to participate. Keywords: Multiple sclerosis, fatigue, web-based education, nurse-led program, telerehabilitation, wearable technologies