1. FOCUS IS IMPORTANT, but sometimes difficult

2. School of Psychology Florida Institute of Technology

3. 3 A persistent feeling of tiredness and lack of energy related to chronic illness Experienced as unearned, unpredictable, and non-responsive to rest or sleep Affects large percentages of individuals with autoimmune disorders; including RA, fibromyalgia, MS, Crohn’s disease, chronic fatigue syndrome, and some cancers CHRONIC ILLNESS-RELATED FATIGUE AND STRATEGIES FOR FATIGUE SELF-MANAGMENT

5. 5 THE FATIGUE MANAGEMENT INSTITUTE The FMI integrates emerging research findings with techniques for day-to-day management of fatigue Conducts research on chronic fatigue and fatigue management interventions Provides fatigue management training in the local community Disseminates research and empirically-based patient information related to fatigue and its management in chronic medical conditions Provides students training in behavioral health care and self- management, the development of integrated community service and research programs as well as experience in the process and logistics of providing community-based services and opportunities to facilitate self-management training groups. The Behavioral Healthcare Team is the advanced practicum associated with the FMI clinical training programs.

6. 6 STUDENT INVOLVEMENT The FMI is largely managed by the students, who may participate as research assistants, self-management training facilitators, DRP students, or a combination of these roles. The team currently has 13 student members, four of whom have taken our programs in new directions based on their personal interests and initiative. Currently, six students are working on DRPs related to FMI programs.

7. 7 CURRENT PROGRAMS Rheumatic Disorders Fatigue Self-Management Training Program Developed by former student Randi Johnson and initially facilitated by Randi and Isaac Levinsky, this program has provided training to over 100 patients. Effectiveness studies from the program have resulted in numerous completed DRPs. Breast Cancer Fatigue Self-Management Training Program This program was developed by a team of several students and has been provided in the community for the past two years. Two DRPs using data for this project are in progress. National Chronic Fatigue Survey Corinne Russell and I developed the online survey and collected data in 2009-2010 from over 1500 individuals with chronic illness-related fatigue. Several DRPs based on data from the survey have been completed Self-Management Training for Teens with Diabetes Tory Sank led a team of students who developed this community program. Survey of Parents of Children with Chronic Illness This survey is currently in progress. We are looking at parenting stress, parenting self-efficacy, and parent coping strategies; as well as chronically ill child behaviors and sibling interaction.

8. A Cognitive Behavioral Intervention to Manage Fatigue Developed and Sponsored by The Fatigue Management Institute School of Psychology Florida Tech Life after Breast Cancer

9. 9 HOW DO YOU EXPERIENCE FATIGUE? Physical weakness Mental exhaustion Lack of vitality Inability to complete everyday tasks Difficulty concentrating Memory difficulties Feeling unusually lazy Feeling depressed

10. 10 KEEPING A REGULAR SLEEP SCHEDULE Make a “bedtime routine” Go to bed at the same time each night Don’t sleep in! The truth about sleep cycles and the 8 hour myth Bedside Notepad Napping properly Power naps Napping too much No evening naps

11. 11 RESTORATIVE ACTIVITIES Prioritize and ensure time for valued & pleasurable activity Try to spend at least 1-2 hours each day doing something you enjoy in order to maintain your activity level and positive mental health. Massage/Spa Relaxation & guided imagery Spiritual Wellness

12. Fatigue Management Training Effectiveness Research This involves a two-group design, with one group receiving only their usual medical treatment (UMT), and a second group, which in addition to UMT receives FMT. To what degree is Fatigue Management Training effective when provided to community patients, relative to their usual medical treatment?

13. Because patients for the two groups actively chose to participate in FMT or were only provided the option to continue UMT, assignment to groups was not random. Design Considerations I Additionally, patients were not required to be free from other medical conditions. Due to these factors, the study is not a randomized clinical trial (RCT). However, it does represent a comparative effectiveness study, where findings are considered to represent the utility of the treatment when applied by practitioners in the general community.

14. IV = Fatigue Management Training (FMT) Tx Effectiveness Measure = Self-efficacy DVs =Fatigue Levels Functional Impairment Patients in the two groups were matched statistically via the use of propensity scores, to reduce the selection bias inherent in nonrandom assignment to groups. Disclaimer: Propensity procedures were conducted by professionals under controlled conditions. Do not attempt these at home. Design Considerations II

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