Enhancing self management of fatigue and low mood in renal disease

L Fisher

Institute of Psychiatry & King’s College Hospital, London

Problem: Many patients with renal disease experience fatigue and low mood. Even the most effective interventions available may not entirely eliminate these unpleasant symptoms and some essential treatments may precipitate them. A structured approach to helping patients with renal disease cope with non-specific symptoms, unresponsive to, and in some cases caused by medical treatment, is lacking.

Purpose: Cognitive behavioural interventions are increasingly used in chronic illness populations to improve coping and thus quality of life. The presentation describes how the principles of a pragmatic and evidence-based approach used in other areas has been adapted to help patients with renal disease manage these poorly defined symptoms.

Content: The presentation will cover:

· The cognitive behavioural model and empowering patients

· Managing mood: working with patients to define and change unhelpful thinking in the context of fluctuating symptoms and changes in physical state.

· Coping with fatigue: negotiating plans for activity, rest and keeping fit in the context of fluctuating symptoms and changes in physical state.

Objective: For delegates to become familiar with a basic repertoire of cognitive behavioural interventions to assist self management of fatigue and low mood in renal disease.

Conclusion & clinical relevance: Such interventions in combination with conventional medical management may offer an increased opportunity for patients to actively engage in managing their illness and more importantly optimize their quality of life. This approach appears to have been useful to the small number of patients that it has been used with and feedback has been positive. However, these techniques need to be developed further and require formal evaluation of efficacy and acceptability to patients.