Abstract | Purpose: This study explored patient experiences of Guided graded Exercise Self-help delivered as part of a randomised controlled trial for people with chronic fatigue syndrome/myalgic encephalomyelitis, which found that Guided graded Exercise Self-help was better than specialist medical care at reducing fatigue and improving physical functioning. Methods: Semi-structured interviews were conducted with patients reporting improvement (n=9) and deteriorated (n = 10), and analysed using a thematic “constant comparison”. Results: The improved group described more facilitators to doing Guided graded Exercise Self-help, and were more likely to describe high levels of self-motivation, whilst the deteriorated group described more barriers to Guided graded Exercise Self-help (including worse exacerbation of symptoms after Guided graded Exercise Self-help, greater interference from comorbid conditions and obstacles to Guided graded Exercise Self-help in their lives), and had been ill for longer. Having the capacity to do Guided graded Exercise Self-help was important; of note, those with relatively lower levels of functioning sometimes had more time and space in their lives to support their Guided graded Exercise Self-help engagement. We identified an important ‘indeterminate phase’ early on, in which participants did not initially improve. Conclusions: Guided graded Exercise Self-help may be improved by targeting those most likely to improve, and education about the indeterminate phase. |
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