P693 Care needs and reasons for (not) seeking care among fatigued patients with Inflammatory Bowel Disease: A qualitative study

Abstract

Abstract Background Fatigue is one of the most prevalent and burdensome symptoms experienced by patients with inflammatory bowel disease (IBD), even when the disease is in remission. Many patients report dissatisfaction towards fatigue-related care and uptake of available interventions is often low. This study aims to explore reasons why IBD patients do or do not engage in professional fatigue-related care and their needs regarding type of care and how to offer care. Methods We conducted a qualitative study, taking a phenomenological methodological approach. Sixteen adult IBD patients with disease in remission and severe fatigue (i.e., Checklist Individual Strength – subjective fatigue ≥ 35) were recruited from an academic hospital. We performed semi-structured interviews. Data were analysed using template analyses. Results We identified six themes regarding reasons why to (not) seek care for fatigue: 1) cognitions about fatigue and coping (e.g., a need to deal with fatigue alone), 2) perceptions of fatigue-related care and previous care experiences (e.g., perceiving that nothing can be done about fatigue), 3) knowledge and behaviour of the healthcare provider (e.g., fatigue complaints are not taken seriously), 4) somatic factors (e.g., physical symptoms of IBD), 5) social factors (e.g., feeling misunderstood by others) and 6) practical factors (e.g., time and money). Furthermore, we identified needs regarding how to offer care, i.e., proactive screening and active offer of care by healthcare providers, a holistic and person-centred approach and practical needs taken into account. Finally, regarding what care to offer, patients suggested a broad range of options, including information provision on fatigue management, eliminating physical causes of fatigue, discussing medication options, lifestyle support, psychological support, peer support and practical support. Conclusion IBD patients’ perceptions, coping and knowledge, as well as healthcare professionals’ behaviours play a major role in seeking fatigue-related care. Findings emphasize the importance of discussing IBD-related fatigue actively and taking a holistic and patient-centred approach to treat fatigue, targeting a broad range of physical- and psychological factors. These findings yield a better understanding of factors that hinder and facilitate care seeking in fatigued IBD patients and hereby provide ways to optimize the uptake of care.