Fatigue is a clinical symptom that has been described as the most disturbing by around 50% of patients with PBC. It has an important impact on patients' quality of life and is associated with an increased mortality risk. To treat fatigue in PBC, only medical treatments have been tested with limited efficacy or serious sides' effects. In other diseases, mostly cancer, psychological interventions showed efficacy on fatigue decrease. Most interventions consist in psychoeducation with: education about fatigue, development of self-care or coping techniques, activity management and learning to balance between activities and rest. Hypnosis, which consists in a body work for psycho-therapeutic use (e.g., through imagination), has also shown promising results. Moreover, psychological intervention efficacy seems to be influenced by patients' characteristics, such as personality. Therefore, the first aim of the present single-center randomized controlled phase 2 trial is to assess the efficacy of a psycho educational intervention and a hypnosis intervention on PBC patients' fatigue to demonstrate that both psychoeducational and hypnosis interventions decrease patient fatigue.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
55
The psychoeducational intervention will be a structured education programme and will consist of informing patients about fatigue dimensions, aetiology and treatments, by helping them to develop strategies to cope with fatigue better and by teaching them to manage the balance between activities and rest. The construction of the contents of the sessions of this intervention will aim to reduce fatigue via the programme developed by Reif et al. in cancer patients and is composed of 6 sessions of 90 minutes, one session per week. It is a group intervention for 8 patients. For this project, the investigators have reorganised the sessions and their content to fit with an individual format adapted to PBC. This format is more appropriate to take into account the specificity of the manifestation of fatigue for each patient.
The hypnosis intervention will consist of decreasing fatigue and the related distress, and increasing feelings of energy and well-being. Therefore, each hypnosis exercise will be audiotaped and given to the patient at the end of the session. Patients will be asked to use these recordings as much as they want to help them to manage fatigue. The techniques used are inspired by those used in chronic pain management and fatigue.
Service hépatologie Hôpital Saint-Antoine
Paris, France
PBC-40 questionaire
Time frame: At month 3
Short Form Health Survey (SF36) (1)
Time frame: At Day 0
Short Form Health Survey (SF36) (2)
Time frame: At week 5
Short Form Health Survey (SF36) (3)
Time frame: At month 3
Short Form Health Survey (SF36) (4)
Time frame: At month 6
Multidimensional fatigue inventory (MFI) (1)
Time frame: At Day 0
Multidimensional fatigue inventory (MFI) (2)
Time frame: At week 5
Multidimensional fatigue inventory (MFI) (3)
Time frame: At month 3
Multidimensional fatigue inventory (MFI) (4)
Time frame: At month 6
PBC-40 questionaire (1)
Time frame: At Day 0
PBC-40 questionaire (2)
Time frame: At week 5
PBC-40 questionaire (3)
Time frame: At month 6
Pittsburg Sleep Quality Inventory (PSQI) (1)
Time frame: At Day 0
Pittsburg Sleep Quality Inventory (PSQI) (2)
Time frame: At week 5
Pittsburg Sleep Quality Inventory (PSQI) (3)
Time frame: At month 3
Pittsburg Sleep Quality Inventory (PSQI) (4)
Time frame: At month 6
Epworth Sleeping Scale (ESS) (1)
Time frame: At Day 0
Epworth Sleeping Scale (ESS) (2)
Time frame: At week 5
Epworth Sleeping Scale (ESS) (3)
Time frame: At month 3
Epworth Sleeping Scale (ESS) (4)
Time frame: At month 6
Hospital Anxiety and Depression Scale (HADS) (1)
Time frame: At Day 0
Hospital Anxiety and Depression Scale (HADS) (2)
Time frame: At week 5
Hospital Anxiety and Depression Scale (HADS) (3)
Time frame: At month 3
Hospital Anxiety and Depression Scale (HADS) (4)
Time frame: At month 6
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