# A qualitative follow-up on perceptions of energy management education and daily life by individuals with fatigue undergoing hemodialysis treatment

## TL;DR

This study explores how energy management education helps people on hemodialysis manage fatigue and improve daily life participation.

## Contribution

The study introduces a novel energy management program that helps hemodialysis patients reconstruct their daily life participation through metacognitive strategies.

## Key findings

- Participants shifted from an illness-focused experience to one centered on living and participating in daily activities.
- The energy management program was perceived as supportive in applying learned strategies to improve life participation.
- Fatigue significantly impacts life participation, but education can help mitigate its effects.

## Abstract

People on chronic hemodialysis identify fatigue and its negative impact on their life participation (i.e., ability to accomplish valued daily occupations) as central to their illness experience. We explored how fatigue, as experienced by people on hemodialysis, shaped their participation in daily occupations, and participants’ experiences in the Personal Energy Planning programme.

This qualitative follow-up study to a pilot randomized controlled trial used an interpretive description approach with six participants who completed an energy management programme for people treated with hemodialysis in Calgary, Canada. Each participant completed one semistructured interview about their experiences with fatigue management, life participation and the programme. Data were analyzed using modified constant comparative analysis.

Participants described moving from an illness experience to one of living, where they could envision participation in both activities of daily living and social leisure occupations. Participants also described how they felt supported by the programme with its focus on applying the learning from the programme to improve their participation.

Fatigue has an extensive impact on various facets of life participation. For people treated with hemodialysis, the reconstruction of their occupational lives can be enabled through energy management education programmes focused on the development of personal metacognitive strategies.