Experiences of multiple sclerosis patients with self-management of fatigue: a qualitative systematic review protocol

Objective: The objective of this review is to explore and synthesize the evidence on the experience of self-managing multiple sclerosis fatigue among adult patients. Introduction: Multiple sclerosis is a growing neurologic auto-immune disease, and fatigue is considered one of the most common and debilitating side effects. Understanding how multiple sclerosis patients experience fatigue, the cause of their fatigue, as well as how they self-manage their fatigue will better inform healthcare providers and patients. Inclusion criteria: The review will consider qualitative studies investigating the perceptions, experiences and meaning of fatigue associated with multiple sclerosis, the factors contributing to fatigue and the self-management strategies used to control fatigue in adults. Studies that include adult patients diagnosed with multiple sclerosis and experiencing fatigue, regardless of their participation in pharmacological interventions and non-pharmacological interventions, will be included. Any patients with multiple sclerosis residing in hospital-based care or residential in patient care will not be included. Methods: A three-step search strategy will be utilized in this review. The initial step consists of a limited search in MEDLINE and CINAHL using "multiple sclerosis" and "fatigue" as search terms. Studies will be excluded if they have not been translated into English, but will not be limited by date. Each article will go through a preliminary review based on title and abstract to exclude any articles not pertaining to this study. After the search is completed, two reviewers will individually appraise retrieved qualitative studies for methodological quality prior to inclusion in the review. Findings will be pooled using meta-aggregation, and a ConQual Summary of Findings will be presented.