Web-based Rehabilitation for Persistent Physical Symptoms. (DigiPimo)
Persistent Physical Symptoms, Indoor Environment Associated Symptoms, Indoor Air Associated Symptoms
About this trial
This is an interventional treatment trial for Persistent Physical Symptoms focused on measuring Indoor air, Persistent physical symptoms, Chronic Fatigue Syndrome, Web-based intervention, Rehabilitation, Indoor environment, EHealth
Eligibility Criteria
Inclusion Criteria:
- Fluent Finnish (web-program is in Finnish)
- Duration of the symptoms Onset of symptoms with disability maximum of 3 years before the study
- Symptomatology A) Indoor air-related symptoms or B) Persistent, chronic fatigue
A) Indoor air-related symptoms
- Self-reported symptoms attributed to indoor (non-industrial) environments include: i) symptoms from at least two different organ systems eg. respiratory, digestive or nervous system.
- Symptoms recurrently i) occur in more than one indoor environment or ii) continue despite environmental improvements (e.g. study or work arrangements and/or workplace repairs)
or
B) Chronic fatigue
- Post-exertional malaise and/ or post-exertional fatigue.
- Unrefreshing sleep or disturbance of sleep quantity or rhythm disturbance.
Multiorgan symptoms i) Pain, often widespread, ii) Two of more neurological or cognitive symptoms, iii) At least two symptoms of following categories: Autonomic manifestations, neuroendocrine manifestations or immune manifestations
- Duration and severity of the condition: Symptoms minimum of six months; Symptoms are not lifelong and result in substantial functional restrictions in daily life.
Exclusion Criteria:
- Work situation: Long sick leave (≥3 months) without return to work plan, not actively participating in study or work life (retired or unemployed)
Medical reasons
- Some serious and/or acute medical disease or illness explains the symptoms i) Somatic disease that explains the symptoms (e.g. uncontrolled asthma, hypothyroidism, sleep apnea)
- Psychiatric disorder (bipolar disorder, psychotic disorders, alcohol and/or drug dependency or abuse, eating disorders, and/or severe mood disorders)
- Developmental disorders
- Current psychotherapy
- Other Patient refusal
Sites / Locations
- Finnish Institute of Occupational Health
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Case formulation with web-program
Treatment as usual
The intervention will start with two video meetings with a psychologist to build up and present an individual case formulation, based on behavioural analysis, and to build up a shared decision of individual goals for the web program. The intervention continues with a web program consisting of ten manualized web-based modules, each at one-week intervals based on relational frame theory (RFT) and acceptance and commitment therapy (ACT). The pilot programme included six two-weeks modules and it was in use until 5/2021. The programme is in Finnish. Both participants in the intervention arm and in the treatment as the usual arm will receive usual care, meaning that TAU will be enhanced with the study intervention in the intervention arm. In addition to TAU, all participants will be given self-help and educational leaflet based on scientific knowledge related to their condition.
Treatment as usual includes all the routine care that individual receives when he or she is presenting his or her symptoms at the primary or the occupational health care unit (corresponds primary care level treatment) or other unit that recommends the study for the participant. In practice, TAU may vary between the study participants based on their individual needs e.g. treatments for co-morbid somatic diseases or psychiatric disorders that this study will not interfere. Both participants in the intervention arm and in the treatment as usual arm will receive usual care, meaning that TAU will be enhanced with the study intervention in the intervention arm. In addition to TAU all participants will be given self-help and educational leaflet based on scientific knowledge related to their condition.