Appreciating the experience of multiple sclerosis fatigue.

Introduction: Fatigue is one of the most common symptoms experienced by people with multiple sclerosis (MS) and can have a significant negative impact on participation in valued roles and activities. Understanding and supporting the management of MS fatigue is a priority to promote participation in life roles. This study explored how participants with MS who were enrolled in a fatigue management randomized clinical trial describe and explain their fatigue experience using a secondary qualitative analysis of interventionists' treatment notes. Method: Clinical documentation including the subjective and objective portions of 85 treatment notes were collected and analyzed using a qualitative research design with multiphase coding. Results: Four major themes were identified including Fatigue Nature, Struggle, and Responding to the Reality of Fatigue with an overarching identified theme of Impact on Participation. Under the major themes, subthemes (11 total) were also identified and provided nuanced detail into each theme. Conclusion: People with MS fatigue describe their experience in a variety of ways. Findings will support occupational therapy practitioners to enhance empathy, understanding, and collaboration when working with clients with MS fatigue.