Towards vitality: a longitudinal pilot study with a cognitive bias modification e-health intervention (VitalMe) to reduce fatigue in patients with chronic kidney disease

Abstract

Background: This longitudinal pilot trial investigated the effects of novel Cognitive Bias Modification (CBM) training targeting fatigue on cognitive biases, fatigue, vitality, and fatigue-related behaviour in people with chronic kidney disease (CKD). Methods: Thirty patients were alternately allocated to a week of CBM training with either attentional bias modification (ABM) or self-identity bias modification (SIBM), followed by a second week with the trainings combined. Twenty-two participants (12 pre-dialysis, 10 dialysis) completed the study, where cognitive biases and self-reported outcomes were measured at baseline, post-training, and follow-up. Possible interaction effects between CBM focus and disease stage were explored. Results: A significant effect of time was found on both cognitive biases; participants' attentional bias (Cohen's d = 0.88–0.99) and self-identity bias (Cohen's d = 1.16–1.28) were significantly more vitality oriented at post and follow-up compared to baseline. On the self-report outcomes, a small beneficial effect was found on vitality, but only for the ABM training. Conclusions: This is the first study to introduce CBM, which targets fatigue, to people with CKD. Despite the limitations in sample size and design, this study revealed strong effects on cognitive biases. It is recommended to replicate these findings in an adequately powered randomised controlled trial.