App-Based self-management program for people dealing with Fatigue and Trouble Concentrating (DiEgO): Protocol for Participatory Development, Pilot Testing, and Qualitative Process Evaluation

Background Fatigue is a common symptom in both Post-COVID Syndrome (PCS) and chronic inflammatory rheumatic conditions, associated with physical, cognitive, and mental impairments that reduce quality of life. Evidence-based management approaches remain limited. The DiEgO study addresses this gap by developing an interactive self-management and support application for people with fatigue and trouble concentrating. Methods/design This study combines a participatory research approach with qualitative methods (content analyses, grounded theory). A development team comprising PCS individuals, occupational therapists, and academic researchers will collaboratively develop the intervention through three iterative cycles. The developed app will then be tested by 20-30 people with rheumatic-disease-related fatigue, assigned to either supported use (with occupational therapy) or independent use. Evaluation includes qualitative interviews with pilot participants to assess usability, feasibility, and acceptability. In addition, the participatory development process will be reflexively evaluated through participant observation and interviews with development team members. Discussion The DiEgO study will develop an mHealth self-management application for people with fatigue and trouble concentrating. The participatory design involving affected individuals and occupational therapists throughout the development process enhances user-centeredness and real-world applicability. By providing flexible, low-threshold access through an open-source platform, this study may expand accessible self-management support for individuals with Post-COVID Syndrome and rheumatic conditions.