The impact and management of cancer-related fatigue on patients and families

Joan Hamilton, Lorna Butler, Hieke Wagenaar, Terry Sveinson, K. Anne Ward, Leslie McLean, Donna Grant, Florence MacLellan

Abstract


Fatigue has been identified as both a chronic and recurrent problem for individuals diagnosed with and treated for cancer, yet there is little information on how to manage the impact of fatigue. Describing what happens to individuals and their families as a result of fatigue and identifying what individuals do to manage or reduce the impact of fatigue are essential elements in determining multidimensional nursing interventions. The purpose of this pilot study was to examine the impact of fatigue on individuals with cancer of the lung and their families, and explore how they managed as a result of the fatigue. A semi-structured interview guide was used with 22 lung cancer patients and 14 family members six weeks post completion of radiation therapy.

Results indicated that fatigue was not reported as a major concern by many of the participants in this study. For those who did experience fatigue, it was considered an inconvenience and a frustration that had to be dealt with for a limited time period. Some patients appeared to gradually adjust and accommodate to the fatigue and were not really aware of the changes that took place over time. Over half of the family members felt more of the impact of fatigue than did their loved ones. Family subtly assumed or took over responsibilities and activities the patient could no longer perform.

The symptom of fatigue has been well documented in the cancer experience as both a chronic and recurrent problem for individuals diagnosed with and treated for cancer. The emphasis of previous work has been on deriving a conceptual definition of fatigue, achieving consensus on a definition, and developing theoretical frameworks to guide further study of this complex construct. Fatigue has been conceptualized as a multidimensional phenomenon, attributable to multiple causes and having a negative effect on quality of life (Piper, 1993; Tiesinga, Dasson, & Halfens, 1996). Describing what happens to individuals and their families as a result of fatigue and identifying what individuals do to manage or reduce the effects caused by the fatigue are essential elements in determining multidimensional nursing interventions.


Full Text:

PDF

References


Belzar, B.A., Henke, C.J., Yelin, E.H., Epstein, V.V., & Gillis, D.L.

(1993). Correlates of fatigue in older adults with rheumatoid

arthritis. Nursing Research, 42(2), 93-98.

Bruera, E., & MacDonald, R.N. (1988). Overwhelming fatigue in

advanced cancer. American Journal of Nursing, 88, 99-100.

Cancer Treatment and Research Foundation [CTRF]. (1996).

Treatment guidelines for lung tumor site group. Halifax, NS:

Author.

Cardenas, D., & Kutner, N. (1982). The problem of fatigue in dialysis

patients. Nephron 30, 336-340.

Christensen, T., & Kehlet, H. (1993). Postoperative fatigue. World

Journal of Surgery, 17, 220-225.

Crosby, L.J. (1988). Stress factors, emotional stress and rheumatoid

arthritis disease activity. Journal of Advanced Nursing, 13, 452-461.

Downe-Wamboldt, B. (1992). Content analysis: Method,

applications, and issues. Health Care for Women International,

, 313-321.

Fisk, J.D., Ritvo, P.G., Ross, L., Haase, D.A., Marrie, T.J., & Schlech,

W.F. (1994). Measuring the functional impact of fatigue: Initial

validation of the fatigue impact scale. Clinical Infectious Disease,

, S79-83.

Glaus, A. (1993). Assessment of fatigue in cancer and non-cancer

patients and in healthy individuals. Supportive Care in Cancer,

, 305-315.

Graydon, J. (1994). Women with breast cancer: Their quality of life

following a course of radiation therapy. Journal of Advanced

Nursing, 19, 617-622.

Graydon, J., Bubela, N., Irvine, D., & Vincent, L. (1995). Fatigue

reducing strategies used by patients receiving treatment for cancer.

Cancer Nursing, 18, 23-28.

Hait, L.K. (1978). Fatigue in the patient with multiple sclerosis.

Research in Nursing and Health, 1(4), 147-157.

Irvine, D., Vincent, L., Bubela, N., Thompson, L., & Graydon, J. (1991).

A critical appraisal of the research literature investigating fatigue in

the individual with cancer. Cancer Nursing, 14(5), 188-199.

Irvine, D., Vincent, L., Graydon, J., Bubela, N., & Thompson, L.

(1994). The prevalence and correlates of fatigue in patients

receiving treatment with chemotherapy and radiotherapy. Cancer

Nursing, 17(5), 367-378.

Jamar, S. (1989). Fatigue in women receiving chemotherapy for ovarian

cancer. In S.G. Funk, E.M. Tornquist, M.T. Champagne, L.A. Copps,

& R.S. Wiese (Eds.). Key aspects of comfort: Management of

pain, fatigue and nausea (pp. 224-233). New York: Springer.

Johnson, J., Nail, L., Lauver, D., King, K., & Keys, H. (1988).

Reducing the negative impact of radiation therapy on functional

status. Cancer Nursing, 61, 46-51.

Knobf, M. (1986). Physical and psychological distress associated

with adjuvant chemotherapy in women with breast cancer.

Journal of Clinical Oncology, 4, 678-684.

Krupp, L.B., Larocca, N.G., Muir, J.M., & Steinberg, A. (1990). A

study of fatigue in systemic lupus erythematosus. The Journal of

Rheumatology, 17, 1450-1452.

Krupp, L.B., Larocca, N.G., Muir-Nash, J., & Steinberg, A. (1989).

The fatigue severity scale: Application to patients with multiple

sclerosis and systemic lupus erythematosus. Archives of

Neurology, 46, 1121-1123.

Larson, P., Carrieri-Kohlman, V., Dodd, M., Douglas, M., Fawcett, J.,

Froelicher, E., Gortner, S., Halliburton, P., Janson, S., Lee, K.,

Miaskowski, C., Savedra, M., Stotts, N., Taylor, D., &

Underwood, P. (1994). A model for symptom management.

Image: Journal of Nursing Scholarship, 26(4), 272-276.

McCorkle, R., & Quint-Benoliel, J. (1983). Symptom distress, current

concerns and mood disturbances after diagnosis of life-threatening

disease. Social Science and Medicine, 17(7), 431-438.

Munkres, A., Oberst, M.T., & Hughes, S.H. (1992). Appraisal of

illness, symptom distress, self-care burden and mood states in

patients receiving chemotherapy for initial and recurrent cancer.

Oncology Nursing Forum, 19, 1201-1209.

Nail, L., & King, K. (1994). Fatigue. Seminars in Oncology

Nursing, 3, 257-262.

Packer, T., Foster, D., & Brouwer, B. (1997). Fatigue and activity

patterns of people with chronic fatigue syndrome. Occupational

Therapy Journal of Research, 17(3), 186-199.

Packer, T., Sauriol, A., & Brouwer, B. (1994). Fatigue secondary to

chronic illness: Postpolio syndrome, chronic fatigue syndrome,

and multiple sclerosis. Archives of Physical Medicine and

Rehabilitation, 75, 1122-1126.

Pickard-Holley, S. (1991). Fatigue in cancer patients. Cancer

Nursing, 14, 13-19.

Piper, B. (1988). Fatigue in cancer patients: Current perspectives on

measurement and management. In Nursing Management of

Common Problems [Pamphlet]. American Cancer Society, Inc.

Piper, B. (1989). Fatigue: Current bases for practice. In S.G. Funk,

E.M. Tornquist, M.T. Champagne, L.A. Copps, & R.S. Wiese

(Eds.), Key aspects of comfort: Management of pain, fatigue

and nausea (pp. 187-189). New York: Springer.

Piper, B. (1993). Fatigue. In V. Carrieri, A. Lindsey, & C. West (Eds.),

Pathophysiological phenomena in nursing: Human responses

to illness 2nd ed., (pp. 279-302). Philadelphia: Saunders.

Piper, B., Lindsey, A., & Dodd, M. (1987). Fatigue mechanisms in

cancer patients: Developing nursing theory. Oncology Nursing

Forum, 14, 17-23.

Rhodes, V., Watson, P., & Hanson, B. (1988). Patients’ descriptions of

the influence of tiredness and weakness on self-care abilities.

Cancer Nursing, 11(3), 186-194.

Srivastava, R.H. (1989). Fatigue in end-stage renal disease patients.

In S.G. Funk, E.M. Tornquist, M.T. Champagne, L.A. Copp, &

R.S. Wiese (Eds.), Key aspects of comfort: Management of

pain, fatigue and nausea (pp. 217-224). New York: Springer.

Tiesinga, L., Dasson, T., & Halfens, R. (1996). Fatigue: A summary

of the definitions, dimensions and indicators. Nursing Diagnosis,

(2), 51-62.

Wagenaar, H. (1995). An exploratory descriptive study of fatigue

in women with Systemic Lupus Erythematosus. Unpublished

manuscript, Dalhousie University, Halifax, NS.

Winningham, M., Nail, L., Barton Burke, M., Brophy, L., Cimprich,

B., Jones, L., Pickard-Holley, S., Rhodes, V., St. Pierre, B., Beck,

S., Glass, E., Mock, V., Mooney, K., & Piper, B. (1994). Fatigue

and the cancer experience: The state of the knowledge. Oncology

Nursing Forum, 21(1), 23-36.


Refbacks

  • There are currently no refbacks.