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Online Exclusive Article

A Qualitative Analysis of Cancer-Related Fatigue in Ambulatory Oncology

Tami Borneman
Barbara Fliegel Piper
Marianna Koczywas
Carla M. Munevar
Virginia Sun
Gwen C. Uman
Betty R. Ferrell
CJON 2012, 16(1), E26-E32 DOI: 10.1188/12.CJON.E26-E32

The purpose of this study was to describe patients' perceptions of the causes, relief, related symptoms, meaning, and suffering secondary to cancer-related fatigue (CRF). In total, 252 patients with breast, lung, colon, and prostate cancers were enrolled in a quasiexperimental study to test the effects of a clinical intervention on reducing barriers to symptom management in ambulatory care. Analysis of data reported in this article was derived from the Piper Fatigue Scale-Revised. Using qualitative research methods and content analysis, written statements related to the impact of CRF were coded using the following themes: patients' perceptions of CRF, causes, relief, related symptoms, meaning, and suffering. Comments were categorized and reviewed for content. Overall, CRF had a significant impact on physical, psychological, social, and spiritual well-being. CRF limited the ability of participants to function, socialize, and participate in enjoyable activities. Emotional issues as a result of CRF were common. The negative impact of CRF on patients' overall well-being alters the meaning and suffering related to the cancer experience. The assessment of personal meaning and suffering related to CRF is an important component of the multidimensional assessment of CRF and will enable nurses to better understand the suffering related to CRF.

References 

Berger, A. M. (1998). Patterns of fatigue and activity and rest during adjuvant breast cancer chemotherapy. <i>Oncology Nursing Forum, 25</i>, 51-62.

Berger, A. M. (2009). Update on the state of the science: Sleep-wake disturbances in adult patients with cancer [Online exclusive]. <i>Oncology Nursing Forum, 36</i>, E165-E177. doi:10.1188/09.ONF.E165-E177

Borneman, T., & Brown-Saltzman, K. (2010). Meaning in illness. In B. R. Ferrell & N. Coyle (Eds.), <i>Oxford textbook of palliative nursing</i> (pp. 673-686). New York, NY: Oxford University Press.

Cassell, E. J. (1999). Diagnosing suffering: A perspective. <i>Annals of Internal Medicine, 131</i>, 531-534.

Ferrell, B. R., & Coyle, N. (2008). <i>The nature of suffering and the goals of nursing</i>. New York, NY: Oxford University Press.

Hofman, M., Ryan, J. L., Figueroa-Moseley, C. D., Jean-Pierre, P., & Morrow, G. R. (2007). Cancer-related fatigue: The scale of the problem. <i>Oncologist, 12</i>(Suppl. 1), 4-10. doi:10.1634/theoncologist.12-S1-4

Jean-Pierre, P., Figueroa-Moseley, C. D., Kohli, S., Fiscella, K., Palesh, O. G., & Morrow, G. R. (2007). Assessment of cancer-related fatigue: Implications for clinical diagnosis and treatment. <i>Oncologist, 12</i>(Suppl. 1), 11-21. doi:10.1634/theoncologist.12-S1-11

Mitchell, S. A., & Berger, A. M. (2008). Fatigue. In V. T. DeVita, Jr., T. S. Lawrence, & S. A. Rosenberg (Eds.), <i>DeVita, Hellman, and Rosenberg's cancer: Principles and practice of oncology</i> (8th ed., pp. 2710-2718). Philadelphia, PA: Lippincott Williams and Wilkins.

National Comprehensive Cancer Network. (2012). <i>NCCN Clinical Practice Guidelines in Oncology: Cancer-related fatigue</i> [v.1.2012]. Retrieved from <a target="_blank" href='http://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf'>http://...

Piper, B. F., Dibble, S. L., Dodd, M. J., Weiss, M. C., Slaughter, R. E., & Paul, S. M. (1998). The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. <i>Oncology Nursing Forum, 25</i>, 677-684.

Ramfelt, E., Severinsson, E., & Lützén, K. (2002). Attempting to find meaning in illness to achieve emotional coherence: The experiences of patients with colorectal cancer. <i>Cancer Nursing, 25</i>, 141-149. doi:10.1097/00002820-200204000-00011

Reich, W. T. (1987). Models of pain and suffering: Foundations for an ethic of compassion. <i>Acta Neurochirurgica. Supplementum, 38</i>, 117-122. doi:10.1007/978-3-7091-6975-9_20

Reich, W. T. (1989). Speaking of suffering: A moral account of compassion. <i>Soundings, 72</i>(1), 83-108.

Steeves, R. H. (1992). Patients who have undergone bone marrow transplantation: Their quest for meaning. <i>Oncology Nursing Forum, 19</i>, 899-905.

Taylor, E. J. (2000). Transformation of tragedy among women surviving breast cancer. <i>Oncology Nursing Forum, 27</i>, 781-788.

Taylor, E. J. (2003). Spiritual needs of patients with cancer and family caregivers. <i>Cancer Nursing, 26</i>, 260-266.

Thompson, P. (2007). The relationship of fatigue and meaning in life in breast cancer survivors. <i>Oncology Nursing Forum, 34</i>, 653-660. doi:10.1188/07.ONF.653-660

Woo, B., Dibble, S. L., Piper, B. F., Keating, S. B., & Weiss, M. C. (1998). Differences in fatigue by treatment methods in women with breast cancer. <i>Oncology Nursing Forum, 25</i>, 915-920.