Abstract
Background: Fatigue is a prevalent symptom among cancer patients, even after completing treatment. The National Comprehensive Cancer Network Guidelines recommend incorporating physical activity as a strategy to combat cancer-related fatigue. Objectives: The goal was to develop and implement an evidence-based translational research quality improvement project to improve fatigue in patients starting oral cancer treatment. Methods: Outpatient oncology nurses (registered nurses and licensed practical nurses) responsible for educating patients starting treatment for cancer were provided education about the walking program. The information was incorporated into education for patients starting oral chemotherapy. Nursing knowledge, beliefs, and attitudes were evaluated before and after the subject-intensive education. Patient study participants were provided with pedometers and completed the Brief Fatigue Inventory and a survey about their beliefs and attitudes before and after implementing the walking program. Outcomes: Fatigue scores showed a slight decrease post intervention but not a statistically significant difference. Advanced-stage cancer showed a near-significant relationship with increased fatigue levels. Nursing knowledge improved by 13%, and nurses reported increased confidence in six of nine topics. Nursing barriers to education shifted from personal comprehension to a need for resources. Recommendations: Patients diagnosed with advanced-stage cancer should receive timely fatigue prevention and management education. In addition, educating nurses to address this knowledge deficit is imperative. The information gathered from this project presents an opportunity for further research using a walking plan and nursing education to improve current interventions used to reduce cancer-related fatigue.
References
Aapro, M., Scotte, F., Bouillet, T., Currow, D., & Vigano, A. (2017). A practical approach to fatigue management in colorectal cancer. Clinical Colorectal Cancer, 16(4), 275–285. https://doi.org/10.1016/j.clcc.2016.04.010
Abbott, L. & Hooke, M. C. (2017). Energy through motion: An activity intervention for cancer-related fatigue in an ambulatory infusion center. Clinical Journal of Oncology Nursing, 21(5), 618–626. https://www.proquest.com/openview/f6d3e656ab700c67a13a033c0dec5305/1?pq-origsite=gscholar&cbl=33118
Bower, J. E., Wiley, J., Petersen, L., Irwin, M. R., Cole, S. W., & Ganz, P. A. (2018). Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories. Health Psychology, 37(11), 1025–1034. https://psycnet.apa.org/doi/10.1037/hea0000652
Brown, J. C., Huedo-Medina, T. B., Pescatello, L. S., Pescatello, S. M., Ferrer, R. A., & Johnson, B. T. (2011). Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: A meta-analysis. Cancer Epidemiology, Biomarkers & Prevention, 20(1), 123–133. https://doi.org/10.1158/1055-9965.EPI-10-0988
Cramp, F., & Byron-Daniel, J. (2012). Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews, 2012(11), CD006145. http://dx.doi.org/10.1002/14651858.CD006145.pub3
Eickmeyer, S. M., Gamble, G. L., Shahpar, S., & Do, K. D. (2012). The role and efficacy of exercise in persons with cancer. PM&R: The Journal of Injury, Function, and Rehabilitation, 4(11), 874–881. https://doi.org/10.1016/j.pmrj.2012.09.588
Mohandas, H., Jaganathan, S. K., Mani, M. P., Ayyar, M., & Thevi, G. R. (2017). Cancer-related fatigue treatment: An overview. Journal of Cancer Research and Therapeutics, 13(6), 916–929. https://doi.org/10.4103/jcrt.jcrt_50_17
National Comprehensive Cancer Network. (2022). NCCN Clinical Practice Guidelines in Oncology: Cancer-Related Fatigue. https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf
Paramanandam, V. S. & Dunn, V. (2015). Exercise for the management of cancer-related fatigue in lung cancer: A systematic review. European Journal of Cancer Care, 24(1), 4–14. https://doi.org/10.1111/ecc.12198
Puetz, T. W. & Herring, M. P. (2012). Differential effects of exercise on cancer-related fatigue during and following treatment: A meta-analysis. American Journal of Preventative Medicine, 43(2), e1–e24. https://doi.org/10.1016/j.amepre.2012.04.027
