Nursing management of fatigue in cancer patients: Mixed methods study

Abstract Background Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated and undertreated in clinical practice. The aims of this study were to detect the presence of fatigue in cancer patients, describe how patients and nurses perceived it and how nurses managed fatigue. Methods This is a mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. Results A total of 71 questionnaires were analysed (39 males, mean age 65.7 years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems associated to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, and being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nurses’ contribution to the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. Conclusions The approach to the management of fatigue was unstructured. Patients were satisfied with the care they received but needed more information and specific interventions. Useful aspects were identified that could be used to change health professionals’ approach towards the management of fatigue.

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Nursing Management of Fatigue in Cancer Patients: Mixed Methods Study

10.21203/rs.3.rs-257672/v1 ◽

2021 ◽

Author(s):

Angela Tolotti ◽

Loris Bonetti ◽

Carla Pedrazzani ◽

Monica Bianchi ◽

Laura Moser ◽

...

Keyword(s):

Mixed Methods ◽

Focus Groups ◽

Cancer Patients ◽

Ad Hoc ◽

Study Data ◽

Mixed Methods Study ◽

Nursing Management ◽

Patient Interviews ◽

Brief Fatigue Inventory

Abstract BackgroundFatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated in clinical practice and undertreated. The aims of this study were to detect the presence of fatigue in cancer patients, describe the perceptions of patients and nurses regarding it and describe the nursing management of fatigue.MethodsMixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis.ResultsA total of 71 questionnaires were analysed (39 males, mean age 65,7(±14) years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems related to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nursing contribution within the multidisciplinary management of fatigue, and difficulty in evaluating outcomes.DiscussionThe approach to the management of fatigue was unstructured. Patients were satisfied with the care received but needed more information and specific interventions. Useful aspects were identified that could be used to change the professional approach towards the management of fatigue.

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A longitudinal mixed methods study on changes in body weight, body composition, and lifestyle in breast cancer patients during chemotherapy and in a comparison group of women without cancer: study protocol

BMC Cancer ◽

10.1186/s12885-018-5207-7 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 7

Author(s):

J. Th. C. M. de Kruif ◽

M. Visser ◽

M. M. G. A. van den Berg ◽

M. J. M. Derks ◽

M. R. de Boer ◽

...

Keyword(s):

Breast Cancer ◽

Body Composition ◽

Body Weight ◽

Mixed Methods ◽

Cancer Patients ◽

Study Protocol ◽

Comparison Group ◽

Mixed Methods Study ◽

Breast Cancer Patients ◽

Cancer Study

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The impact of music therapy versus music medicine on psychological outcomes and pain in cancer patients: a mixed methods study

Supportive Care in Cancer ◽

10.1007/s00520-014-2478-7 ◽

2014 ◽

Vol 23 (5) ◽

pp. 1261-1271 ◽

Cited By ~ 59

Author(s):

Joke Bradt ◽

Noah Potvin ◽

Amy Kesslick ◽

Minjung Shim ◽

Donna Radl ◽

...

Keyword(s):

Mixed Methods ◽

Music Therapy ◽

Cancer Patients ◽

Psychological Outcomes ◽

Mixed Methods Study ◽

Music Medicine ◽

The Impact

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Effects of family-based dignity intervention and expressive writing on anticipatory grief of family caregivers of patients with cancer: a study protocol for a four-arm randomized controlled trial and a qualitative process evaluation

Trials ◽

10.1186/s13063-021-05718-3 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Naima Seyedfatemi ◽

Tahereh Najafi Ghezeljeh ◽

Jafar Bolhari ◽

Masoud Rezaei

Keyword(s):

Mixed Methods ◽

Cancer Patients ◽

Family Caregivers ◽

Study Protocol ◽

Expressive Writing ◽

Intervention Group ◽

Mixed Methods Study ◽

Trial Registration ◽

Anticipatory Grief ◽

Family Based

Abstract Background Family caregivers of dying cancer patients are affected by grief experiences and bereavement complications. Several approaches such as psycho-emotional care and an increase in spirituality have been suggested to diminish these complications. However, the knowledge about the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients is limited. This is a study protocol describing a hospital-based mixed-methods study on the effects of family-based dignity intervention and expressive writing on anticipatory grief in family caregivers of dying cancer patients. Methods This mixed-methods study will be done in an embedded explanatory design with two quantitative and qualitative phases. In the first phase (quantitative), a randomized clinical trial will be done, in which 200 family caregivers of dying cancer patients will be randomly assigned to one of the four groups: family-based single dignity intervention (group 1), expressive writing intervention (group 2), combined family-based single dignity intervention and expressive writing (group 3), and control (group 4). At baseline, 1 week and 2 weeks after the interventions, anticipatory grief will be assessed by a 13-item anticipatory grief scale. After the quantitative phase, the qualitative phase will be conducted through the conventional content analysis approach of Granheim and Lundman, in which an individual semi-structured interview will be taken from participants in the first phase to collect data on their experiences on interventions. Finally, data from the quantitative and qualitative phases will be analyzed and discussed. Discussion Family caregivers of dying cancer patients usually experience depression, anxiety, and psychological distress due to isolation and inadequate social support. Psychological interventions such as dignity and expressive writing interventions may help caregivers to obtain a better understanding of themselves and to increase their abilities to cope with caregiving difficulties. Therefore, there is a need for a comprehensive study confirming the effects of mentioned interventions on family caregivers of dying cancer patients. Trial registration Iranian Registry of Clinical Trials (www.irct.ir) identifier: IRCT20210111050010N1. Date of trial registration: Feb 6, 2021. This is the first version of this protocol.

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Who is at risk for palliative care misconceptions and how do we address them? A mixed-methods study of metastatic lung cancer patients.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.67 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 67-67

Author(s):

Laurie McLouth ◽

Jennifer Gabbard ◽

Beverly J Levine ◽

Chandylen L Nightingale ◽

Kate Furgurson ◽

...

Keyword(s):

Lung Cancer ◽

Palliative Care ◽

African American ◽

Mixed Methods ◽

Health Literacy ◽

Cancer Patients ◽

Mixed Methods Study ◽

Lung Cancer Patients ◽

Definition Of ◽

Inadequate Health Literacy

67 Background: A major misperception of palliative care (PC) is that it is only for people who are about to die. We recently identified this misperception as a barrier to PC in metastatic non-small cell lung cancer (mNSCLC) patients, patients who should all receive early PC per guidelines. The goal of this study was to assess patient characteristics associated with misperceptions about PC and to elicit patient perspectives on how to address them. Methods: We conducted a mixed-methods study of mNSCLC patients on immunotherapy or chemo-immunotherapy. A survey assessed sociodemographics, health literacy, and PC misperceptions. Semi-structured interviews queried perceptions of PC, experiences discussing PC with providers, and reactions to our institutional definition of PC. Qualitative data from interviews were analyzed using directed content analysis approach. Results: Sixty patients (Mean age = 63, 40% male; 18% African American, 45% inadequate health literacy) completed the survey. Twelve of the survey participants (Mean age = 65, 50% male, 25% African American, 67% inadequate health literacy; 50% with caregivers participating) also completed a semi-structured interview. Quantitative survey results showed equating PC with death and/or hospice did not differ based on gender, health literacy, rural vs. urban residence, or time since diagnosis (p’s > .05). Qualitative results showed patients and caregivers consistently associated PC with death (e.g., “the next step to the graveyard”) and hospice. Though some patients noted differences between our institution’s definition of PC and their perceptions (e.g., “delivered at any stage”), the definition did not increase interest and sometimes reinforced misperceptions (e.g., “See, that's a death spiral”). To address misconceptions, patients and caregivers suggested distinguishing PC from end of life and hospice, presenting it positively, and discussing it early into treatment. Conclusions: Lung cancer patients may associate PC with death even if they have adequate health literacy. Commonly used definitions of PC may not quell patient fears. PC needs to be presented as a positive service to patients early into treatment.

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