scholarly journals Non Pharmacological Interventions to Manage Cancer-Related Fatigue (CRF) - An Overview

Author(s):  
. Shambhavi ◽  
Diana Lobo

Fatigue is almost a common problem often reported by the cancer patients that severely affects all aspects of quality of life. Prevalence of cancer related fatigue ranges from 50% to 90% of cancer patients overall. After addressing treatable contributing factors, such as hypothyroidism, anemia, insomnia, pain, emotional distress, medication adverse effects, metabolic disturbances, or organ dysfunction such as heart failure, myopathy, and pulmonary fibrosis, patients may be screened with a short fatigue assessment tool. There is a pressure for pharmacologic therapy to shift away from reliance on opioids and ineffective procedures toward comprehensive cancer related fatigue (CRF) management that includes evidence-based nonpharmacologic options. This review details the magnitude of the current CRF problem including its impact on quality of life as well as the challenges of CRF management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Transforming the current system of CRF care to a responsive comprehensive model necessitates those options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. Patients with cancer related fatigue may benefit from self-administrable nonpharmacological interventions without any side effects. Health care personnel often have insufficient knowledge about fatigue and its treatments or underestimate the impact of fatigue on quality of life. A practical review may be useful to health care professionals in order to identify the cancer related fatigue during the early period of cancer process and treat it effectively to improve the quality of life which contribute to the positive outcomes in cancer clients. Therefore, the main purpose of this review is to analyze the possible nonpharmacological approach to manage cancer related fatigue and recommend future research that will clarify these approaches and facilitate the formulation of new treatment options.

2016 ◽  
Vol 38 (7) ◽  
pp. 893-908 ◽  
Author(s):  
Hong-Yi Tung ◽  
Tung-Bo Chao ◽  
Yu-Hua Lin ◽  
Shu-Fen Wu ◽  
Hui-Yen Lee ◽  
...  

In this study, we sought to explore the prevalence of depression and fatigue in colorectal cancer patients during and after treatment to examine how these variables affect quality of life (QoL). In total, 170 patients with colorectal cancer participated in this study. The study population was divided into two groups: one receiving treatment and another that had finished treatment. The results showed that depression and fatigue measurements were higher in patients receiving treatment. Depression was a strong and significant predictor of QoL in both groups, whereas fatigue was not, with the exception of the symptom score. These findings underscore the importance of early detection and management of depression and fatigue during the treatment and survival stages of patients with colorectal cancer. Our findings indicate that health care professionals should provide appropriate nursing intervention to decrease depression and fatigue and enhance patient QoL.


2009 ◽  
Vol 79 (3) ◽  
pp. 585-591 ◽  
Author(s):  
Zhijian Liu ◽  
Colman McGrath ◽  
Urban Hägg

Abstract Objective: To assess the current evidence of the relationship between malocclusion/orthodontic treatment need and quality of life (QoL). Materials and Methods: Four electronic databases were searched for articles concerning the impact of malocclusion/orthodontic treatment need on QoL published between January 1960 and December 2007. Electronic searches were supplemented by manual searches and reference linkages. Eligible literature was reviewed and assessed by methodologic quality as well as by analytic results. Results: From 143 reviewed articles, 23 met the inclusion criteria and used standardized health-related QoL (HRQoL) and orthodontic assessment measures. The majority of studies (18/23) were conducted among child/adolescent populations. Seventeen of the papers were categorized as level 1 or 2 evidence based on the criteria of the Oxford Centre for Evidence-Based Medicine. An observed association between HRQoL and malocclusion/orthodontic treatment need was generally detected irrespective of how they were assessed. However, the strength of the association could be described as modest at best. Key findings and future research considerations are described in the review. Conclusions: Findings of this review suggest that there is an association (albeit modest) between malocclusion/orthodontic treatment need and QoL. There is a need for further studies of their relationship, particularly studies that employ standardized assessment methods so that outcomes are uniform and thus amenable to meta-analysis.


2021 ◽  
Vol 10 (9) ◽  
pp. 1833
Author(s):  
Suzanne Kaal ◽  
Emma Lidington ◽  
Judith Prins ◽  
Rosemarie Jansen ◽  
Eveliene Manten-Horst ◽  
...  

This study aimed to identify health-related quality of life (HRQoL) issues of relevance for adolescent and young adult (AYA) cancer patients, the perception of relevant HRQoL issues for AYA in generalby the health care professionals (HCP), and discrepancies between issues identified by AYAs and HCP. Dutch AYAs aged 18–35 years at the time of cancer diagnosis (N = 83) and HCPs (N = 34) involved in AYA oncology were invited to complete the Quality of Life for Cancer Survivors questionnaire. HCPs rated physical symptoms such as fatigue, appetite, pain, constipation, sleep disorders, nausea and neuropathy among AYA cancer patients significantly higher (i.e., more problems) than AYA cancer patients. AYA cancer patients rated overall physical health and quality of life, happiness, satisfaction, usefulness and support from others, all positively formulated questions, significantly higher (i.e., more positive) than HCPs. The most highly rated issues (negative and positive combined) for AYAs were: perceived support from others, distress about initial cancer diagnosis, distress for family and overall quality of life. HCPs identified distress about diagnosis, treatment, family and interference of illness with employment/study as the most problematic issues (all negative) for AYAs. Five of the ten most common issues listed by patients and HCPs were the same. Male AYAs, patients treated with curative intent and those with a partner rated positive HRQoL issues higher than their counterparts. The discrepancy between the perception of patients and HCPs illustrates the importance of patient involvement in organizing physical and psychosocial care.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Anita Van Eck van der Sluijs ◽  
Sanne Vonk ◽  
Anna Bonenkamp ◽  
Brigit Van Jaarsveld ◽  
Alferso C Abrahams

Abstract Background and Aims Recommendations regarding dialysis education and treatment are provided in various (inter)national guidelines, which should ensure that these are applied uniformly in nephrology and dialysis centers. However, there is much practice variation which could be explained by good practices: practices developed by local health care professionals, which are not evidence-based. Because an overview of good practices is lacking, we performed a scoping review to identify and summarize the available good practices for dialysis education, treatment and eHealth. Method Embase, Pubmed, and the Cochrane Library databases were searched for relevant articles using all synonyms for the words ‘kidney failure’, ‘dialysis’ and ‘good practice’. Relevant articles were structured according to the categories dialysis education, dialysis treatment or eHealth, and assessed for content and results. Results Nineteen articles (12 for dialysis education, 3 for dialysis treatment, 4 for eHealth) are identified. The good practices for education endorse the importance of providing complete and unbiased predialysis education, assisting PD patients in adequately performing PD, educating HD patients on self-management, and talking with dialysis patients about their prognosis. The good practices for dialysis treatment focus mainly on dialysis access devices and general quality improvement of dialysis care. Finally, eHealth is useful for HD and PD and affects both quality of care and health-related quality of life. Conclusion The results of our scoping review can inspire nephrological health care professionals to change their practices and these good practices could be used in addition to guidelines. It is important to increase the attention for local good practices, because they can truly support health care professionals and can improve outcomes and quality of life for patients, even if they are not evidence-based.


2015 ◽  
Vol 39 (5-6) ◽  
pp. 272-280 ◽  
Author(s):  
Hilde M. de Vocht ◽  
A.M.G. Marcella Hoogeboom ◽  
Bob van Niekerk ◽  
Marjolein E.M. den Ouden

Background: The aim was to assess the impact of a one-to-one 30-min individualized interaction per day on the behavior and quality of life of care-dependent residents with dementia. Methods: In a pre-/post-test study, 15 care-dependent residents with dementia (mean age 88.8 years, 86.7% women) were included. Resident behavior was measured using video observation and quality of life using Qualidem. Health care professionals (n = 13) and direct relatives (n = 4) were interviewed about the effect of the intervention. The effect of the intervention was analyzed using the Friedman analysis of variance. Results: The video observation showed that maintaining eye contact, touching, responding to speaking, tracking observable stimuli and asking questions about the activity significantly increased during the intervention. These findings were supported by interviews with nurses who described experiences of making human-to-human contact with the residents. No significant overall changes were found in quality of life. These findings were partially supported by interviews with health care professionals and relatives as some perceived effects beyond the 30-min intervention. Conclusions: Interaction offered on a one-to-one basis tailored to individual preferences significantly improved positive interactive behavior of care-dependent residents with dementia during the intervention. Surveys revealed no significant overall effect of the intervention. The interviews indicated there might be effects beyond the intervention for some residents.


2009 ◽  
Vol 123 (12) ◽  
pp. 1352-1357 ◽  
Author(s):  
K Reid ◽  
C Hicks ◽  
S Herron-Marx ◽  
S Parmar

AbstractAim:To investigate whether information about the size of an oral tumour influences the multi-disciplinary team's judgement about the quality of life of head and neck cancer patients.Method:Using a between-group design, two groups of health care professionals rated a hypothetical patient on 20 outcome variables. The patient description was identical for both groups, except for the tumour size.Results:Comparison of variable ratings revealed only three significant differences between the groups' predictions and no consistency within conditions, suggesting that the participants held few common assumptions about the impact of tumour size on a range of patient experiences.Conclusion:The lack of agreement amongst the health care professionals suggests that, where humane judgements are used in treatment decisions for head and neck cancer patients, these may be random and inconsistent. Consequently, patients should have a direct input into treatment decisions, via formalised quality of life data.


2018 ◽  
Author(s):  
Stephanie E Pearson ◽  
John Taylor ◽  
Derek J Hoare ◽  
Poulam Patel ◽  
David M Baguley

BACKGROUND Many cancer patients and survivors experience permanent and life-debilitating effects, such as ototoxicity, from treatment. Ototoxicity manifests as high-frequency hearing loss and tinnitus, which can have a detrimental effect on the quality of life (QoL) of those affected. Currently, there is little information and support offered to these patients who experience ototoxicity, potentially leading to many being undiagnosed and untreated. OBJECTIVE The aim of this study was to explore the extent of ototoxic side effects, such as hearing loss and tinnitus, and their impact on cancer patients following chemotherapy treatment. Secondary objectives included detecting the time periods of onset and duration of the ototoxicity and identifying what support was available to this population. METHODS Posts from publicly available online forums were thematically analyzed using the guidelines by Braun and Clarke. A coding manual was iteratively developed to create a framework for the analysis of the ototoxicity experience among the cancer population. RESULTS A total of 9 relevant online forums were identified, consisting of 86 threads and 570 posts from 377 members. Following the bottom-up thematic analysis, 6 major themes were identified: nature of ototoxicity, time of experienced ototoxicity, information on ototoxicity, quality of life, therapies, and online social support. CONCLUSIONS There was a significant number of reports expressing concerns about the lack of information on the risk of ototoxicity. More support for those suffering is needed; for example, improved interdepartmental communication between oncology and audiology services could optimize patient care. Patients should also be encouraged to communicate with their health care professionals about their ototoxicity and relay how their QoL is impacted by ototoxicity when accessing support. Tinnitus was the most common concern and was associated with distress. Hearing loss was less common; however, it was associated with fear and employment issues. Those who reported preexisting conditions were fearful about worsening their condition as their QoL was already impacted.


2021 ◽  
Vol 21 (2) ◽  
pp. 168-177
Author(s):  
Maria Ishaq Khattak ◽  
Muslim Khan ◽  
Saad Ishaq Khattak ◽  
Zohaib Khan ◽  
Zia Ul Haq ◽  
...  

This is a critical review of the current evidence on patients’ experiences with oral cancer. The impact on the quality of life and implications to clinical practice and research were also discussed. A comprehensive search of three databases, PubMed, Scopus, and Google Scholar was undertaken. The search was restricted to English-language primary research papers from 2009 till 2019. The following keywords were used: mouth neoplasms, patients, experiences, oral cancer, physical, social, psychological. A total of 173 studies were retrieved using the search strategy. After removing duplicate reports and scrutinising those based on title and abstract, 68 studies were shortlisted for full text review. Three major themes emerged from the literature: (1) physical experiences of oral cancer patients, (2) psychological experiences of oral cancer patients, and (3) social experiences of oral cancer patients. Experiences of oral cancer patients are complex and subjective, and phases of physical, psychological, and social experiences of oral cancer have not been explored in detail. However, there is evidence that experiences such as pain, facial alterations, body image disturbances, anxiety, depression, social avoidance, social support, and financial implications affect patients’ quality of life. This review underlines the importance of further research to look into the type of support needed to address various experiences of oral cancer patients.


Jurnal NERS ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 35
Author(s):  
I Komang Leo Triandana Arizona ◽  
Tintin Sukartini ◽  
Ferry Efendi ◽  
Primalova Septiavy Estiadewi ◽  
Ni Putu Dian Ayu Anggraeni

Introduction: Cancer-related fatigue (CRF) is one of the symptoms commonly experienced and it is a subjective feeling felt by cancer patients. The aim of this systematic review was to summarize how fatigue has been described from the perspective of adult cancer patients, the impact of fatigue on their quality of life, what the patient reported as contributing factors and potential coping strategies to reduce fatigue.Methods: A systematic review is in line with PRISMA guidelines. Five databases were systematically searched (Scopus, PubMed, Springerlink, ProQuest and Science Direct) from January 2009 to February 2019 for qualitative studies describing the experience of adult cancer patients using a predefined search strategy and any relevant keywords.Results: In total, 13 out of 4692 studies were included. The ages of the included patient cancer ranged from 26 to 84 years. The majority of studies used in-depth interviews and semi-structured interviews to elicit the participant’s experiences of fatigue. Four themes were identified: the perception of cancer-related fatigue, the etiology of cancer fatigue, impact and coping strategies.Conclusion: Fatigue is impactful on quality of life from the perspective of cancer patients. Future research should focus on the prospective exploration of the impact of fatigue on woman's and men's health and identifying approaches to reduce fatigue. 


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 168.2-168
Author(s):  
L. Wagner ◽  
S. Sestini ◽  
C. Brown ◽  
A. Finglas ◽  
R. Francisco ◽  
...  

Background:Inborn metabolic disorders (IMDs) currently encompass more than 1,500 diseases with new ones still to be identified1. Each of them is characterised by a genetic defect affecting a metabolic pathway. Only few of them have curative treatments, that target the respective metabolic pathway. Commonly, treatment examples include diet, substrate reduction therapies, enzyme replacement therapies, gene therapy and biologicals, enabling IMD-patient now to survive to adulthood. About 30 % of all IMDs involve the musculoskeletal system and are here referred to as rare metabolic RMDs. Generally, IMDs are very heterogenous with respect to symptoms and severity, often being systemic and affecting more children than adults. Thus, challenges include certified advanced training of adult metabolic experts, standardised transition plans, social support and development of therapies for diseases that do not have any cure yet.Objectives:Introduction of MetabERN, its structure and objectives, highlighting on the unique features and challenges of metabolic RMDs and describing the involvement of patient representation in MetabERN.Methods:MetabERN is stratified in 7 subnetworks (SNW) according to the respective metabolic pathways and 9 work packages (WP), including administration, dissemination, guidelines, virtual counselling framework, research/clinical trials, continuity of care, education and patient involvement. The patient board involves a steering committee and single point of contacts for each subnetwork and work package, respectively2. Projects include identifying the need of implementing social science to assess the psycho-socio-economic burden of IMDs, webinars on IMDs and their transition as well as surveys on the impact of COVID-193 on IMD-patients and health care providers (HCPs), social assistance for IMD-patients and analysing the transition landscape within Europe.Results:The MetabERN structure enables bundling of expertise, capacity building and knowledge transfer for faster diagnosis and better health care. Rare metabolic RMDs are present in all SNWs that require unique treatments according to their metabolic pathways. Implementation of social science to assess the psycho-socio-economic burden of IMDs is still underused. Involvement of patient representatives is essential for a holistic healthcare not only focusing on clinical care, but also on the quality of life for IMD-patients. Surveys identified unmet needs of patient care, patients having little information on national support systems and structural deficits of healthcare systems to ensure HCP can provide adequate clinical care during transition phases. These results are collected by MetabERN and forwarded to the Directorate-General for Health and Food Safety (DG SANTE) of the European Commission (EC) to be addressed further.Conclusion:MetabERN offers an infrastructure of virtual healthcare for patients with IMDs. Thus, in collaboration with ERN ReCONNET, MetabERN can assist in identifying rare metabolic disorders of RMDs to shorten the odyssey of diagnosis and advise on their respective therapies. On the other hand, MetabERN can benefit from EULAR’s longstanding experience regarding issues affecting the quality of life, all RMD patients are facing, such as pain, stiffness, fatigue, rehabilitation, maintaining work and disability claims.References:[1]IEMbase - Inborn Errors of Metabolism Knowledgebase http://www.iembase.org/ (accessed Jan 29, 2021).[2]MetabERN: European Refence Network for Hereditary Metabolic Disorders https://metab.ern-net.eu/ (accessed Jan 29, 2021).[3]Lampe, C.; Dionisi-Vici, C.; Bellettato, C. M.; Paneghetti, L.; van Lingen, C.; Bond, S.; Brown, C.; Finglas, A.; Francisco, R.; Sestini, S.; Heard, J. M.; Scarpa, M.; MetabERN collaboration group. The Impact of COVID-19 on Rare Metabolic Patients and Healthcare Providers: Results from Two MetabERN Surveys. Orphanet J. Rare Dis.2020, 15 (1), 341. https://doi.org/10.1186/s13023-020-01619-x.Acknowledgements:The authors thank the MetabERN collaboration group, the single point of contacts (SPOC) of the MetabERN patient board and the Transition Project Working Group (TPWG)Disclosure of Interests:None declared


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