CORRELATES OF FATIGUE AND RELATED OUTCOMES IN INDIVIDUALS WITH CANCER UNDERGOING TREATMENT WITH CHEMOTHERAPY.

Description

This descriptive correlational study was designed to examine the relationship of pre-treatment factors and treatment-related symptoms on the incidence and severity of fatigue for individuals receiving chemotherapy for cancer. Fatigue was conceptualized as a multidimensional symptom complex resulting from physical and psychological stress. The relationships of age, gender, education, socioeconomic status, stage of disease, previous cancer treatment, fatigue before chemotherapy, the number of other symptoms, appraisal of threat, appraisal of challenge, and optimism to fatigue and related outcomes of mood, use of self-care behaviors, and disruption in usual activities were studied. An existing data set on 229 adults who participated in a cancer clinical trial on the efficacy of self-care behaviors following chemotherapy was analyzed. Fatigue and its related outcomes were operationalized using subscales of the bipolar form of the Profile of Mood States (POMS-BI) and instruments designed by the investigator. Subjects had one of 30 cancer diagnoses and reported their symptom experiences over two cycles of chemotherapy. Subjects were studied at five time points in relation to the cycles of chemotherapy: before beginning chemotherapy, on the second and fifth days of Cycle 1, and on the second and fifth days of Cycle 2. Mean age of the sample was 54.7 years; subjects were typically white (90%) and well-educated. Descriptive statistics, multiple regression and factor analysis were used to analyze the relationships of the predictor variables to outcomes of fatigue, mood, disruption in usual activities, and use of self-care behaviors. The incidence and severity of fatigue were highest on day 2 of Cycle 1. The number of symptoms and fatigue before chemotherapy were found to be significant predictors when outcomes were analyzed individually. The number of symptoms predicted 31.8% of the variance ($p < .001$) when fatigue, mood, disruption in usual activities, and use of self-care behaviors were combined as one composite variable. Implications for practice include regular assessment of fatigue as a side effect of cancer chemotherapy and emphasis on preventing or alleviating treatment side effects to control their negative impact. Future research should be designed to examine if the significant variables are useful in predicting fatigue over time and the potential role of physiologic variables in predicting the development of fatigue.

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