Barsevick, A. M., Dudley, W., Beck, S., Sweeney, C., Whitmer, K., & Nail, L. (2004). A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer, 100, 1302–1310.

The energy conservation and activity management (ECAM) intervention consisted of information provision, guidance in formulating and implementing a plan for energy conservation and activity management, and support in appraising the effectiveness of symptom management efforts. The intervention included completing a journal to monitor fatigue, sleep, rest, activity, and other symptoms; listing and prioritizing usual activities; and creating a tailored energy conservation plan. The intervention was delivered by nurse counselors in three telephone sessions that were 15 to 30 minutes in length.

• The study included 396 adults (age range 18–83 years); 85% were women, and most were Caucasian.
• Multiple diagnoses were included, but 71% of participants had breast cancer.
• All participants were initiating treatment with chemotherapy (47%), radiotherapy (44%), or concurrent chemoradiotherapy (9%).

Outpatient services of two large university cancer centers

Patients were undergoing the active treatment phase of care.

The study was a randomized, clinical trial with a repeated-measures design and an attentional control group.

• Profile of Mood States (POMS)
• Schwartz Cancer Fatigue Scale (SCFS)
• General Fatigue Scale (GFS)

• The ECAM intervention had a statistically significant effect in reducing fatigue, but the clinical effect was modest.
• The intervention group experienced significantly less disruption of usual activities compared with the control group, although the intervention was not associated with changes in overall functional status.

Efficacy findings were not confounded by the inability of patients who were in poorer health to complete the data collection process.

• Overrepresentation of women and a breast cancer diagnosis limits the generalizability to men, patients with other diagnoses, and those in poorer health.
• The amount of missing data was substantial. 
• Costs were not addressed.

Minimal training with the intervention materials is needed.