Berger, A. M., VonEssen, S., Kuhn, B. R., Piper, B. F., Agrawal, S., Lynch, J. C., & Higginbotham, P. (2003). Adherence, sleep, and fatigue outcomes after adjuvant breast cancer chemotherapy: results of a feasibility intervention study. Oncology Nursing Forum, 30, 513–522.

DOI Link

Intervention Characteristics/Basic Study Process

Patients received a multi-component, cognitive-behavioral therapy (CBT), individual sleep promotion plan (ISPP) that included

  • Sleep hygiene
  • Relaxation prescription
  • Stimulus control
  • Sleep restriction delivered by a registered nurse (RN).

The ISPP started two days before the first prescription; continued during chemotherapy prescription; was revised 30, 60, and 90 days after the last prescription; and was reinforced seven days later. There were three doses and reinforcements.

Sample Characteristics

  • Twenty-one Caucasian patients (100% female) were included. 
  • Mean age was 55.3 years (range 43–66).
  • Patients had stage I or II breast cancer following adjuvant chemotherapy.

Setting

  • Midwestern United States
  • Patient homes 

Phase of Care and Clinical Applications

Patients were undergoing the long-term follow-up phase of care.

Study Design

This was a prospective, repeated measures, feasibility study with a single group and no control.

Measurement Instruments/Methods

  • Piper Fatigue Scale (PFS) and single fatigue intensity item
  • Piper’s Integrated Fatigue Model (IFM)
  • Adherence
  • Sleep

Results

Adherence to the intervention was high except for stimulus control. Fatigue scores were not significantly different over time.

Limitations

  • The pilot study was not designed to test the effectiveness of the intervention.
  • The study had a small sample size.
  • Research RN training was needed.
  • The actigraph had costs.