Purcell, A., Fleming, J., Burmeister, B., Bennett, S., & Haines, T. (2011). Is education an effective management strategy for reducing cancer-related fatigue? Supportive Care in Cancer, 19, 1429–1439.

DOI Link

Study Purpose

To examine whether providing pre-, post-, or pre-/post-radiotherapy fatigue education and support (RFES) reduced the severity of fatigue at the end of six weeks post radiotherapy.

Intervention Characteristics/Basic Study Process

A 60-minute session was held using a PowerPoint presentation, participant handbook, goal setting sheet, and progress diary. Follow-up telephone calls were made to patients two and four weeks after the session to reinforce the information. Content included radiotherapy processes, side effects, and behaviors to reduce fatigue, such as activity modification, sleep hygiene, and relaxation.

Sample Characteristics

  • In total, 91 patients (49% male, 51% female) were included.   
  • Mean age was 57.65 years.
  • Cancer diagnoses included were breast (34%), prostate (33%), other diagnosis (13%), melanoma (11%), and head and neck (9%).
  • Length of radiotherapy was 29.5 days.

Setting

  • Single site   
  • Outpatient
  • Radiation oncology department of a major metropolitan hospital in Brisbane, Australia

Phase of Care and Clinical Applications

Patients were undergoing the active treatment phase of care.

Study Design

The study used a three-group, quasiexperimental, pre/post design.

Measurement Instruments/Methods

  • Medical Outcomes Study (MOS) Sleep Scale
  • Multidimensional Fatigue Inventory (MFI)
  • EuroQol-5D (EQ-5D)
  • Frenchay Activities Index (FAI)
  • International Physical Activity Questionnaire (IPAQ)
  • Hospital Anxiety and Depression Scale (HADS)
  • Health and Labour Questionnaire (HLQ)
     

Results

Pre-RFES showed no improvement in fatigue compared to no pre-RFES. Post-RFES showed no improvement in fatigue compared to no post-RFES.

Conclusions

Patient-reported fatigue was unaffected by the intervention for any of the time points it was delivered.

Limitations

  • The study had a small sample size, with less than 100 patients.
  • No appropriate nonintervention control group was used.

Nursing Implications

 Additional interventions should be considered when attempting to alleviate fatigue in patients receiving radiotherapy.