Reif, K., de Vries, U., Petermann, F., & Görres, S. (2013). A patient education program is effective in reducing cancer-related fatigue: a multi-centre randomised two-group waiting-list controlled intervention trial. European Journal of Oncology Nursing, 17, 204–213.

To evaluate a patient education program aimed at reducing fatigue.

Patients were randomly assigned to intervention or wait-list control groups. The intervention consisted of group education and support sessions for 90 minutes once weekly for six weeks. Data were collected at baseline and at six weeks and six months postintervention. Patients were encouraged to keep a diary at home, perform exercises, and implement lifestyle changes.

• In total, 234 patients (2.6% male, 97.4% female) were included.
• Mean age was 57.5 years.
• Patients had breast, colon, and prostate cancers.
• Greater than 90% of the patients had fatigue for longer than six months. Baseline fatigue scores from multiple tools showed that patients were highly fatigued and had significant fatigue interference with daily activities.

• Multisite 
• Outpatient 
• Germany

Patients were undergoing the late effects and survivorship phase of care.

The study was a randomized, controlled trial.

• Fatigue Assessment Questionnaire
• European Organisation for Research and Treatment of Cancer Quality of Life (EORTC-QOL)
• General Self Efficacy (GSE) Scale
• Exercise Self Efficacy (EXSE) Scale
• Frieburg Questionnaire on Physical Activity
• Hospital Anxiety and Depression Scale (HADS)
• Fatigue Knowledge Scale (developed by the investigator)
   

Analysis showed that, over time, fatigue was significantly reduced in the intervention group (effect size of partial eta² = 0.248; p < 0.001). GSE and EXSE improved over time in the intervention group but declined in the control group.

Findings demonstrated that the psychoeducational intervention was effective in reducing cancer-related fatigue.

• The study had risks of bias due to no appropriate attentional control condition and no blinding.
• Unintended interventions or applicable interventions were not described that would have influenced the results (no information was provided about the use of medications or other interventions that could have influenced the outcomes).

The study adds to the body of evidence that supports the effectiveness of psychoeducational interventions for the management of cancer-related fatigue. This group of patients was very fatigued at baseline, and the effect size of the intervention was substantial, suggesting that the psychoeducational approach effect was clinically meaningful in a challenging group of patients.