Williams, S. A., & Schreier, A. M. (2005). The role of education in managing fatigue, anxiety, and sleep disorders in women undergoing chemotherapy for breast cancer. Applied Nursing Research, 18, 138–147.

Patients were given a 20-minute audiotape that provided information about exercise and relaxation to manage anxiety, fatigue, and sleep problems. A printed self-care diary (SCD) of self-care behaviors that mirrored the audiotape was also provided. Participants were instructed to listen to the audiotape 12 to 24 hours before the start of chemotherapy cycles and as often as desired during the course of treatment. Patients in the control group received the standard education and care given to all patients during chemotherapy, whereas the experimental group received standard education and care, the audiotape, and the printed SCD.

• The study included 71 women (control group, n = 33; experimental group, n = 38) who were newly diagnosed with breast cancer; 85% had stage I or II breast cancer.
• Mean age was 50.41 years (range 30–74); 50% were younger than 50 years. 
• Of the women, 50% were Black, 56% were Caucasian, and a few were Hispanic.
• Mean education level was 13.23 years (range 6–24).
• Of the women, 60% had an income of less than $29,000 (US).
• About half of the women were married.
• Most women received cytoxan/adriamycin; less than 13% received cytoxan/adriamycin/5FU.
• Patients were excluded if they were undergoing any therapy other than chemotherapy, were younger than 18 years, had a Karnofsky Performance Status (KPS) rating of less than 70%, or were non-English speaking.

• Multisite
• Tertiary medical center in the Southeastern United States and a satellite cancer treatment clinic 

Patients were undergoing the active treatment phase of care.

This was a randomized study; patients were randomly assigned to either the control or experimental group.

SCD

A higher percentage of women in the control group reported fatigue compared to the experimental group. Although the experimental group increased the number of self-care behaviors to address fatigue compared to the control group, this difference was not statistically significant.

• There was no control over information from outside sources that was provided to the women at the time of treatment; therefore, this varied between patients.
• The lack of significant findings may be due to insufficient use of self-care tapes, and measures to promote compliance will be needed in the future.
• The study had a small sample size.