Patterns of fatigue and factors influencing fatigue during adjuvant breast cancer chemotherapy
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Dr. Ann M. Berger, RN, PhD, AOCNS
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- Gamma Pi at-Large
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Women beginning adjuvant chemotherapy for breast cancer seek information from health professionals regarding fatigue, but knowledge regarding this distressing symptom is currently limited. The purposes of this study were to describe the patterns of fatigue and of factors influencing fatigue across the first three cycles of chemotherapy and to determine the extent to which health and functional status, chemotherapy protocol, physical activity behaviors, activity/rest cycles, nutrition behaviors and status, stress management behaviors, interpersonal relations behaviors, symptom distress and reaction to the diagnosis of cancer explain fatigue at each treatment and predict fatigue at the mid-point of the first three chemotherapy cycles. A model drawn from Piper's framework (1987) guided this prospective, descriptive, repeated measures design study. Data collection included: Background data, Piper Fatigue Scale, MOS-SF-36, Health-Promoting Lifestyle Profile II, wrist actigraph, hematocrit, body mass index, Modified Symptom Distress Scale and Reaction to the Diagnosis of Cancer Questionnaire. Descriptive statistics, paired t-tests, simple and repeated measures ANOVA, cosinor and path analyses were used. In this sample of 60 women, total fatigue and its 4 dimensions and severity of symptoms distress fluctuated significantly from higher levels at treatment times to lower levels at cycle mid-points, with activity/rest cycles varying in an inverse pattern. Fatigue was explained at treatment times (R$\sp2$ =.52-.71) by symptom distress ($\beta$ =.54-.62), chemotherapy protocol ($\beta$ =.32) and interpersonal relations behaviors ($\beta = -.40$) and predicted at cycle mid-points (R$\sp2$ =.45-.60) by symptom distress at the time of treatments ($\beta$ =.33-.43), physical function status ($\beta = -.39$), general health ($\beta = -.32$) and reaction to the diagnoses of cancer ($\beta = -.39).$ Higher perceived fatigue levels were associated with lower daytime activity indicators and high levels of night-time awakenings at various times. Women can be instructed to monitor fatigue intensity and to expect the patterns of fatigue to be similar during the first three chemotherapy cycles. These findings provide a foundation for future intervention studies aimed at modification of fatigue.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 9710329; ProQuest document ID: 304298909. The author still retains copyright.
This item has not gone through this repository's peer-review process, but has been accepted by the indicated university or college in partial fulfillment of the requirements for the specified degree.
Type | Dissertation |
Acquisition | Proxy-submission |
Review Type | None: Degree-based Submission |
Format | Text-based Document |
Evidence Level | Other |
Research Approach | Quantitative Research |
Keywords | Chemotherapy for Breast Cancer; Health During Treatment; Symptoms |
CINAHL Subject(s) | Women; Breast Neoplasms; Chemotherapy, Adjuvant--Adverse Effects; Fatigue--Symptoms; Symptom Distress--Evaluation; Functional Status--Evaluation; Psychosocial Aspects of Illness--Evaluation; Chemotherapy, Adjuvant; Fatigue; Symptom Distress; Functional Status; Psychosocial Aspects of Illness |
Grantor | University of Nebraska Medical Center |
Advisor | Walker, Susan Noble |
Level | PhD |
Year | 1996 |
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