The Relation of Sick Leave Benefits, Employment Patterns, and Individual Characteristics to Radiation Therapy-related Fatigue

Abstract

Fatigue has consistently been found to be the most common and distressing side effect of radiation therapy. This study examined the relation of a specific life-style behavior with many policy and economic implications, participation in the workforce, on radiation therapy-related fatigue. The aims of this longitudinal study were to: describe sick leave benefits available to patients undergoing radiation therapy; examine the relation between sick leave benefits, individual characteristics, and employment patterns in patients undergoing radiation therapy; and examine the relation between employment patterns, individual characteristics, and fatigue in patients receiving radiation therapy. The Conceptual Model of Nursing and Health Policy (CMNHP) and the Piper Integrated Fatigue Model (IFM) guided this study. Seventy-seven study participants receiving radiation therapy to the breast, chest, head and neck, pelvis, and prostate were recruited from one community hospital. The revised Piper Fatigue Scale (PFS), the Brief Fatigue Inventory (BFI) and a single item 0–10 numeric scale were used to measure five dimensions of subjective fatigue. The study employed a prospective, longitudinal design. Data were collected at baseline prior to starting radiation therapy, weekly during treatment, and at the one month follow-up visit. Mean total fatigue scores on the PFS ranged from 0–4.77 at baseline (M = 0.46, SD = 0.93), 0–8.77 at the completion of treatment (M = 2.84, SD = 2.40), and 0–4.82 (M = 0.77, SD = 1.20) at one month post-treatment. Treatment-related side effects, education, living situation, age, treatment site, and work were associated with fatigue along the trajectory of radiation therapy. Study participants who were working at the end of radiation therapy had lower fatigue scores than those who were not working t(75) = 4.85, p < .0001. Age, pain, gender, side effects, availability of sick leave benefits, and fatigue were associated with work along the trajectory of radiation therapy. Only 49% of study participants had paid sick leave benefits available at the start of radiation. Study findings supported the credibility of the CMNHP and the Piper IFM, which can be used to guide and focus future research into employment and sick leave policies and their impact on cancer-related fatigue.