The trajectory of fatigue in adult patients with breast and ovarian cancer receiving chemotherapy.

Publisher: Oncology Nursing Society Country of Publication: United States NLM ID: 7809033 Publication Model: Print Cited Medium: Internet ISSN: 1538-0688 (Electronic) Linking ISSN: 0190535X NLM ISO Abbreviation: Oncol Nurs Forum Subsets: MEDLINE

Publication: Pittsburgh, PA : Oncology Nursing Society
Original Publication: New York, Oncology Nursing Society.

Oncology Nursing*; Antineoplastic Combined Chemotherapy Protocols/*adverse effects ; Breast Neoplasms/*nursing ; Fatigue/*nursing ; Ovarian Neoplasms/*nursing; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/administration & dosage ; Breast Neoplasms/blood ; Breast Neoplasms/drug therapy ; Clinical Nursing Research ; Fatigue/chemically induced ; Female ; Humans ; Middle Aged ; Outpatients ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/drug therapy ; Research Design ; Risk Factors ; Severity of Illness Index ; Sleep ; Surveys and Questionnaires

Purpose/objectives: To describe the trajectory of fatigue and determine the feasibility of exploring physiologic mechanisms of fatigue in adult patients receiving chemotherapy for breast and ovarian cancer.
Design: Descriptive, longitudinal, repeated measures.
Setting: Outpatient ambulatory cancer centers within two large, academic, teaching hospitals with overnight hospital stays in general clinical research centers.
Sample: Seventeen adult participants with either early-stage breast or ovarian cancer receiving chemotherapy for the first time.
Methods: Demographic questionnaire; Piper Fatigue Scale (PFS); hemoglobin, bilirubin, melatonin, and weight change were measured at baseline, three months, and approximately six months. PFS also was collected at three additional two-week nadir, post-treatment, measurement points. Descriptive statistics and repeated analysis of variance measures were used to analyze data.
Main Research Variables: Fatigue, hemoglobin, bilirubin, melatonin, and presence of other comorbid disease.
Findings: Subjective fatigue was experienced by the majority of patients receiving chemotherapy. It was irregular over time, intensified at three months, and continued after treatment ended. The physiologic trajectory of fatigue from baseline to three months indicated a significant change over time in hemoglobin in the breast cancer group (p = 0.02) and in nighttime melatonin levels for both breast and ovarian cancer groups (p = 0.03). Although not significant, daytime melatonin levels changed over time from baseline to six months.
Conclusions: Fatigue fluctuates during the course of chemotherapy treatment and does not cease after treatment ends. Preliminary findings suggest that fatigue mechanisms may have an undetermined physiologic basis.
Implications for Nursing: Assessment of cancer treatment-related fatigue must be ongoing, even after treatment ends. Findings suggest an awareness of the importance of understanding fatigue mechanisms to enable future testing of research-based interventions.

Date Created: 20021009 Date Completed: 20021029 Latest Revision: 20151119

20240104

10.1188/02.ONF.1334-1340

12370703