• Journal of Korean Academy of Nursing
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• v.29 no.4
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• pp.755-765
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• 1999

Most people experience fatigue at some point in their lives, and they say the word ‘fatigue’ in their ordinary conversational speech. The ordinary word is used as a military or engineering term and has been studied in various different disciplines, such as ergonomics, physiology, psychology, medicine, and nursing. In spite of its widespread uses, however, fatigue has not been well defined. The term of fatigue Is thus often used with different meanings and is applied in diverse contexts that had led to a confusion of ideas. In people with cancer, fatigue is reported as a major distress. Despite the importance of fatigue in cancer patients, the phenomena of fatigue is poorly understood. Therefore, the purpose of the present study is to analyze the concept of fatigue in people with cancer. The process for the concept analysis was guided by Walker and Avant's conceptual analysis methodology. The identified attributes of fatigue in the present study were subjective feeling, lack of energy, sustenance, and multidimensions. The antecedents were cancer treatment and economic status. The consequences were decreased daily, vocational, leisure, and social activities, uncertainty, and difficulties in adjustment. Symptoms (pain, anorexia, and insomnia) and emotional disturbance were not clear whether they are antecedents or consequences. However, they are related with cancer related fatigue. Even though still in the beginning stage, instruments measuring cancer related fatigue have been developed by some nursing investigators.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.10
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• pp.4783-4790
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• 2016

Purpose: Cancer-related fatigue is frequently experienced by patients during and after therapy. The present study was conducted to assess the impact of energy conservation strategies and health promotion in breast cancer survivors. Methods: A randomized controlled trial was carried out to compare the intervention effect (n=69.0) with controls (n=66.0) based on routine oncology ward care. The intervention was five weekly sessions for groups of 6-8 breast cancer survivors. Data on fatigue and health promotion lifestyle were obtained before and after completion the intervention and then 8 weeks later for analysis of variance (ANOVA) with repeated measures. Results: Our findings showed cancer-related fatigue to be reduced in the intervention group from pre- to post-intervention, and this persisted over the 8-weeks follow-up period (F = 69.8, p<0.001). All subscales of the cancer fatigue scale demonstrated statistically significant effects with partial eta-squared values ranging from 0.15 (the smallest effect in cognitive fatigue) to 0.21 (the largest for affective fatigue). Changes in the health promotion life style indicated a significant promotion from pre- to post-intervention, and this again continued after 8-weeks follow-up (F = 41.6, p < 0.001). All six domains of a health promoting life style featured significantly elevated values, the largest effect being seen in the interpersonal relations subscale (F=57.7, partial ${\eta}^2=0.21$, p<0.001) followed by physical activity (F=51.9, partial ${\eta}^2=0.18$, p<0.001). Conclusions: The program was effective in decreasing cancer related fatigue and promoting a healthy lifestyle.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3029-3033
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• 2014

Background: Dynamic changes of cancer-related fatigue (CRF) among hospitalized patients with colorectal cancer were determined. Materials and Methods: This longitudinal, descriptive study involved 96 hospitalized patients with colorectal cancer, all recruited from a tertiary general hospital in Guangzhou, China. Patients completed questionnaires three times to assess the degree of fatigue, and measurement points were within one week of admission, at 2 to 3 days after surgery and 3 weeks after surgery. Results: Significant differences among the three measurement points (p<0.01) were observed. The scores of fatigue in the second survey were the highest, followed by the third and first surveys. Colon cancer patient scores were higher than those of rectal cancer patients with a significant difference (p<0.05). Colorectal patients experienced different degrees of fatigue at different periods during hospitalization. Conclusions: This study highlights the importance of interventions that are carefully tailored to patients based on the characteristics at different periods to alleviate fatigue.

• Asian Oncology Nursing
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• v.10 no.1
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• pp.10-18
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• 2010

Purpose: This study was intended to identify the patterns of fatigue and its related factors in patients with stomach cancer during chemotherapy. Methods: Thirty participants (24 males and 6 females) were recruited for this study which utilized a longitudinal and descriptive approach. The research instruments included the Revised Piper Fatigue Scale, Symptom Distress Scale, and Linear Analogue Self Assessment Scale. The participants received 5-FU and Adriamycin at the first week and 5-FU only at the second and third week. The instruments were measured six times in total. The data were analyzed using SPSS 17.0. Results: It was found that fatigue scores in patients with stomach cancer, receiving 5-FU and Adriamycin (FA) regimen, reached the highest level on the third day (F=9.37, p=.024) after the initial infusion, and decreased gradually afterward. The symptom and psychological distress scores illustrated very similar pattern. The concept of multidimensionality of fatigue in patients with stomach cancer was supported in this study, showing that all four dimensions of the scale were positively correlated. Conclusion: The results of this study provided useful information of patients with stomach cancer on fatigue and other related symptoms which they experienced during weekly scheduled chemotherapy with FA regimen.

• Korean Journal of Adult Nursing
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• v.15 no.1
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• pp.33-44
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• 2003

Purpose: The purpose of this study was to identify the patterns and related factors of fatigue in patients with breast cancer undergoing radiotherapy. Method: 31 women with breast cancer receiving radiotherapy were recruited from the out-patient radiologic clinic of the university hospital in Seoul, Korea over a period of 3 months. Data was collected prospectively concerning three points for $5\frac{1}{2}\;-\;6\frac{1}{2}$ weeks : before radiotherapy(T1), 2 weeks after starting radiotherapy(T2) and the completion of radiotherapy(T3). Data were analysed by repeated measure ANOVA, Pearson correlaton, and multiple regression. Result: 1. Score of fatigue increased significantly over the course of radiotherapy. 2. Score of symptom distress and emotional distress increased and functional status scores decreased significantly over time. 3. Fatigue was positively related with symptom distress and emotional distress and negatively related with functional status over the course of radiotherapy. 4. At T2, emotional distress explained 24.7% of the variation in fatigue. At T3, symptom distress(41.9%) and emotional distress(7.2%) explained the variance in fatigue. Conclusion: The results of this study provided evidence that fatigue increased over the course of radiotherapy and symptom distress and emotional distress were influencing factors of fatigue in this group. The results of this study suggest that comprehensive intervention strategy for fatigue should be developed to maintain quality of life during and following radiotherapy considering these factors.

• Korean Journal of Adult Nursing
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• v.15 no.4
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• pp.617-627
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• 2003

Purpose: The purpose of this study is to investigate fatigue and its related factors in cancer patients receiving radiotherapy. Method: The subjects of this study consisted of 98 patients receiving radiotherapy. Subjects were recruited from C University Hospital radiation oncology unit located in Gwangju from March to May, 2001. Questionnaire and medical records were used for data collection. The obtained data was analyzed using SAS program that included descriptive statistics, t-test, ANOVA, Post-hoc test(Fisher's LSD) and Pearson's correlation coefficients. Result: The fatigue perceived by the subjects was middle level ($5.59{\pm}1.59$) and 72.4% of them reported greater than 5 points. The subjects in no religion, low income, and spouse caregiver groups experienced the higher fatigue than another groups, respectively. The subjects in nasopharyngeal cancer, head & neck radiation site, and analgesics medication groups did, experience fatigue as well. The fatigue not only positively correlated with symptom distress, disruption of usual activity, sleep dissatisfaction, and mood state, but also negatively with less family support. Conclusion: Cancer patients receiving radiotherapy experience the middle level of fatigue and it correlates with the multi-dimensional factors. However, further research is needed to identify the changes in fatigue over the radiotherapy period through longitudinal design and to develop nursing intervention for fatigue decrease.

• Journal of Korean Academy of Nursing
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• v.33 no.4
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• pp.478-487
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• 2003

Purpose. The purpose of this study was to identify the relationship between fatigue and nutritional status in patients undergoing radiotherapy. Design. A correlational and crossectional study design was used. Method. One-hundred-fifty-one subjects with cancer receiving radiotherapy were recruited from a university hospital in Chonan, Korea. Fatigue was measured using Piper's Fatigue Scale (PFS). The parameters for nutritional status included body weight, body mass index, hemoglobin, and lymphocyte counts. Cancer stage was controlled in analyzing the differences in fatigue, body weight and body mass index. Results. The patients who experienced most fatigue were in their fifties, employed, had head and neck cancer, received radiotherapy on the head and neck, and had concomitant chemotherapy. Disease-related characteristics such as cancer type, and treatment type were frequently related to poorer nutritional status. Patients who showed poorer nutritional status, such as those with lower body weight, lower body mass index and lower hemoglobin levels were more fatigued than those who did not exhibit such characteristics. Lymphocyte counts did not correlate with fatigue. Conclusion: The findings can be used by nurses who are taking care of patients undergoing radiotherapy. Considering the relationship between fatigue and nutritional status, nurses can identify the risk group most vulnerable to fatigue and malnourishment in order to provide appropriate interventions for them.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1063-1067
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• 2015

Background: Tumor associated fatigue (TAF) or cancer related fatigue (CRF) is not a new concept. Nonetheless, no real headway has been made in the quantitative analysis of its successful treatment via cognitive behavioral therapy. Since 20 to 30% of all breast cancer patients suffer from anxiety and/or depression within the first year of their diagnosis, this issue needs to be addressed and a standard treatment protocol has to be developed. This study focused on developing a simple, reproducible and short (8 weeks) protocol for the cognitive behavioral therapy support of tumor associated fatigue patients. Materials and Methods: Between the year 2011 and 2012, 23 breast cancer patients fulfilled the diagnosis TAF requirements and were introduced into this study. Our method focused on a psycho-oncological support group using a predetermined, highly structured and reproducible, cognitive behavioral therapy treatment manual. Eight weekly, 90 minute sessions were conducted and patients were evaluated before and after this eight session block. Tumor fatigue specific questionnaires such as the multidimensional fatigue inventory (MFI) as well as the hospital anxiety and depression scale (HADS) were used in order to quantitatively evaluate patient TAF. Results: Of the 23 patients enrolled in the study, only 7 patients fulfilled the TAF diagnostic criteria after the psycho-oncological group treatment. This represents a 70% reduction in diagnosable tumor associated fatigue. The HADS analysis showed a 33% reduction in patient anxiety as well as a 57% reduction in patient depression levels. The MFI scores showed a significant reduction in 4 of the 5 evaluate categories. With the exception of the "mental fatigue" MFI category all results were statistically significant. Conclusions: This study showed that a highly structured, cognitive behavioral therapy group intervention will produce significant improvements in breast cancer patient tumor associated fatigue levels after only 8 weeks.

• Journal of Korean Academy of Nursing
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• v.46 no.3
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• pp.420-430
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• 2016

Purpose: The purpose of this study was to test a hypothetical model of chemotherapy-related cognitive impairment (CRCI) and depression in people with gastrointestinal cancer. Methods: A purposive sample of 198 patients undergoing chemotherapy was recruited from November 2014 to July 2015. The instruments were Everyday Cognition (ECog), Hospital Anxiety Depression Scale (HADS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), and M. D. Anderson Symptom Inventory-Gastrointestinal Cancer Module. Data were analyzed using descriptive statistics, correlation, and path analysis. Results: CRCI was directly affected by cancer symptoms (${\beta}=.19$, p=.004) and fatigue (${\beta}=.56$, p<.001)($R^2=47.2%$). Depression was directly affected by fatigue (${\beta}=.48$, p<.001) and CRCI (${\beta}=.27$, p<.001). However, The impact of cancer symptoms on depression was confirmed through the mediating effect of CRCI. Conclusion: Results indicate that in patients with gastrointestinal cancer undergoing chemotherapy along with the direct physiologic effects (fatigue, symptoms) of cancer treatment may have altered cognitive function leading to depression.

• Journal of Haehwa Medicine
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• v.20 no.2
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• pp.79-89
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• 2012

Objective : This study was conducted to evaluate of efficacy and safety of Vanadium Water (VW) on Cancer related Fatigue of Non-advanced Cancer Patients. Methods : Experimental Group Administration. Participants in treatment group consumed three 500 ml/bottle bottles of Jeju Island's VW, which contains 40.2 ${\mu}g/L$ of vanadium, three times a day (morning, afternoon, evening) for 4 weeks (28 days) without any additional treatments for fatigue improvement. The control group participants consumed three 500 ml/bottle bottles of ordinary water (0 ${\mu}g/L$ of vanadium) three times a day for the same period of time without any additional treatments for fatigue improvement. Results : After 4 weeks of VW consumption, total score of Revised Piper Fatigue Scale (RPFS) was reduced 30% and basal score after Fisher's Exact Test resulted statistical borderline significance (p=0.0799) and result of t-test of comparison between two groups' RPFS total score and fatigue cognitive/mood changes resulted statistical significance (p=0.0112). In detail, only 36.4% of control group (N=11) showed improvement while 77.8% of treatment group (N=9) showed fatigue improvement and thyroid hormone level changes. No other lab measures indicated any significant differences between two groups. Conclusion : Daily consumption of 1.5 L of Vanadium water for 4 weeks showed improvement of non-advanced cancer patients' fatigue.