5942 - Nursing management of fatigue in cancer patients: mixed methods study

Background

Fatigue represents a complex and frequent symptom in cancer patients and influences their quality of life. Although nurses consider the initial evaluation of the patient to be fundamental, this problem is underestimated in clinical practice and often leads to under-treatment. In addition, the patients and their families still often do not report the symptom because they fear that it will lead to a reduction or suspension of treatment or they think that the symptom is inevitable.

Methods

Mixed methods study. Data were collected using Brief Fatigue Inventory, patients’ interviews, focus groups with nurses and analysis of patients’ records. The setting is represented by two impatient departments of Oncology Institute of Southern Switzerland. Quantitative data were analysed with SPSS 22.0. For the interviews and focus groups, the analysis processes were conducted according to conventional content analysis using Nvivo 10 software.

Results

71 questionnaires were analysed, 39 males and 32 females. The mean age was 65,7±14 years. Fatigue was reported 5 times (7%) in nursing documents and 17 times problems fatigue was reported by nurses 5 times (7%) in patients’ records, while in 17 cases (23.9%) related problems were reported. 12 patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gesture, to be informed. Three themes were identified from nurses focus group: objectivity and subjectivity in the assessment of asthenia, nursing contribution in the multidisciplinary management of asthenia and difficulty in evaluating outcomes.

Conclusions

A not systematic approach to the management of fatigue emerges. Patients are satisfied with the care received but would like more information and specific interventions. Quantitative and qualitative results seem converge. Fatigue is still an underestimated problem in clinical practice. Specific training interventions for health professionals are needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Scientific Research Advisory Board (ABREOC).

Disclosure

All authors have declared no conflicts of interest.