A randomized controlled trial to evaluate the effectiveness of a brief, behaviorally oriented intervention for cancer-related fatigue

Authors

  • Jo Armes PhD, MSc, BSc, RGN,

    Corresponding author
    1. Florence Nightingale School of Nursing and Midwifery, King's College London, Waterloo Bridge Wing, Franklin Wilkins Building, Stamford Street, London, United Kingdom
    • Florence Nightingale School of Nursing and Midwifery, Specialist and Palliative Nursing Section, King's College London, Waterloo Bridge Wing, Franklin Wilkins Building, Stamford Street, London SE1 9NH, United Kingdom
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    • Fax: (011) 44 (0)20-7848 3764.

  • Trudie Chalder PhD, MSc, RMN,

    1. Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
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  • Julia Addington-Hall PhD, BSc,

    1. School of Nursing and Midwifery, University of Southampton, Highfield, Southampton, United Kingdom
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  • Alison Richardson PhD, MSc, BN, RN,

    1. Florence Nightingale School of Nursing and Midwifery, King's College London, Waterloo Bridge Wing, Franklin Wilkins Building, Stamford Street, London, United Kingdom
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  • Matthew Hotopf PhD, MSc, MRCPsych, MBBS, BSc

    1. Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
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Abstract

BACKGROUND.

It has been shown that nonpharmacologic interventions are effective management techniques for cancer-related fatigue (CRF) in cancer survivors. However, few studies have investigated their effectiveness in patients who are receiving chemotherapy. In this study, the authors tested the effectiveness of a brief behaviorally oriented intervention in reducing CRF and improving physical function and associated distress in individuals who were receiving chemotherapy.

METHODS.

For this randomized controlled trial, 60 patients with cancer were recruited and received either usual care or the intervention. The intervention was delivered on an individual basis on 3 occasions over a period from 9 weeks to 12 weeks, and the objective of the intervention was to alter fatigue-related thoughts and behavior. Primary outcomes were assessed as follows: CRF using the Visual Analogue Scale-Global Fatigue; physical functioning using the European Organization for Research and Treatment of Cancer Quality-of-Life Core 30 Questionnaire, and CRF-associated distress using the Fatigue Outcome Measure. Assessments were made on 4 occasions: at baseline (T0), at the end of chemotherapy (T1), 1 month after chemotherapy (T2), and 9 months after recruitment (T3). Normally distributed data were analyzed using t tests and random-slope/random-intercept mixed models.

RESULTS.

The intervention demonstrated a trend toward improved CRF, although this effect was reduced once confounders had been controlled statistically. There was a significant improvement in physical functioning (coefficient, 10.0; 95% confidence interval, 2.5–17.5; P = .009), and this effect remained once the confounding effects of mood disturbance and comorbid disorders were controlled statistically. No decrease in fatigue-related distress was detected.

CONCLUSIONS.

The behaviorally oriented intervention brought about significant improvements in physical functioning, indicated a trend toward improved CRF, but detected no effect for fatigue-related distress. Cancer 2007. © 2007 American Cancer Society.

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