title: Correlates of fatigue during and following adjuvant breast cancer chemotherapy: a pilot study.
abstract: OBJECTIVE
  To examine patterns of and relationships between activity, sleep, symptom distress, health status, and fatigue during and following adjuvant breast cancer chemotherapy with doxorubicin and cyclophosphamide.
  
  
  METHODS
  Prospective, descriptive, repeated measures.
  
  
  METHODS
  Midwestern, urban, oncology clinics.
  
  
  METHODS
  14 women, ages 32-69 (X = 52.4), with stage I or II breast cancer receiving four cycles of chemotherapy.
  
  
  METHODS
  Wrist actigraph, modified Morin Sleep Diary, Symptom Experience Scale, Medical Outcomes Study-Short Form 36, and Piper Fatigue Scale were used to collect data two days prior to and during the 21-day cycle 3, and for three days at three weeks and two months following treatment 4.
  
  
  METHODS
  Activity, sleep, symptom distress, health status, and fatigue.
  
  
  RESULTS
  Fluctuating patterns of lowered activity, disturbed sleep, mild-to-moderate symptom distress, and moderate fatigue were identified. Mean activity levels ranged from 65%-80% of norms during and following treatments. Patterns of sleep (total rest, sleep latency, wake after sleep onset, and sleep efficiency) differed from established norms. Patients experienced the highest levels of fatigue and symptom distress during the first four days after treatment 3. Correlates of fatigue were greater symptom distress, lower activity, and poorer physical and social health status; variables representing disturbed sleep trended toward associations with fatigue.
  
  
  CONCLUSIONS
  Activity, sleep, symptom distress, and health status cluster in patterns associated with either lower or higher fatigue.
  
  
  CONCLUSIONS
  Efforts to manage symptoms, remain active, and obtain quality sleep, especially in women with poorer health status, may assist in modifying fatigue.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, Omaha, USA. aberger@unmc.edu
authors.forename: A M
authors.initials: AM
authors.lastname: Berger
authors.forename: P
authors.initials: P
authors.lastname: Higginbotham
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D017024:Chemotherapy, Adjuvant; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D009068:Movement; D010865:Pilot Projects; D011446:Prospective Studies; D012890:Sleep / Q000187:drug effects; D011795:Surveys and Questionnaires; D013997:Time Factors; D014851:Wakefulness / Q000187:drug effects; D014953:Wrist / Q000503:physiopathology
chemical_list: D000903:Antibiotics, Antineoplastic; D018906:Antineoplastic Agents, Alkylating; D004317:Doxorubicin; D003520:Cyclophosphamide