Cancer-related fatigue. Suffering a different fatigue.
OBJECTIVE
The purpose of this naturalistic inquiry was to understand, from the patient's perspective, the differences between cancer-related fatigue (CRF) and "typical" fatigue and to describe its impact on their lives.


METHODS
The sample consisted of 17 adult patients with cancer who agreed to participate, yielding 23 in-depth audio-taped interviews. Participants included inpatients and outpatients from a dedicated cancer center and a Veterans Affairs Hospital. Symbolic interactionism was the framework used for the interviews to understand how individuals and groups construct and discover the meaning of events. Transcribed data were coded by distress category to classify the textual information and to reduce the text to more relevant and manageable bits of data. Five to 10 representative excerpts from each coding category were chosen and were coded independently by a second coder to evaluate intercoder reliability.


RESULTS
CRF was found to be more rapid in onset, more energy draining, more intense, longer lasting, more severe, and more unrelenting when compared with "typical" fatigue. CRF caused distress in the physical, social, spiritual, psychological, and cognitive domains of the participants' lives. All participants agreed that CRF was different than the typical fatigue of everyday life.


CONCLUSIONS
This study's findings indicate that because of this different fatigue, CRF, participants did not just experience the symptom, but they suffered with it. The current oncology literature and texts do not portray the morbidity of the CRF experience as described by the participants in this study. These data can be used as part of an experiential teaching guide to assist healthcare students and practitioners in understanding the CRF experience. This increased awareness will afford clinicians a better foundation for implementing management strategies. A CRF distress instrument is in development based on these data.
Holley
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James A. Haley VA Hospital, University of South Florida College of Nursing, Tampa, Florida, USA.
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D005221:Fatigue / Q000145:classification / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009369:Neoplasms / Q000150:complications*; D015404:Nursing Methodology Research; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires