title: Fatigue in adolescents with and following a cancer diagnosis: developing an evidence base for practice.
abstract: Although fatigue has been a focus for research in adult cancer care for some time, the same cannot be said for adolescent oncology practice. This paper summarises the literature concerning fatigue in adolescents with, and following, cancer diagnoses, drawing on data from four empirical studies. Fatigue is multidimensional, multifactorial and highly subjective, but can be managed to enhance self-caring and coping strategies. All of the studies reviewed within indicate that fatigue is a troublesome symptom, which impacts on quality of life. From this review, we set up a research study. This paper provides a brief report of preliminary data from this study drawn from a group of adolescents in late remission from childhood cancer. These data are used to evaluate the utility of focus groups as a method of data collection in exploring the concept of fatigue in adolescents. Concurring with the studies we reviewed, findings from the preliminary data suggest that fatigue is a highly subjective and 'abnormal' phenomenon that holds a variety of implied meanings and associated metaphors connected with past experiences of childhood cancer. The focus group proved to be a viable research method to facilitate mutual disclosure and provoke discussion. Recognition of the research challenges with adolescents, where there is the potential for a range of meanings for the experience of fatigue, is an important finding for future studies.
authors.affiliation: Children's Cancer Nursing, Great Ormond Street Hospital for Children NHS Trust, Directorate of Nursing, Great Ormond Street Hospital, London WCIN 3JH, UK. edwarj2@gosh.nhs.uk
authors.forename: J L
authors.initials: JL
authors.lastname: Edwards
authors.forename: F
authors.initials: F
authors.lastname: Gibson
authors.forename: A
authors.initials: A
authors.lastname: Richardson
authors.forename: B
authors.initials: B
authors.lastname: Sepion
authors.forename: E
authors.initials: E
authors.lastname: Ream
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D019317:Evidence-Based Medicine; D005221:Fatigue / Q000209:etiology* / Q000523:psychology / Q000628:therapy; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy; D011788:Quality of Life