title: Representations of fatigue in women receiving chemotherapy for gynecologic cancers.
abstract: OBJECTIVE
  To describe women's representations of fatigue and fatigue-related coping efforts by women receiving chemotherapy.
  
  
  METHODS
  Descriptive, correlational.
  
  
  METHODS
  Outpatient gynecologic oncology clinic.
  
  
  METHODS
  Women receiving chemotherapy for gynecologic cancers. Fifty-four women were recruited; 49 (91%) completed measures. This report focuses on the 27 women who identified fatigue as one of their most noticed symptoms and subsequently completed the fatigue representations measure.
  
  
  METHODS
  Women completed measures of key research variables at home seven days after receiving chemotherapy.
  
  
  METHODS
  Representations of fatigue (identity, cause, timeline, consequences, cure or controllability, and emotional representation), fatigue-related coping efforts (communication with healthcare provider, adherence, and self-directed coping strategies), and overall symptom interference with life activities.
  
  
  RESULTS
  Women reported a mean of 13.44 different symptoms. They reported a mean fatigue identity (severity) score of 6.48 on a scale of 0-10. On a 0-4 scale, women reported mean fatigue consequences of 2.21, cure or controllability of 1.58, and emotional representations (distress) of 2.16. A majority (59%) had not communicated with their healthcare providers about fatigue at their last appointments, and 56% reported never receiving recommendations for managing fatigue. Sleep or rest was the most common strategy used for managing fatigue.
  
  
  CONCLUSIONS
  Fatigue is a prevalent, severe symptom that is perceived as distressing and uncontrollable by women receiving chemotherapy for gynecologic cancers. These perceptions may be reinforced by a lack of recommendations from healthcare providers for managing fatigue.
  
  
  CONCLUSIONS
  Nurses must make extra efforts to ask patients about fatigue and to provide self-care suggestions for coping with fatigue. Research efforts must continue to evaluate the efficacy of nursing interventions aimed at decreasing cancer-related fatigue.
authors.affiliation: Department of Acute and Tertiary Care, School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. donovanh@pitt.edu
authors.forename: Heidi S
authors.initials: HS
authors.lastname: Donovan
authors.forename: Sandra
authors.initials: S
authors.lastname: Ward
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D005833:Genital Neoplasms, Female / Q000188:drug therapy*; D006306:Health Surveys; D006801:Humans; D010045:Outpatients; D011788:Quality of Life; D012720:Severity of Illness Index; D013315:Stress, Psychological
chemical_list: D000970:Antineoplastic Agents