Randomized controlled trial of an educational intervention for managing fatigue in women receiving adjuvant chemotherapy for early-stage breast cancer.
OBJECTIVE
To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue.


METHODS
This randomized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart. Instruments included a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; the Functional Assessment of Cancer Therapy-Fatigue and Piper Fatigue Scales; the Cancer Self-Efficacy Scale; the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2, T3, and T4) were conducted, controlling for the variable's corresponding baseline value.


RESULTS
Compared with the intervention group, mean difference scores between the baseline (T1) and immediate after the test (T2) assessments increased significantly more for the control group for worst and average fatigue, Functional Assessment of Cancer Therapy-Fatigue, and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life.


CONCLUSIONS
Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue.
Yates
Patsy
P
Centre for Health Research, Nursing, and Centre for Palliative Care Research and, Education, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, Australia 4059. p.yates@qut.edu.au
Aranda
Sanchia
S
Hargraves
Maryanne
M
Mirolo
Bev
B
Clavarino
Alexandra
A
McLachlan
SueAnne
S
Skerman
Helen
H
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D005221:Fatigue / Q000209:etiology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010353:Patient Education as Topic; D011788:Quality of Life; D020377:Self Efficacy; D016896:Treatment Outcome