Patterns of fatigue in adolescents receiving chemotherapy.
OBJECTIVE
To describe patterns of fatigue in adolescents and the impact of fatigue during one month of chemotherapy, to explore variables that affect fatigue, and to explore the feasibility of collecting daily self-report data in this population.


METHODS
Longitudinal, descriptive.


METHODS
Two pediatric oncology centers in central Virginia.


METHODS
20 adolescents with a variety of cancer diagnoses receiving chemotherapy.


METHODS
Adolescents described daily fatigue for one month using rating scales and qualitative diaries.


METHODS
Fatigue severity.


RESULTS
Adolescents commonly reported a peak in fatigue in the days immediately following chemotherapy administration. The most common pattern for adolescents who received chemotherapy on a schedule every three to four weeks was a "declining rollercoaster" pattern, with fatigue severity alternating on a daily basis but gradually declining until chemotherapy was scheduled again. Adolescents who received chemotherapy weekly showed more frequent peaks and troughs (the "yo-yo" pattern) that did not diminish in severity over the weeks of the study. Adolescents associated fatigue with other symptoms, particularly sleep-wake disturbances, pain, and nausea, and frequently reported that fatigue interfered with daily activities.


CONCLUSIONS
Fatigue commonly bothers adolescents receiving chemotherapy, particularly in the days following chemotherapy administration and when other symptoms are present. Although fatigue interfered with the adolescents' abilities to maintain their usual lifestyles, many still participated in the typical activities of adolescence.


CONCLUSIONS
Fatigue is a complex and dynamic symptom. Oncology clinicians and researchers should frequently assess fatigue in adolescents receiving chemotherapy and apply timely and tailored interventions to match the factors that contribute to fatigue and influence fatigue severity. Management of fatigue during treatment will help adolescents stay involved in age-related activities and meet developmental milestones.
Erickson
Jeanne M
JM
School of Nursing, University of Virginia, Charlottesville, USA. jme3a@virginia.edu
Beck
Susan L
SL
Christian
Becky
B
Dudley
William N
WN
Hollen
Patricia J
PJ
Albritton
Karen
K
Sennett
Margaret M
MM
Dillon
Robyn
R
Godder
Kamar
K
D000293:Adolescent; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005221:Fatigue / Q000139:chemically induced* / Q000451:nursing*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000188:drug therapy* / Q000451:nursing*; D015404:Nursing Methodology Research; D009859:Oncology Nursing / Q000379:methods*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents