Fatigue and other variables during adjuvant chemotherapy for colon and rectal cancer.
OBJECTIVE
To examine patterns of fatigue and other variables (sleep quality, sleep-wake variables, activity and rest, circadian rhythms, quality of life [QOL], blood counts, and demographic and medical variables) during colon and rectal cancer adjuvant chemotherapy, as well as feasibility of the study.


METHODS
Longitudinal, descriptive feasibility study.


METHODS
Two oncology clinics in the midwestern region of the United States.


METHODS
From April 2006-December 2008, 27% of screened subjects (n = 21) enrolled and 14 completed the study. Participants were middle aged, partnered, and employed and had postsecondary education.


METHODS
Measurements completed during the first week of three two-week cycles (chemotherapy 1-3) and at six weeks (before chemotherapy 4) were the Piper Fatigue Scale, Pittsburgh Sleep Quality Index, wrist actigraphy, Functional Assessment of Cancer Therapy-Colon, blood counts, and demographic and medical data form. Analysis included descriptive statistics and repeated-measures analysis of variance.


METHODS
Fatigue, sleep quality, sleep-wake variables, activity-rest, circadian activity rhythms, and QOL.


RESULTS
Fatigue was mild at baseline and rose to moderate levels during chemotherapy 1-3. Sleep quality was poor the months prior to chemotherapy 1 and chemotherapy 4. Actigraphy data revealed disturbed sleep, low daytime activity, and impaired circadian activity rhythms during the first week after chemotherapy 1-3. QOL ratings were similar to those in other cancer populations. Fatigue increased, and white blood cell counts decreased significantly over time.


CONCLUSIONS
During adjuvant chemotherapy, patients reported moderate fatigue and poor sleep quality; actigraphs confirmed problems with sleep maintenance as well as low daytime activity and disturbed circadian rhythms. Multiple barriers were encountered during the study.


CONCLUSIONS
Clinicians should screen for fatigue and sleep-wake variables and use guidelines to select interventions.
University of Nebraska Medical Center in Omaha, USA. aberger@unmc.edu
Ann M
AM
Berger
Jean L
JL
Grem
Constance
C
Visovsky
Heather A
HA
Marunda
Justin M
JM
Yurkovich
D056044:Actigraphy; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D002940:Circadian Rhythm / Q000187:drug effects; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000451:nursing; D015897:Comorbidity; D005221:Fatigue / Q000139:chemically induced / Q000453:epidemiology / Q000451:nursing; D005240:Feasibility Studies; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000451:nursing; D012146:Rest; D012890:Sleep / Q000187:drug effects