title: Fatigue in patients undergoing chemotherapy, their self-care and the role of health professionals: a qualitative study.
abstract: OBJECTIVE
  Fatigue affects most chemotherapy recipients, who commonly experience it as distressing. Previous publications showed that cancer patients frequently lacked information and education regarding fatigue; and while most engaged in self-care activities, it remained unclear why they chose specific activities or how effective those were. We explored cancer chemotherapy recipients' current perspectives regarding fatigue, with particular attention to related communication with health professionals, self-care activities, and perceived effectiveness of these measures. This study was part of a larger project that explored patients' symptom experiences during chemotherapy over three months.
  
  
  METHODS
  In this qualitative study, 19 patients with lymphomas, breast, lung or colorectal cancer participated concurrently with treatment at a Swiss tertiary care hospital's oncology outpatient clinic. Data on patients' fatigue experiences were collected via individual interviews following their third cycle of chemotherapy. Grounded Theory methodology guided data analysis.
  
  
  RESULTS
  At the start of their chemotherapy, health professionals informed patients that common side effects included fatigue. While all participants experienced different dimensions of fatigue, then, all were willing to endure it for the sake of an expected improvement in their conditions. Individuals' fatigue experiences depended largely on their particular life and illness circumstances. Most engaged in fatigue-related self-care activities and managed the symptom on their own. Communication with or input from health professionals was virtually absent during chemotherapy.
  
  
  CONCLUSIONS
  Adequate and systematic information regarding fatigue and related self-care strategies need to be implemented at the beginning of chemotherapy, along with continuous assessment and individual guidance of patients throughout their treatment.
authors.affiliation: Institute of Nursing Science, Faculty of Medicine, University Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. Elisabeth.spichiger@unibas.ch
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Spichiger
authors.forename: Evelyn
authors.initials: E
authors.lastname: Rieder
authors.forename: Christa
authors.initials: C
authors.lastname: Müller-Fröhlich
authors.forename: Annemarie
authors.initials: A
authors.lastname: Kesselring
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000451:nursing; D015179:Colorectal Neoplasms / Q000188:drug therapy / Q000451:nursing; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000451:nursing; D008223:Lymphoma / Q000188:drug therapy / Q000451:nursing; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000451:nursing; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D024382:Professional Role; D011369:Professional-Patient Relations; D036301:Qualitative Research; D012648:Self Care; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents