title: Management of cancer-related fatigue during chemotherapy through telephone motivational interviewing: modeling and randomized exploratory trial.
abstract: OBJECTIVE
  Fatigue is a common cancer-related symptom and exacerbated by chemotherapy. Psychological interventions for fatigue show promise. One, Beating Fatigue, was adapted for delivery by telephone and evaluated in an exploratory trial.
  
  
  METHODS
  Eight patients and 12 professionals contributed to focus groups that guided adaptation of the intervention. The intervention, modified for delivery by telephone using motivational interviewing, was tested in an exploratory trial. Forty-four patients were recruited to the trial and randomized between the intervention (n=23) and control (n=21). Outcome data were collected on fatigue intensity, fatigue distress, fatigue self-efficacy, anxiety and depression at baseline and following completion of chemotherapy. These data were augmented by interviews conducted to inform understanding of the intervention's mechanism, feasibility and acceptability.
  
  
  RESULTS
  The intervention was both feasible and acceptable to patients and most reduced fatigue distress (Effect Size ES=0.62). It also reduced fatigue intensity (ES=0.18), fatigue self-efficacy (ES=-0.34), and anxiety (ES=0.31). It did not reduce depression.
  
  
  CONCLUSIONS
  These preliminary data are encouraging and support the delivery of interventions for cancer-related fatigue by telephone. Motivational interviewing appeared key to the intervention's success. A larger definitive RCT is indicated.
  
  
  CONCLUSIONS
  Opportunities should be sought to deliver psychologically-based interventions for fatigue by telephone.
authors.affiliation: Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK. Electronic address: emma.ream@kcl.ac.uk.
authors.forename: Emma
authors.initials: E
authors.lastname: Ream
authors.affiliation: Independent Researcher formerly Florence Nightingale School of Nursing and Midwifery, King's College London, London, UK.
authors.forename: Gian
authors.initials: G
authors.lastname: Gargaro
authors.affiliation: Cancer Prevention & Control Program, Fox Chase Cancer Center, Philadelphia, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barsevick
authors.affiliation: Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Richardson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003863:Depression / Q000209:etiology / Q000523:psychology; D019468:Disease Management; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D062405:Motivational Interviewing; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D010043:Outcome and Process Assessment, Health Care; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*; D018579:Patient Selection; D020377:Self Efficacy; D013689:Telephone; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Chemotherapy; Fatigue; Motivational interviewing; Psychological intervention; Telephone intervention