title: Differences in fatigue severity in a sample of adult cancer patients.
abstract: OBJECTIVE
  To describe differences in fatigue severity in a sample of adult Puerto Rican patients during and postcancer treatments.
  
  
  BACKGROUND
  Hispanics, including Puerto Ricans, are an understudied population who are under-represented in clinical trials, especially in symptom research. Although symptom management is a clinical priority in oncology care, treatment-related differences in Puerto Rican cancer patients' report of fatigue severity have not been well described.
  
  
  METHODS
  A cross-sectional survey was conducted from data of self-report of 138 Puerto Rican patients during and postcancer treatments at two ambulatory facilities located in San Juan, Puerto Rico. Fatigue severity was assessed using the Fatigue subscale from the Functional Assessment of Cancer Therapy-Fatigue quality of life questionnaire Spanish version. Differences in fatigue severity across type of treatment (radiation therapy, chemotherapy, combined radiation chemotherapy and post-treatment) were evaluated using nonparametric (Kruskal-Wallis and Mann-Whitney test) statistical tests.
  
  
  RESULTS
  The majority of the participants had prostate (33%) and breast (32%) cancers and were receiving radiation therapy (43%) or chemotherapy (28%). The Kruskal-Wallis test showed that there was a statistically significant difference in fatigue scores between the different four treatment conditions, χ2(3) = 39.1, p = .001 with patients on combined radiation chemotherapy or chemotherapy alone experiencing more severe fatigue.
  
  
  CONCLUSIONS
  Findings from the current study suggest that type of treatment is a key component of the symptom burden of fatigue among the Puerto Rican oncology population. Specially, patients receiving combined therapy or chemotherapy alone were at increased risk for experiencing severe fatigue, compared to radiation therapy and post-treatment patients.
  
  
  CONCLUSIONS
  With the worldwide increase in migration of Puerto Rican families, nurses need to recognise that type of treatment is a key component of the symptom burden of fatigue among the Puerto Rican population. The results of this study will improve understanding of treatment-related fatigue to identify therapeutic targets and improve quality of life of patients.
authors.affiliation: University of South Florida College of Nursing, Tampa, FL, USA.
authors.forename: Velda J
authors.identifier: http://orcid.org/0000-0002-7236-0182
authors.initials: VJ
authors.lastname: Gonzalez
authors.affiliation: University of South Florida College of Nursing, Tampa, FL, USA.
authors.forename: Cindy S
authors.initials: CS
authors.lastname: Tofthagen
authors.affiliation: University of South Florida College of Nursing, Tampa, FL, USA.
authors.forename: Xusheng
authors.initials: X
authors.lastname: Chen
authors.affiliation: School of Pharmacy, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico.
authors.forename: Elsa
authors.initials: E
authors.lastname: Pedro
authors.affiliation: Symptom Management Branch, National Institute of Nursing Research Intramural Research Program, Bethesda, MD, USA.
authors.forename: Leorey N
authors.initials: LN
authors.lastname: Saligan
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000145:classification / Q000453:epidemiology*; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000628:therapy; D011647:Puerto Rico / Q000453:epidemiology; D011788:Quality of Life; D012306:Risk; D057566:Self Report; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric
keywords: cancer; fatigue; symptom perception