The importance of self-care for fatigue amongst patients undergoing chemotherapy for primary cancer

Abstract

To measure Cancer Related Fatigue (CRF), and explore fatigue self-care strategies used to ameliorate CRF amongst patients undergoing chemotherapy for primary cancer. A consecutive sample of patients (n=362) undergoing chemotherapy with a primary diagnosis of breast, colorectal, Hodgkin's and non-Hodgkin's lymphoma cancers were recruited. A mixed methods design was utilised. The study questionnaires included: the Piper Fatigue Scale-Revised and a researcher developed fatigue Self-Care Survey. The mean total fatigue score was 4.9 (SD=2.2); the highest mean subscale score occurred in the affective meaning dimension (M=5.4, SD=2.9). The mean number of strategies used at least "occasionally" was 14.8, (SD=3.42, range=5-24). The most frequently used self-care strategies were: "Receiving support from family and friends" (66.6%); "having a healthy diet" (57.1%); "taking part in hobbies or distraction activities" (42.9%); "spending time chatting with friends"(37.3%); "adjusting mood and being more positive" (36.3%) and "resting and taking it easy" (33.8%). The self-care strategies of socializing (OR=0.66, 95% CI=0.47-0.930, p=0.016) and exercise (OR=0.73, 95% CI=0.57-0.93, p=0.012) were associated with decreased odds of developing CRF. Four categories emerged following analysis of qualitative data, these included: rest and relaxation, physical activity, psychological well-being, and supportive care. CRF is a debilitating, complex phenomenon, therefore multiple CRF strategies should be used for the optimum management of CRF including exercise and socializing. Health care professionals have an important role in promoting the use of evidence based fatigue management strategies.