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Randomized Controlled Trial of an Educational Intervention for Managing Fatigue in Women Receiving Adjuvant Chemotherapy for Early-Stage Breast Cancer

From the Centre for Health Research, Nursing, and Centre for Palliative Care Research and Education, Queensland University of Technology, Kelvin Grove; School of Population Health, University of Queensland, Brisbane; Haematology and Oncology Clinics of Australasia, Milton, Queensland; Peter MacCallum Cancer Institute; and St Vincent's Hospital, Victoria Parade, Melbourne, Victoria, Australia

Address reprint requests to Patsy Yates, PhD, RN, Centre for Health Research, Nursing, and Centre for Palliative Care Research and, Education, Queensland University of Technology, Victoria Park Rd, Kelvin Grove, Queensland, Australia 4059; e-mail: p.yates{at}qut.edu.au

PURPOSE: To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue.

PATIENTS AND METHODS: This randomized controlled trial involved 109 women commencing adjuvant chemotherapy for stage I or II breast cancer in five chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10- to 20-minute sessions 1 week apart. Instruments included a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; the Functional Assessment of Cancer Therapy–Fatigue and Piper Fatigue Scales; the Cancer Self-Efficacy Scale; the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2, T3, and T4) were conducted, controlling for the variable's corresponding baseline value.

RESULTS: Compared with the intervention group, mean difference scores between the baseline (T1) and immediate after the test (T2) assessments increased significantly more for the control group for worst and average fatigue, Functional Assessment of Cancer Therapy–Fatigue, and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre- or post-test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life.

CONCLUSION: Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue.

Supported by grants received from the Queensland Nursing Council and the National Breast Cancer Foundation, Australia.

The views expressed in this article do not necessarily represent the views of the Queensland Nursing Council or the members, executive officer, or staff of the Council.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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