Congress Abstracts 2004

15

A RANDOMIZED CONTROLLED TRIAL OF AN EDUCATIONAL INTERVENTION FOR MANAGING FATIGUE IN WOMEN RECEIVING ADJUVANT CHEMOTHERAPY FOR EARLY STAGE BREAST CANCER. Patsy Yates, PhD, RN, Queensland University of Technology, Kelvin Grove, Australia; Sanchia Aranda, PhD, RN, and Peter MacCallum, Cancer Institute, Melbourne VIC, Australia; Maryanne Hargraves, MHlthSc, Hematology and Oncology Clinics of Australasia, Brisbane QLD, Australia; SueAnne McLaughlan, MBBS, MSc, St. Vincents Hospital, Melbourne, Australia; Beverley Mirolo, Hematology and Oncology Clinics of Australasia, Brisbane QLD, Australia; and Donna Milne, MN, Peter MacCallum Cancer Institute, Melbourne VIC, Australia.

Effective patient education is integral to cancer symptom management, yet there is limited evidence to guide design of specific educational strategies.

This study aimed to evaluate the impact of a nurse-administered educational intervention for women with breast cancer in improving confidence with managing fatigue, fatigue intensity, and quality of life.

Piper’s integrated fatigue model and Greene’s PRECEDE Model of Health Promotion were used to develop specific educational content and strategies.

A randomized, controlled trial with a consecutively recruited sample of 108 women commencing adjuvant chemotherapy for stage I or II breast cancer was conducted. Women completed a self-report survey at first treatment visit, prior to randomization. The intervention group received a one-to-one fatigue education program delivered over three 10-20-minute sessions one week apart. The first session (delivered at the second treatment visit) involved face-to-face instruction, while two follow-up sessions were delivered by phone. Participants completed follow-up surveys at three subsequent treatment visits. Measures included two 11-point numeric rating scales assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; FACT-F and Piper Fatigue Scales, EORTC QLQ-C30, and Hospital Anxiety and Depression Scale. All scales had alpha reliabilities greater than 0.7.

Separate analyses of covariance of change scores for each outcome variable between baseline and three follow-up time points were conducted, controlling for the variable’s corresponding baseline value.

Mean fatigue scores for both groups increased over time. However, the mean baseline immediate post-intervention increase was significantly greater for the control group for worst (p < .01) and average fatigue (p < .02), and FACT (p < .04) and Piper Fatigue scores (p < .01). Mean impact of fatigue on social activities, sexual activities, and enjoyable activities was greater for the control group (p < .03, p < .01, p < .02 respectively for baseline immediate post-intervention change scores). These differences were not significant for follow-up assessments. No significant differences in pre- post-intervention change scores were identified for confidence with managing fatigue, anxiety, depression, or quality of life (p > .05). Findings suggest educational interventions have potential for assisting women in coping with cancer-related fatigue and its effects; however, further research is needed to identify ways to improve the extent and sustainability of such effects.