Nursing Management of Fatigue in Cancer Patients: Mixed Methods Study

Background: Fatigue is a complex and frequent symptom in cancer patients, influencing their quality of life, but it is still underestimated in clinical practice and undertreated. The aims of this study were to detect the presence of fatigue in cancer patients, describe the perceptions of patients and nurses regarding it and describe the nursing management of fatigue. Methods: Mixed methods study. Data were collected in two oncological wards using the Brief Fatigue Inventory (BFI), an ad hoc questionnaire, patient interviews, focus groups with nurses and the review of nursing records. Interviews and focus groups were analysed through thematic analysis. We used SPSS 22.0 for quantitative data and Nvivo 10 for qualitative data analysis. Results: A total of 71 questionnaires were analysed (39 males, mean age 65,7(±14) years). Fatigue was reported 5 times (7%) in nursing records, while in 17 cases (23.9%) problems related to it were reported. Twelve patients were interviewed. Five themes were identified: feeling powerless and aggressive, my strategies or what helps me, feeling reassured by the presence of family members, feeling reassured by nurses’ gestures, being informed. Three themes were identified through the focus groups: objectivity and subjectivity in the assessment of fatigue, nursing contribution within the multidisciplinary management of fatigue, and difficulty in evaluating outcomes. Discussion: The approach to the management of fatigue was unstructured. Patients were satisfied with the care received but needed more information and specific interventions. Useful aspects were identified that could be used to change the professional approach towards the management of fatigue.