Fatigue is reported by advanced cancer patients to be their most prevalent and distressing symptom. Despite this, few interventions have been developed and tested to manage this debilitating symptom. This paper describes a pilot study undertaken to test the effects of a 28-day exercise intervention on levels of fatigue in advanced cancer patients. All participants were able to increase their activity levels with no increase in reported fatigue. Furthermore, a trend was noted in all patients toward increased quality of life scores and decreased anxiety scores, All participants described a sense of satisfaction in attaining increased activity levels. These preliminary pilot results suggest that patients who initially report the highest levels of fatigue may achieve the largest decrease in fatigue scores. These findings provide support for the suitability of this intervention for the palliative care population and justify the importance of further hypothesis testing.

After pain management, poor communication with health professionals creates the most distress for families of patients with cancer. Difficulties communicating with families also have been identified as potentially stressful for nurses. This is particularly the case for nurses working in acute care settings. However, little research has been undertaken to examine the specific problems and challenges confronting nurses who endeavor to communicate with families of patients with cancer in a hospital setting. The purpose of this study was to describe nurses' perceptions of communication issues, potential barriers, and strategies associated with nurse-family interactions in an acute cancer hospital setting. Focus groups were conducted with nurses from two cancer wards at an Australia hospital. Four distinct themes emerged. First, all nurses described communication difficulties they encountered when interacting with families. Second, team factors appeared to be a central determinant of the quality of nurse-family communication. Third, nurses described difficulties associated with the delivery of bad news and treatment plans that are not clearly defined for the patient. Finally, the effects of poor communication on nurses were notably and vividly described. In this report, recommendations for clinical practice and subsequent research are offered.

Objectives: To examine the perceptions of practising aged care physicians with respect to bereavement care. Method: A questionnaire survey was sent to 427 Consultant Geriatricians and Advanced Trainees in Geriatric Medicine. Results: Ninety eight percent of respondents believed it was important to provide bereavement care for patients and their families. Fifty six percent did not feel it was their role to provide this support. For those who provided bereavement care (33%), most used a combination of hospital and community based resources. Fifty nine percent of respondents believed that they had inadequate training in bereavement care. Seventy one percent of respondents were not aware of resources available to fellow colleagues experiencing difficulties coping with the death of a patient. Conclusions: Aged care physicians differ in their approaches to bereavement care. Aged care physicians may need further education in bereavement care.