Forming new habits in the face of chronic cancer-related fatigue: An interpretative phenomenological study

Abstract

Purpose The growing group of patients who suffer from chronic cancer-related fatigue (CCRF) after cancer have helpful and less helpful ways of responding to this long-lasting and disruptive problem. This qualitative study aimed to gain insight in essential elements of how patients respond to CCRF, with a focus on helpful responses to facilitate adaptation. Methods We conducted semi-structured interviews with a purposive sample of 25 participants who experienced severe CCRF for at least 3 months. Participants were recruited via media, patient associations, meetings, and health professionals until data saturation was attained. We used a topic guide with open-ended questions about lived experiences. Interpretative phenomenological analysis (IPA) was used for analysis of the transcripts. Results We identified five interrelated themes of how patients respond to CCRF: (1) discovering physical and emotional boundaries; (2) communicating support needs; (3) reorganizing and planning activities and rest; (4) letting go of one’s habitual identity; and (5) recognizing and accepting CCRF. Conclusion This study highlights the development of new habits and positive beliefs in the face of CCRF and the importance of (social) support in this process. This experiential knowledge on helpful responses can be used to inform patients and their significant others and improve self-efficacy. Health professionals could use these insights to improve recognition of CCRF and personalize treatment.

Navigating severe chronic cancer-related fatigue: an interpretative phenomenological analysis

“…In turn, this can facilitate patients in regaining one's 'I can' , which is not a disabling dimension, like the other themes, but a productive dimension that entails adaption (Grīnfelde, 2018). The re-functioning results in a positive transformation of one's habitual identity that could facilitate new possibilities of perception, action, and self-understanding (Bootsma et al, 2021(Bootsma et al, , 2020. It helps to respond in a healthy way to CCRF.…”

“…As the questioning was positively evaluated, we included this interview in the analysis. We published a separate paper that focused on what helps patients in responding to CCRF (Bootsma et al, 2021).…”

Using smartphone-based ecological momentary assessment and personalized feedback for patients with chronic cancer-related fatigue: A proof-of-concept study

“…The selection process of EMA items was guided by previous qualitative research on the patients' perspective on CCRF, group-level network studies on CCRF, and clinical expertise in treating patients with CCRF ( Bootsma et al, 2021a , Bootsma et al, 2021b , Bootsma et al, 2020 ; Bruggeman-Everts, 2019 ; Schellekens et al, 2020 ; Wolvers et al, 2021 ). We selected items that we expected to vary momentarily and measured the experiences and responses to CCRF: fatigue-related symptoms, positive and negative mood, activity, coping with fatigue, and context ( Table A.1 ).…”

“…Patients with CCRF experience several limitations in their daily life. Along the way, learning new habits (e.g., reorganizing and planning of activities and rest) and adapting their beliefs (e.g., accepting their limits) helps them to deal with this long-lasting problem ( Bootsma et al, 2021a ). The dynamics, differences, and interrelations of experiences and responses to this complex problem require a person-centered approach.…”

Effect of Somatosensory Interaction Transcutaneous Electrical Acupoint Stimulation on Cancer-related Fatigue and Immunity

“…The inclusion criteria for patients were as following: all the subjects were diagnosed as malignant tumors by pathology or cytology; they met the CRF diagnostic criteria specified in the International Classification of Diseases (Version 10) (ICD-10) that included recurrence and duration of fatigue symptoms for over 2 weeks, accompanied by 5 or more other symptoms 19 ; they were scored ≥4 on the Revised Piper Fatigue Scale (RPFS) 20 ; their expected survival time was ≥6 months; They were aged 60 years or below; they or their family members were able to use computers and smartphones; they were willing to participate in this study.…”