Patient-Related Barriers to Fatigue Communication in Cancer Patients Receiving Active Treatment

Abstract

Objective. To explore barriers to reporting fatigue in cancer patients receiving active treatment and the significant factors associated with those barriers from fatigue characteristics (i.e., intensity, duration, and interference with daily life), to demographic characteristics and disease/treatment variables.Methods. Patients with various types of cancer (n ‫؍‬ 288) were recruited from an outpatient chemotherapy center, and from seven oncology and hematology units in a teaching hospital in northern Taiwan. Data were collected using the Fatigue Management Barriers Questionnaire to explore barriers to fatigue communication.Results. Fear of distracting the doctor was rated as the highest barrier of reporting fatigue. The degree of fatigue interference with daily life by patients was associated with the willingness to report fatigue. Patients with gastrointestinal cancer experienced more barriers to reporting fatigue than those with hematological cancer. Patients without religion perceived the highest level of barriers to fatigue communication. Outpatients had higher levels of concern than inpatients.Conclusions. Discussion with patients about their high level of perceived fatigue barriers before implementing patient education is recommended. Assessing fatigue interference with daily life and identifying factors associated with barriers to reporting fatigue (i.e., type of cancer, religion, and the setting for receiving treatment) are suggested in order to provide better fatigue management in clinical settings. The Oncologist 2009;14:936 -943

Cancer‐Related Fatigue: State of the Science

“…The authors of studies [14‐18] that span diverse populations suggest that screening and evaluation of fatigue in patients with cancer is suboptimal, that fatigue is undertreated, and that health‐care professionals may not fully appreciate the degree of distress and functional loss that fatigue produces. Identified barriers to communication between patients and their clinicians about fatigue include (1) the clinician's failure to offer interventions (47%), (2) patients' lack of awareness of effective treatments for fatigue (43%), (3) a desire on the patient's part to treat fatigue without the use of medications (40%), (4) and a tendency of the patient to be stoic about fatigue to avoid being labeled as a “complainer” (28%) [2,19].…”

Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis

“…Recent research reveals the potential benefit of training patients to overcome communication barriers . However, to our knowledge, only a few studies address the nature of communication barriers from a patient's perspective . Such knowledge would help to tailor training interventions to patients' needs.…”

“…the nature of communication barriers from a patient's perspective [25][26][27][28]. Such knowledge would help to tailor training interventions to patients' needs.…”

A Comparative Study of Data Collection Methods in the Process of Nursing: Detection of Chemotherapy Side Effects Using a Self-Reporting Questionnaire

“…Th ese conditions often are not considered really compromising by attending physicians from a prescriptive point of view, but prove to be highly invalidating [21][22][23] from the point of view of patients. In particular, highly signifi cant results are achieved concerning the presence of alteration of bowel function, pain, anxiety and depression, malaise, fatigue and abnormal sleep-rest pattern 8,24 , as such toxicities, very frequently suggested by patients, tend to be underestimated and undervalued by operators [25][26][27][28][29] ( Table 2, Fig. 2).…”