Using Perceived Self-efficacy to Improve Fatigue and Fatigability In Postsurgical Lung Cancer Patients

Abstract

Background Fatigue remains a prevalent and debilitating symptom in persons with non-small cell lung cancer (NSCLC). Exercise has been shown to be effective in reducing fatigue; yet interventions are limited for post-surgical NSCLC patients. To date, while surgery is offered as a standard curative treatment for NSCLC, no formal guidelines exist for post-surgical rehabilitation. Objective This study focuses on the design and testing of a post-surgical intervention for NSCLC patients to promote perceived self-efficacy for fatigue self-management targeting cancer-related fatigue (CRF) severity and its associated fatigability through exercise. Interventions/ Methods A two-arm randomized controlled trial (RCT) was used to examine the impact of a 6-week rehabilitative CRF self-management exercise intervention on 37 NSCLC participants compared with 35 control group participants receiving usual care from diagnosis to 6 weeks post-surgical hospital discharge. Results We exceeded goals for recruitment (66%), retention (97%), adherence (93%), and acceptability. Our 6-week exercise intervention demonstrated preliminary efficacy in significantly reducing CRF severity and fatigability as compared to usual care, with mean CRF levels restored to levels lower than pre-surgery. Likewise, the exercise group's functional performance (physical and mental health scores) exceeded usual care. Further, no adverse events were reported; participants had a mean age of 67 and a mean of 8 comorbid conditions. Conclusions An exercise intervention for post-surgical NSCLC patients is feasible, safe, and highly acceptable showing positive changes in CRF self-management. Implications for Practice To advance practice, testing of the effectiveness of this health-promoting self-management exercise intervention in a larger-scale RCT.

Effectiveness of e‐health based self‐management to improve cancer‐related fatigue, self‐efficacy and quality of life in cancer patients: Systematic review and meta‐analysis

“…Cancer patients with lower self-efficacy are inclined to experience more fatigue (Johansson, Brink, Cliffordson, & Axelsson, 2018). Therefore, self-management is implemented in studies and proven as an effective treatment for improving self-efficacy, CRF and QOL (Foster et al, 2016;Hoffman et al, 2017) by developing patients' selfmanagement theories and skills through role, medical and emotional management tasks (Medicine, 2004). However, traditional self-management support is limited by the availability of medical professionals, time, money, facilities, and setting resources (Stubblefield, 2017), insufficient to meet the needs of patients, such as ongoing follow-up support (Ostby, Armer, Smith, & Stewart, 2018).…”

Relationship Between Self-Efficacy and Self-Esteem in Patients With Cancer

“…The relationship between self-efficacy and quality of life has also been identified in some studies (Kiaei et al 2016;Mudrak et al 2016;Yeung & Lu 2014). In another study, the positive effect of self-efficacy on postsurgical complications in lung cancer was addressed (Hoffman et al 2017). Increasing self-efficacy in the caregivers of hospitalized cancer patients has been proven to reduce cancer symptoms as well as caregivers' stress for their practice (Hendrix et al 2016).…”

Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence?

“… 19 Of the remaining 21 studies, 2 were editorials 20 , 21 and 5 were published as abstracts 22 – 26 and therefore data were not complete. Regarding these abstracts, two 22 , 26 were excluded because they were already included as full texts 27 , 28 in our initial bibliographic research. Concerning the three remaining abstracts, we contacted the corresponding authors in order to obtain complete data.…”

“…Therefore, six RCTs were included in this review. 8 , 25 , 27 , 37 – 39 The flow chart representing selection process of studies is reported in Figure 1 .…”

“…One of the included studies focused on preoperative PR, 37 while the other five focused on postoperative PR. 8 , 25 , 27 , 38 , 39 Detailed study characteristics are presented in Table 1 .…”