1
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The correlation between the quality of pain and fatigue in children with acute lymphoblastic leukemia (ALL). ENFERMERIA CLINICA 2021. [PMID: 33849193 DOI: 10.1016/j.enfcli.2020.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This study aimed to analyze the relationship between the quality of pain and fatigue in ALL children 1-3 days after chemotherapy. A cross-sectional design with a consecutive sampling technique was used to 44 ALL children in Jakarta aged 7-18 years as the samples. Brief Pain Inventory (BPI) and Allen-Child Oncology Fatigue questionnaire were used to measure quality of pain and fatigue. The obtained mean scores for the quality of pain were 1.63932, and the mean score for fatigue was 9.25. The results also showed that there was a significant relationship between the quality of pain and fatigue (p=0.006), relapse status and fatigue (p=0.058), and companion when in pain and fatigue (p=0.016) in children with ALL. These study recommend the importance of pain assessment and management of pharmacological and non-pharmacological combinations for post-chemotherapy pain to reduce fatigue in cancer children.
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2
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Ito N, Petrella A, Sabiston C, Fisher A, Pugh G. A Systematic Review and Narrative Synthesis of Exercise Interventions to Manage Fatigue Among Children, Adolescents, and Young Adults with Cancer. J Adolesc Young Adult Oncol 2021; 10:361-378. [PMID: 33625879 DOI: 10.1089/jayao.2020.0136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Exercise is known to improve fatigue among adult cancer patients however there is limited understanding of this relationship in children, adolescents, and young adults (AYA) with cancer. The aim is to evaluate the effect of exercise on fatigue outcomes among children and AYA with cancer and to identify important parameters of exercise (frequency, intensity, time, type, and setting), which may be relevant for future intervention design. A systematic search of PubMed, MedLine, CENTRAL, Embase, and Web of Science databases was conducted in December 2019, for studies within the last decade, reporting the effect of exercise on fatigue among cancer patients and survivors 0-24 years of age. Quality assessment was conducted using the Physiotherapy Evidence Database (PEDro) and "Before/After Studies with No Control Group" scales. Seventeen studies (n = 681 participants) were included, of which six were randomized controlled trials (RCTs), and the remaining being pilot (n = 5) or feasibility studies (n = 6). Across studies there was great heterogeneity in intervention delivery, frequency (range: 1-7 days a week), time (range: 10-60 minutes), and duration (range: 3-24 weeks). A positive effect of exercise on fatigue was observed, however, most changes in fatigue were not statistically significant. Exercise is beneficial for reducing fatigue in young cancer patients. However, due to the heterogeneity and quality of existing interventions, firm conclusions about the most effective mode and format of exercise intervention cannot be drawn. There is a need for more definitive large-scale RCTs that can provide data of sufficient quality.
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Affiliation(s)
- Nonoka Ito
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
| | - Anika Petrella
- Department of Kinesiology, University of Toronto, Toronto, Canada
| | | | - Abigail Fisher
- Department of Behavioral Science and Health, University College London, London, United Kingdom
| | - Gemma Pugh
- Centre for Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom
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3
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Loades ME, James V, Baker L, Jordan A, Sharma A. Parental Experiences of Adolescent Cancer-Related Fatigue: A Qualitative Study. J Pediatr Psychol 2020; 45:1093-1102. [DOI: 10.1093/jpepsy/jsaa080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/15/2020] [Accepted: 08/15/2020] [Indexed: 11/15/2022] Open
Abstract
Abstract
Objective
Cancer-related fatigue is common, disabling, and chronic, but professional help is not necessarily sought. Parents can support symptom management and facilitate help-seeking. This study explored parental experiences of their adolescent’s cancer-related fatigue and what they do to help.
Methods
Qualitative semi-structured interviews were conducted with 21 parents of 17 adolescents aged 12–18 who were previously diagnosed with cancer. Reflexive thematic analysis was used to analyze the data.
Results
Three high-order themes were generated. Firstly, “fatigue is inevitable and unpredictable.” This encompassed parental perceptions of fatigue as variable, distinct from normal tiredness, and linked to sleep and mood. Fatigue was seen as arising from cancer, which rendered parents helpless. Secondly, “fatigue is disruptive to normal life” beyond cancer treatment, which is contrary to expectations. Thirdly, parents managed fatigue by trying to balance the adolescent’s desires for normality and their own perception of what is realistic with encouraging activities, and by seeking support from others.
Conclusions
Parents see adolescent cancer-related fatigue as multi-faceted and experience it as unpredictable and attributed to cancer. They struggle to distinguish normal adolescent behavior from problematic fatigue, and to balance supporting and empowering the adolescent to live life to the fullest whilst also being realistic about the limitations imposed by fatigue and the benefits of activity. Parents try to manage fatigue practically but want more information about adolescent cancer-related fatigue to help establish their own and their adolescent’s expectations.
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Affiliation(s)
- Maria E Loades
- Department of Psychology, University of Bath
- Bristol Medical School, University of Bristol
| | | | | | - Abbie Jordan
- Department of Psychology, University of Bath
- Centre of Pain Research, University of Bath
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4
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Hooke MC, Linder LA. Symptoms in Children Receiving Treatment for Cancer-Part I: Fatigue, Sleep Disturbance, and Nausea/Vomiting. J Pediatr Oncol Nurs 2020; 36:244-261. [PMID: 31307321 PMCID: PMC7197223 DOI: 10.1177/1043454219849576] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Children and adolescents with cancer often undergo intensive chemotherapy treatment to obtain remission and long-term survival. The pursuit of successful treatment outcomes may lead to high levels of symptom distress related to treatment side effects and toxicities. The Children's Oncology Group Nursing Discipline held a State of the Science Symposium "Symptom Assessment During Childhood Cancer Treatment" in 2018 that included reviews of evidence regarding key symptoms. The purpose of this review is to summarize and synthesize the evidence presented about the prevalence, relationships, trajectories, and associated biomarkers of selected symptoms experienced by children and adolescents during cancer treatment. Five symptoms were selected, with the focus on fatigue, sleep disturbance, and nausea/vomiting and included in Part I of the review. Using Ovid-Medline, studies published between 2008 and 2018 that focused on these specific symptoms during active chemotherapy treatment were selected. Fatigue interferes with normal developmental activities and is associated with sleep disturbances, and its pattern changes within a cycle of chemotherapy as well as across the treatment trajectory. Sleep is disrupted by the hospital environment, treatment medications, and changes in normal childhood and schedules. Disturbances of sleep persist during treatment, preventing recovery from poor quality sleep. Although pharmacologic interventions have advanced for treatment of nausea and vomiting, children and adolescents continue to struggle with this symptom. Its trajectory changes with the intensity of treatment, and over half of the patients report that they experience nausea and/or vomiting. Future research is needed to advance identification of biologic risk factors for symptoms and test effectiveness of symptom-related interventions.
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Affiliation(s)
- Mary C Hooke
- 1 University of Minnesota School of Nursing, Minneapolis, MN, USA
- 2 Children's Minnesota, Minneapolis, MN, USA
| | - Lauri A Linder
- 3 University of Utah College of Nursing, Salt Lake City, UT, USA
- 4 Primary Children's Hospital, Salt Lake City, UT, USA
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5
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Wu LM, Chen CM, Hsu HT, Liu Y, Su HL. Tailored education enhances healthy behaviour self-efficacy in childhood cancer survivors: A randomised controlled study with a 4-month follow-up. Eur J Cancer Care (Engl) 2019; 28:e13063. [PMID: 31020742 DOI: 10.1111/ecc.13063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 01/30/2019] [Accepted: 03/25/2019] [Indexed: 12/18/2022]
Abstract
This study was to evaluate the acceptability and effectiveness of a tailored education on healthy behaviour self-efficacy (HBSE) and health promotion lifestyle (HPL) for childhood cancer survivors. A two-group, randomised study with repeated measures was conducted in Taiwan. Participants were randomly assigned to receive six 45-60 min individual education and follow-up telephone counselling sessions (n = 34) or standard of care only (n = 35). Each participant was assessed with HBSE and HPL questionnaires and was evaluated at three time points (at baseline, and then 1 and 4 months after intervention). The attrition rate was 7.2%. HBSE and HPL scores increased across the three time points in the experimental group (all p < 0.05), except for the HBSE exercise subscale (p = 0.85). HBSE scores were significantly higher for the experimental group than for the control group after 4 months of intervention (F = 5.32, p = 0.02, η2 = 0.25). No significant improvements in HBSE were observed over time in the control group. The intervention was acceptable and effective in promoting HBSE in childhood cancer survivors. Further empirical work is needed to reveal the effects of the intervention over a longer period of time and to improve patient engagement in exercise.
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Affiliation(s)
- Li-Min Wu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Mi Chen
- Department of Nursing, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Hsin-Tien Hsu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi Liu
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsiu-Lan Su
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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6
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Sodergren SC, Husson O, Rohde GE, Tomaszewska IM, Griffiths H, Pessing A, Yarom N, Hooker L, Din A, Darlington AS. Does age matter? A comparison of health-related quality of life issues of adolescents and young adults with cancer. Eur J Cancer Care (Engl) 2019; 27:e12980. [PMID: 30485601 DOI: 10.1111/ecc.12980] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Health-related quality of life (HRQoL) concerns of adolescents and young adults (AYAs) aged 14-25 years were compared with those of older adults (26-60 years) with cancer. METHODS AYAs and older adults receiving curative intent treatment or supportive palliative care for cancer were recruited from eight research centres across Europe. Participants used a rating scale to score the relevance and importance of a list of 77 issues covering 10 areas of HRQoL concern: symptoms; activity restrictions; social; emotional; body image; self-appraisals; outlook on life; lifestyle; treatment-related and life beyond treatment. RESULTS HRQoL issues were reviewed by 33 AYAs and 25 older adults. Several issues were recognised as relevant and important across all age groups: symptoms, emotional impact, outlook on life, lifestyle and treatment-related. A number of issues were more relevant or important to AYAs including interrupted education, greater motivation to achieve academic goals, increased maturity, boredom, fertility and change in living situation. CONCLUSION While there is overlap in several of the HRQoL concerns across the age span, it is important that HRQoL measures used with AYAs capture the diverse and unique psychosocial aspects of this developmental stage.
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Affiliation(s)
| | | | - Gudrun E Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.,Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | | | - Aya Pessing
- Department of Oral & Maxillofacial Surgery, Sheba Medical Center, Tel-Hashomer, Israel
| | - Noam Yarom
- Department of Oral Pathology and Oral Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Louise Hooker
- Teenage and Young Adult Cancer Service, University Hospital Southampton, Southampton, UK
| | - Amy Din
- School of Health Sciences, University of Southampton, Southampton, UK
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7
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Antill Keener T. Childhood Cancer-Related Fatigue and Day-to-Day Quality of Life. J Pediatr Oncol Nurs 2018; 36:74-85. [PMID: 30556476 DOI: 10.1177/1043454218818062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Childhood cancer-related fatigue is often viewed as an inevitable symptom of cancer and cancer treatment leading to underassessment by health care providers and self-management by families in the home and hospital environment. Parents' perspectives of the influence of childhood cancer-related fatigue on their child's day-to-day life is needed to understand how parents may or may not prioritize, report, and/or manage the fatigue symptom. This qualitative study used conventional content analysis to describe parents' observations and perspectives on the influence of fatigue in their child's day-to-day quality of life (QOL). Eleven interviews were gathered from parents. The concept childhood cancer-related fatigue and domains of QOL in pediatric oncology patients were used to guide the study, construct interview questions, and conduct conventional content analysis. A synthesis of three categories and seven codes led to three major findings: (a) parents perceive their child's symptoms as co-occurring not as a discrete entity of fatigue, (b) parents accept the child's behavior as a "new normal," and (c) parents recognize fatigue as a warning sign. The study findings reveal differences in how parents observe childhood cancer-related fatigue and how they perceive the symptom influences day-to-day QOL. Findings of this study support current guidelines underscoring the importance of multidimensional fatigue care. Additionally, the findings suggest a standardized multiple symptom instrument may be helpful in assessing symptom experience.
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8
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Chien CH, Chang YY, Huang XY. The Lived Experiences of Adolescents With Cancer: A Phenomenological Study. Clin Nurs Res 2018; 29:217-225. [PMID: 30188183 DOI: 10.1177/1054773818799226] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This descriptive phenomenological study was conducted to explore the lived experiences of adolescents with cancer. Purposive sampling was used to recruit participants. In-depth, nonstructured interviews were conducted to collect data, and narratives were analyzed using Colaizzi's seven-step method. Data saturation was achieved after interviewing 16 participants. The study was divided into three main themes and 16 subthemes: suffering (caused by symptoms, therapy, cancer recurrence, the feeling of being trapped in hospital, the burden of food therapy, delayed education, the absence of peer relationships, and limited activities), emotional reactions (fear, worry, sadness, anger, and loneliness), and rebalancing (strong family relationships, optimistic thinking, and healthy lifestyles). While adolescents with cancer experience changes in lifestyle, and physical, psychological, and social burden, they also have positive life experiences. Building appropriate learning systems, improving communication skill, and providing appropriate food therapy may alleviate the psychological burden experienced by young patients.
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Affiliation(s)
- Ching-Hui Chien
- National Taipei University of Nursing and Health Sciences, Taiwan
| | | | - Xuan-Yi Huang
- National Taipei University of Nursing and Health Sciences, Taiwan
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9
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Sodergren SC, Husson O, Rohde GE, Tomaszewska IM, Vivat B, Yarom N, Griffiths H, Darlington AS. A Life Put on Pause: An Exploration of the Health-Related Quality of Life Issues Relevant to Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2018; 7:453-464. [DOI: 10.1089/jayao.2017.0110] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gudrun E. Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, United Kingdom
| | - Iwona M. Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Krakow, Poland
| | - Bella Vivat
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, United Kingdom
| | - Noam Yarom
- Oral Medicine Unit, Sheba Medical Center, Tel-Hashomer, Israel
- The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Helen Griffiths
- Department of Psychological Medicine, Oxford University Hospital, Oxford, United Kingdom
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10
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Simioni C, Zauli G, Martelli AM, Vitale M, Ultimo S, Milani D, Neri LM. Physical training interventions for children and teenagers affected by acute lymphoblastic leukemia and related treatment impairments. Oncotarget 2018; 9:17199-17209. [PMID: 29682216 PMCID: PMC5908317 DOI: 10.18632/oncotarget.24762] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 02/25/2018] [Indexed: 12/28/2022] Open
Abstract
A decreased physical fitness has been reported in patients and survivors of acute lymphoblastic leukemia (ALL). This is influenced by the negative effects of the disease and by the treatments of childhood cancer. In the past, children were advised to recover in bed, and to take as much relax as possible. Nowadays, it is considered that too much immobility may result in a further decrease of physical fitness and functioning. Exercise training for ALL children has frequently been reported to improve physical fitness and the well-being of the children, since it prevents the negative effects of a sedentary life-style, such as obesity and a poor skeletal health. In recent years, different studies and protocols on this subject has become available for children and young adults with cancer, both during and after treatment. The efficacy of recent physical exercise training interventions, that act on several ALL impairments in children such as skeletal, musculoskeletal, neuromuscular, cardiopulmonary and cardiovascular systems, fatigue, body balance disorders and metabolism alterations have been examined. These side effects might be prevented or significantly reduced by introducing a physical exercise program during or shortly after cancer treatment. Several interventions are discussed and presented for each impairment, reducing their level caused by the disease and thus suggesting the importance of physical training activity in ameliorating the children quality of life.
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Affiliation(s)
- Carolina Simioni
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgio Zauli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Marco Vitale
- Department of Medicine and Surgery, University of Parma, Parma, Italy.,CoreLab, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Simona Ultimo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Daniela Milani
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Luca M Neri
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
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11
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12
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Spathis A, Hatcher H, Booth S, Gibson F, Stone P, Abbas L, Barclay M, Brimicombe J, Thiemann P, McCabe MG, Campsey R, Hooker L, Moss W, Robson J, Barclay S. Cancer-Related Fatigue in Adolescents and Young Adults After Cancer Treatment: Persistent and Poorly Managed. J Adolesc Young Adult Oncol 2017; 6:489-493. [PMID: 28714766 PMCID: PMC5649403 DOI: 10.1089/jayao.2017.0037] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Cancer-related fatigue is the most prevalent and distressing symptom experienced by adolescents and young adults (AYAs). An electronic survey was undertaken to ascertain current fatigue management and perceptions of its effectiveness. Eighty-five percent of responders (68/80) experienced fatigue, and it was worse more than 1 year after cancer treatment ended, compared to <1 year (p = 0.007). Forty-one percent received no fatigue management. Although advice to exercise was the most frequent intervention, the greatest impact of fatigue was on the ability to exercise and most did not find exercise advice helpful. Early intervention is warranted, supporting AYAs to persevere with increasing activity.
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Affiliation(s)
- Anna Spathis
- 1 Cambridge University Hospitals NHS Foundation Trust , Cambridge, United Kingdom .,2 University of Cambridge , Cambridge, United Kingdom
| | - Helen Hatcher
- 1 Cambridge University Hospitals NHS Foundation Trust , Cambridge, United Kingdom
| | - Sara Booth
- 2 University of Cambridge , Cambridge, United Kingdom
| | - Faith Gibson
- 3 Great Ormond Street Hospital for Children NHS Foundation Trust , London, United Kingdom .,4 University of Surrey , Guildford, United Kingdom
| | - Paddy Stone
- 5 University College , London, United Kingdom
| | - Laura Abbas
- 1 Cambridge University Hospitals NHS Foundation Trust , Cambridge, United Kingdom
| | - Matt Barclay
- 2 University of Cambridge , Cambridge, United Kingdom
| | | | - Pia Thiemann
- 2 University of Cambridge , Cambridge, United Kingdom
| | | | - Rachel Campsey
- 7 The Christie NHS Foundation Trust , Manchester, United Kingdom
| | - Louise Hooker
- 8 University Hospital Southampton NHS Foundation Trust , Southampton, United Kingdom
| | - Wendy Moss
- 1 Cambridge University Hospitals NHS Foundation Trust , Cambridge, United Kingdom
| | - Jane Robson
- 1 Cambridge University Hospitals NHS Foundation Trust , Cambridge, United Kingdom
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13
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Sodergren SC, Husson O, Robinson J, Rohde GE, Tomaszewska IM, Vivat B, Dyar R, Darlington AS. Systematic review of the health-related quality of life issues facing adolescents and young adults with cancer. Qual Life Res 2017; 26:1659-1672. [PMID: 28251543 PMCID: PMC5486886 DOI: 10.1007/s11136-017-1520-x] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2017] [Indexed: 02/03/2023]
Abstract
PURPOSE For adolescents and young adults (AYAs), the impact of a cancer diagnosis and subsequent treatment is likely to be distinct from other age groups given the unique and complex psychosocial challenges of this developmental phase. In this review of the literature, we report the health-related quality of life (HRQoL) issues experienced by AYAs diagnosed with cancer and undergoing treatment. METHODS MEDLINE, EMBASE, CINAHL, PsychINFO and the Cochrane Library Databases were searched for publications reporting HRQoL of AYAs. Issues generated from interviews with AYAs or from responses to patient reported outcome measures (PROMs) were extracted. RESULTS 166 papers were reviewed in full and comprised 72 papers covering 69 primary studies, 49 measurement development or evaluation papers and 45 reviews. Of the 69 studies reviewed, 11 (16%) used interviews to elicit AYAs' descriptions of HRQoL issues. The majority of the PROMs used in the studies represent adaptations of paediatric or adult measures. HRQoL issues were organised into the following categories: physical, cognitive, restricted activities, relationships with others, fertility, emotions, body image and spirituality/outlook on life. CONCLUSION The HRQoL issues presented within this review are likely to be informative to health care professionals and AYAs. The extensive list of issues suggests that the impact of a cancer diagnosis and treatment during adolescence and young adulthood is widespread and reflects the complexities of this developmental phase.
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Affiliation(s)
| | - Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jessica Robinson
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Gudrun E Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, Norway
| | - Iwona M Tomaszewska
- Department of Medical Education, Jagiellonian University Medical College, Kraków, Poland
| | - Bella Vivat
- Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, UK
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14
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Hsiao CC, Chiou SS, Hsu HT, Lin PC, Liao YM, Wu LM. Adverse health outcomes and health concerns among survivors of various childhood cancers: Perspectives from mothers. Eur J Cancer Care (Engl) 2017; 27:e12661. [PMID: 28169481 DOI: 10.1111/ecc.12661] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2016] [Indexed: 01/08/2023]
Abstract
Advanced therapies have improved outcomes and also resulted in a growing risk of long-term adverse health events. This study intends to estimate incidences of adverse health events and examine differences in adverse health events among childhood cancer survivors, and to understand the concerns of mothers after their child has completed cancer treatment. An explanatory sequential mixed-method was used. A total of 201 paediatric cancer survivors' mothers with mean age 43.6 years were recruited. Of the survivors, 12.4% experienced five or more adverse health events. The incidence of adverse health events of altered body image, fatigue and neurocognitive problems were 31.54%, 14.77% and 12.53% respectively. Among survivors, significant differences in adverse health events of pain, endocrine problems and altered body image issues were identified. Survivors receiving radiotherapy, bone marrow transplants or completing treatment after 6-10 years experienced significantly more adverse health events. Maintaining health was the greatest concern for mothers, and the qualitative reports of their concerns could be categorised: living in uncertainty, and keeping forward-looking. Childhood brain tumour survivors were identified as experiencing more adverse health events than other survivors. The need for healthcare teams to consider mothers' health concerns was highlighted.
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Affiliation(s)
- C C Hsiao
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - S S Chiou
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Pediatrics, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - H-T Hsu
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - P C Lin
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Pediatrics, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Y M Liao
- Division of Hematology/Oncology, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - L-M Wu
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
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15
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Spathis A, Booth S, Grove S, Hatcher H, Kuhn I, Barclay S. Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis. J Adolesc Young Adult Oncol 2016; 4:3-17. [PMID: 25852970 DOI: 10.1089/jayao.2014.0023] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE Cancer-related fatigue in adults has been the subject of considerable recent research, confirming its importance as a common and debilitating symptom, and establishing a number of evidence-based interventions. There has, however, been limited focus on the fatigue suffered by teenagers and young adults with cancer, a group recognized as having unique experiences and developmental needs. We have undertaken a systematic review of the literature to provide a comprehensive overview of studies evaluating fatigue in this younger patient group in order to guide clinical practice and future research. METHOD We searched MEDLINE, EMBASE, PsycINFO, and CINAHL databases for literature containing data relating to any aspect of fatigue in patients aged 13-24 at cancer diagnosis or treatment. RESULTS Sixty articles were identified, of which five described interventional clinical trials. Cancer-related fatigue was consistently one of the most prevalent, severe, and distressing symptoms, and it persisted long-term in survivors. It was associated with a number of factors, including poor sleep, depression, and chemotherapy. There was little evidence for the effectiveness of any intervention, although exercise appears to be the most promising. Importantly, fatigue was itself a significant barrier to physical and social activities. CONCLUSION Cancer-related fatigue is a major and disabling problem in young cancer patients. Effective management strategies are needed to avoid compounding the dependence and social isolation of this vulnerable patient group. Future research should focus on providing evidence for the effectiveness of interventions, of which activity promotion and management of concurrent symptoms are the most promising.
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Affiliation(s)
- Anna Spathis
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom
| | - Sara Booth
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom . ; University of Cambridge , Cambridge, United Kingdom
| | - Sarah Grove
- Department of Palliative Care, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom
| | - Helen Hatcher
- TYA Cancer Service, Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust Foundation , Cambridge, United Kingdom
| | - Isla Kuhn
- University of Cambridge Medical Library , Cambridge, United Kingdom
| | - Stephen Barclay
- Department of Public Health and Primary Care, University of Cambridge , Cambridge, United Kingdom
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16
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Tomlinson D, Zupanec S, Jones H, O’Sullivan C, Hesser T, Sung L. The lived experience of fatigue in children and adolescents with cancer: a systematic review. Support Care Cancer 2016; 24:3623-31. [DOI: 10.1007/s00520-016-3253-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 04/26/2016] [Indexed: 12/27/2022]
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17
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Cheng YC, Huang CY, Wu WW, Chang SC, Lee-Hsieh J, Liang SY, Cheng SF. The lived experiences of aboriginal adolescent survivors of childhood cancer during the recovering process in Taiwan: A descriptive qualitative research. Eur J Oncol Nurs 2016; 22:78-84. [PMID: 27179896 DOI: 10.1016/j.ejon.2016.03.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 02/15/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to understand the experiences of Taiwanese aboriginal adolescent survivors of childhood cancer during the process of recovery. METHOD A snowball sampling strategy was used to recruit participants from the pediatrics unit of a medical center in the eastern region of Taiwan. In-depth interviews were conducted with 11 aboriginal adolescent childhood cancer survivors. The data were analyzed using content analysis. RESULTS The results revealed three major themes with subthemes within each theme. The three major themes are: roots of resilience, transformation and growth, and meaning of traditional rituals for resilience. The three subthemes within "roots of resilience" include: "feeling secure through company of family, care and financial support", "receiving support from the important others and religion" and "learning to self-adjust". The three subthemes revealed within "transformation and growth" are: restructuring the relationship with peers, "appreciating parents' hard work", and "learning to seize the moment". The two subthemes within "meaning of traditional rituals to resilience" include: "feeling blessed with the power of ancestral spirits" and "strengthening ethnic identity". CONCLUSION This study provided insight into the experiences of aboriginal adolescents as they recovered from childhood cancer. The experiences made positive impacts by inspiring growth in maturity and consolidating aboriginal ethnic identity. The adolescents were empowered by support from family, friends and clansmen, and by their participation in aboriginal rituals. As healthcare professionals care for the aboriginal adolescents, it is critical to consider this culturally and ethnically specific knowledge/experience of surviving cancer to improve quality of care.
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Affiliation(s)
- Ya-Chun Cheng
- Department of Nursing, Buddhist Tzu Chi General Hospital, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan.
| | - Chu-Yu Huang
- School of Nursing, Cedarville University, 251 N. Main St., Cedarville, OH 45314, USA.
| | - Wei-Wen Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming-te Rd, Peitou District, Taipei City, 11219, Taiwan.
| | - Shu-Chuan Chang
- Department of Nursing, Buddhist Tzu Chi General Hospital, Department of Nursing, Tzu Chi University, No. 707, Sec. 3, Chung Yang Rd., Hualien 970, Taiwan.
| | - Jane Lee-Hsieh
- Graduate Institute of Allied Health Education, National Taipei University of Nursing and Health Sciences, 365 Ming Te Road, Peitou, Taipei City 112, Taiwan.
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming-te Rd, Peitou District, Taipei City, 11219, Taiwan.
| | - Su-Fen Cheng
- School of Nursing, National Taipei University of Nursing and Health Sciences, 365 Ming-te Rd, Peitou District, Taipei City, 11219, Taiwan.
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18
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Ho KY, Li WHC, Lam KWK, Chui SY, Chan CFG. Psychometric properties of the Chinese version of the fatigue scale-adolescent. BMC Cancer 2015; 15:938. [PMID: 26614348 PMCID: PMC4662819 DOI: 10.1186/s12885-015-1945-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 11/20/2015] [Indexed: 12/18/2022] Open
Abstract
Background The availability of a valid and reliable instrument that accurately assesses the level of fatigue among adolescent cancer survivors is crucial before any appropriate interventions to reduce their fatigue can be appropriately planned and evaluated. The study aimed to test the psychometric properties of the Chinese version of the Fatigue Scale for Adolescents. In particular, confirmatory factor analysis was conducted to examine its factorial structure. Methods A cross-sectional study was employed. Adolescents (13- to 18-year-olds) who had survived cancer and attended medical follow-up at the outpatient clinic in Hong Kong were invited to participate. The internal consistency, content validity and construct validity and test-retest reliability of the Chinese version of the Fatigue Scale for Adolescents were assessed. Results The content validity index was 0.92. There was a strong positive correlation between adolescents’ levels of fatigue and depressive symptoms (r = 0.53) and a strong negative correlation between adolescents’ levels of fatigue and quality of life (r = –0.58). The mean levels of fatigue of the survivors group was significantly lower than that of those still receiving treatment in hospital, but significantly higher than that of their healthy counterparts. Confirmatory factor analysis indicated that there were 4 factors underlying the Chinese version of the Cancer Module. Conclusions The findings of the study add further evidence that the Chinese version of the Fatigue Scale for Adolescents (12-item) can be used as a reliable and valid tool in assessing cancer-related fatigue among Hong Kong Chinese adolescents who have survived cancer.
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Affiliation(s)
- Ka Yan Ho
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - William H C Li
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Ka Wai Katherine Lam
- School of Nursing, The University of Hong Kong, 4/F, William MW Mong Block, No 21 Sassoon Road, Pokfulam, Hong Kong.
| | - S Y Chui
- Department of Adolescent Medicine, Queen Mary Hospital, Room 115, New Clinical Building, 102 Pokfulam Road, Hong Kong, Hong Kong.
| | - Chi-Fung Godfrey Chan
- Department of Adolescent Medicine, Queen Mary Hospital, Room 115, New Clinical Building, 102 Pokfulam Road, Hong Kong, Hong Kong.
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19
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Huang IC, Anderson M, Gandhi P, Tuli S, Krull K, Lai JS, Nackashi J, Shenkman E. The relationships between fatigue, quality of life, and family impact among children with special health care needs. J Pediatr Psychol 2013; 38:722-31. [PMID: 23584707 PMCID: PMC3721186 DOI: 10.1093/jpepsy/jst016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 02/19/2013] [Accepted: 02/26/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To examine the relationships among pediatric fatigue, health-related quality of life (HRQOL), and family impact among children with special health care needs (CSHCNs), specifically whether HRQOL mediates the influence of fatigue on family impact. METHODS 266 caregivers of CSHCNs were studied. The Pediatric Quality of Life Inventory Multidimensional Fatigue Scale, Pediatric Quality of Life Inventory Generic Scale, and Impact on Family Scale were used to measure fatigue, HRQOL, and family impact, respectively. Linear regressions were used to analyze the designated relationships; path analyses were performed to quantify the mediating effects of HRQOL on fatigue-family impact relationship. RESULTS Although greater fatigue was associated with family impact (p < .05), the association was not significant after accounting for HRQOL. Path analyses indicated the direct effect of fatigue on family impact was not significant (p > .05), whereas physical and emotional functioning significantly mediated the fatigue-family impact relationship (p < .001). CONCLUSION Fatigue is related to family impact among CSHCNs, acting through the impairment in HRQOL.
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Affiliation(s)
- I-Chan Huang
- Department of Health Outcomes and Policy, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
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20
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Chang CW, Mu PF, Jou ST, Wong TT, Chen YC. Systematic review and meta-analysis of nonpharmacological interventions for fatigue in children and adolescents with cancer. Worldviews Evid Based Nurs 2013; 10:208-17. [PMID: 23809656 DOI: 10.1111/wvn.12007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Fatigue is one of the most distressing and prevalent symptoms reported by pediatric oncology patients. With the increase in cancer survival rates, medical teams have focused on methods that control cancer-related fatigue in children during the disease and its treatment in order to increase the quality of life for these patients. AIM The objective of this systematic review was to synthesize the best available evidence concerning the effectiveness of nonpharmacological interventions for fatigue in children and adolescents with cancer. METHODS The search strategy was designed to retrieve studies published between 1960 and 2010 in either English or Chinese. This review included randomized controlled trials and quasi-experimental studies. The studies that were selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical-appraisal instruments. RESULTS The review included six studies, and the meta-analysis revealed a statistically significant effect of exercise interventions in reducing general fatigue (effect size = -0.76; 95% CI [-1.35, -0.17]) in children and adolescents with cancer. CONCLUSIONS AND IMPLICATIONS The review provides an evidence-based guide to future priorities for clinical practice. Exercise interventions could reduce the levels of general fatigue in children aged 6-18 years. In particular, exercise interventions for fatigue are feasible and safe.
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Affiliation(s)
- Chi-Wen Chang
- Instructor, School of Nursing, Chang Gung University and Doctoral Candidate, School of Nursing, National Yang-Ming University, Taipei, Taiwan, ROC
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21
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Wesley KM, Zelikovsky N, Schwartz LA. Physical symptoms, perceived social support, and affect in adolescents with cancer. J Psychosoc Oncol 2013; 31:451-67. [PMID: 23844924 PMCID: PMC4479176 DOI: 10.1080/07347332.2013.798761] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Treatment for cancer among adolescents is often more intense and lasts longer than treatment for older or younger patients. It typically causes pain, fatigue, and nausea and affects social and emotional well-being. This study examined the relationships among demographics, physical symptoms, perceived social support from friends and family, and affect (positive and negative) in 102 adolescents (age 13-19) with cancer using correlational analyses. Additionally, perceived social support was explored as a mediator and moderator of the relationship between physical symptoms and affect using regression. Females reported significantly lower friend support and higher negative affect compared to males. Minority participants were more likely to endorse physical symptoms and less negative affect compared to White respondents. Higher report of physical symptoms was significantly related to greater negative affect, whereas higher perceived social support from friends was related to higher positive affect. Adolescents consistently reported high levels of social support from family and friends. Additionally, adolescents tended to report average levels of positive affect and low levels of negative affect compared to healthy populations. No significant mediation or moderation effects were found. This research highlights that females and minorities, and those with greater physical symptoms, may be more vulnerable to poor adjustment to cancer during adolescence. However, overall this study lends support to the notion that adolescents with cancer are an especially resilient population, as these patients endorsed generally high levels of social support and positive affect, with low levels of negative affect.
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Affiliation(s)
- Kimberly M Wesley
- Department of Psychology, La Salle University, Philadelphia, PA 19141, USA.
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22
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Chang CW, Mu PF, Jou ST, Wong TT, Chen YC. The effectiveness of non-pharmacological interventions on fatigue in children and adolescents with cancer: a systematic review. ACTA ACUST UNITED AC 2012; 10:574-614. [DOI: 10.11124/jbisrir-2012-60] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Effects of yoga on psychological health, quality of life, and physical health of patients with cancer: a meta-analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2011:659876. [PMID: 21437197 PMCID: PMC3062158 DOI: 10.1155/2011/659876] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 01/14/2011] [Indexed: 11/18/2022]
Abstract
Yoga is one of the most widely used complementary and alternative medicine therapies to manage illness. This meta-analysis aimed to determine the effects of yoga on psychological health, quality of life, and physical health of patients with cancer. Studies were identified through a systematic search of seven electronic databases and were selected if they used a randomized controlled trial design to examine the effects of yoga in patients with cancer. The quality of each article was rated by two of the authors using the PEDro Scale. Ten articles were selected; their PEDro scores ranged from 4 to 7. The yoga groups compared to waitlist control groups or supportive therapy groups showed significantly greater improvements in psychological health: anxiety (P = .009), depression (P = .002), distress (P = .003), and stress (P = .006). However, due to the mixed and low to fair quality and small number of studies conducted, the findings are preliminary and limited and should be confirmed through higher-quality, randomized controlled trials.
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A Pilot Study to Examine the Feasibility and Effects of a Home-Based Aerobic Program on Reducing Fatigue in Children With Acute Lymphoblastic Leukemia. Cancer Nurs 2011; 34:3-12. [DOI: 10.1097/ncc.0b013e3181e4553c] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Yeh CH, Chiang YC, Lin L, Yang CP, Chien LC, Weaver MA, Chuang HL. Clinical factors associated with fatigue over time in paediatric oncology patients receiving chemotherapy. Br J Cancer 2008; 99:23-9. [PMID: 18577992 PMCID: PMC2453020 DOI: 10.1038/sj.bjc.6604434] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The purpose of this study was to investigate the relationships between clinical factors (including haemoglobin value, chemotherapeutic agents, and corticosteroid use) and changing patterns of fatigue before and for the next 10 days following the start of a new round of chemotherapy in children with cancer. A prospective longitudinal design was used to collect data from 48 paediatric oncology patients who were about to begin a new round of chemotherapy and their parents. Fatigue levels were assessed using multidomain questionnaires with three categories of patient self-report (including 'General Fatigue', 'Sleep/Rest Fatigue', and 'Cognitive Fatigue') and four categories of parent proxy-report (including 'Lack of Energy', 'Unable to Function', 'Altered Sleep', and 'Altered Mood'). The findings suggest that fatigue from both patient self-report and parent proxy-report changed significantly over time. The major findings from this study are that patients have more problems with fatigue in the first few days after the start of a cycle of chemotherapy. Corticosteroid use and haemoglobin value were associated with significant increases in fatigue that were sustained for several days and reached the highest level of fatigue at day 5 for those receiving concurrent steroids. The association of chemotherapeutic agents with fatigue varied between patient self-report and parent report, but the type of chemotherapeutic agents used was not associated with most changes in fatigue.
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Affiliation(s)
- C-H Yeh
- Graduate Institute of Nursing Science, Chang Gung University, Kwei-San, Tao-Yuen, Taiwan.
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