Cancer-Related Fatigue: Role of Oncology Nurses in Translating National Comprehensive Cancer Network Assessment Guidelines Into Practice

Abstract

Despite the availability of the National Comprehensive Cancer Network’s (NCCN) evidence-based practice guidelines for the assessment and management of Cancer-Related Fatigue (CRF), assessment of CRF still is not routinely performed at many institutions and oncology practice settings. Numerous patient-, provider-, and system-related barriers exist that hinder the translation of these guidelines into practice by oncology nurses and other health care providers. Oncology nurses can play vital roles in decreasing these barriers to promote the translation of these guidelines into practice to insure that CRF is routinely assessed, managed, and documented. This article briefly reviews the NCCN CRF guidelines for CRF assessment and discusses many of the common barriers that exist that hinder the translation of the CRF guidelines into practice settings. Current assessment/screening and measurement scales validated in patients with cancer are highlighted, and case studies reflect the vital roles that oncology nurses can play in the assessment, documentation, and ongoing monitoring of a patient with CRF.

Influence of Religious Beliefs on the Health of Cancer Patients

“…The physiological and mental distress and side effects caused by cancer treatment frequently prompt cancer patients to use complementary medicine to relieve symptoms and promote wellbeing (Harper & Littlewood, 2005;Molassiotis et al, 2005;Ganz & Bower, 2007). However, medical personnel often neglect and fail to provide adequate nursing measures (Piper et al, 2008). According to the NIH (2012b), cancer patients frequently require spiritual or religious care to cope with the diseases and expect medical teams to provide them with support.…”

Self-Reported Versus Objectively Assessed Exercise Adherence

“…Recruitment was facilitated through the longitudinal observational SLE Clinic Database and SLE in Gullah Health Database (Kamen et al, 2008) and conducted by a research coordinator. To be eligible for participation in the study, participants had to meet the following inclusion criteria: (1) female, age 18 yr or older; (2) self-identification as African-American; (3) diagnosed with SLE and fulfilling at least four of the revised American College of Rheumatology classification criteria for SLE (Hochberg, 1997); (4) ambulatory; (5) experiencing fatigue for the past 3 mo or longer as indicated by a rating of at least 4 (moderate fatigue) on a Fatigue Visual Analog Scale ranging from 0 to 10, with 10 being the most fatigue (Piper et al, 2008); (6) sedentary (exercise <3 times per week for 30 min in the past 6 mo); (7) functionally literate (i.e., able to read and follow exercise directions in English); and (8) having permission from their physician to participate in the study.…”

Is Increasing Physical Activity Necessary to Diminish Fatigue During Cancer Treatment? Comparing Cognitive Behavior Therapy and a Brief Nursing Intervention with Usual Care in a Multicenter Randomized Controlled Trial

“…Intervening with physical activity to reduce fatigue is based on the assumption that a lack of physical activity and deconditioning during cancer treatment can worsen fatigue [18]. When patients are diagnosed with cancer, their activity pattern changes and they become physically less active, possible leading to deconditioning [19]. This is the result of a negative spiral, because when patients become physically less active they become more easily fatigued, and when patients experience fatigue they react by becoming physically even less active.…”

“…There is evidence that such brief interventions for fatigue given by nurses are effective [15][16][17]. Furthermore, it is recognized that oncology nurses can play significant roles in the translation of cancer-related fatigue guidelines by teaching patients and decreasing barriers [19]. The second intervention was an extensive intervention aimed at fatigue based on cognitive behavior therapy (CBT).…”