Creating Individualized Symptom Management Goals and Strategies for Cancer-Related Fatigue for Patients With Recurrent Ovarian Cancer

Abstract

Background Cancer-related fatigue (CRF) is one of the most common symptoms among women with recurrent ovarian cancer, yet it remains extremely difficult to manage. Symptom management typically requires patients to set goals and strategies to manage their CRF, but little is known about how to create individualized CRF symptom management goals and strategies. Objective To describe cancer patients’ goals and strategies for managing cancer-related fatigue along with their process of individualizing both. Methods This study is a qualitative analysis with supportive quantitative description of a web-based symptom management RCT, the WRITE Symptom Study. Researchers conducted a content analysis on N=47 participants’ CRF symptom care-plans to identify common themes in participants’ goals, categorize strategies, and describe the individualization process. Results Four general themes were identified among participants’ CRF goals: 1) Enjoying time with friends and family, 2) Doing the things I enjoy, 3) Having energy to be physically active, and 4) Keeping up with what I need to do. CRF strategies were categorized into 13 groups including conserving energy, increasing activity, and talking with healthcare providers. A multistep individualization process resulted in personally-meaningful strategies. Conclusions The process by which participants individualized their CRF strategies consisted of identifying, confirming, testing, and evaluating different CRF strategies and resulted in refined, specific and individualized strategies intended to eventually ensure participants achieve their goal. Implications for Practice Clinicians can assist patients in individualizing their CRF goals and strategies. Individualization of CRF goals and strategies assists patients in visualizing how improving CRF will impact their life.

Experiencing and responding to chronic cancer‐related fatigue: A meta‐ethnography of qualitative research

“…Concurrence was reached to exclude four extra articles, based on article type (brief report) or deductive qualitative methodology (secondary data‐analysis or testing a model) . Finally, we included 16 studies in the meta‐ethnography . Study characteristics are summarised in Table S2.…”

“…Data of healthy subjects and other patient groups were excluded from analysis. Some studies were part of larger projects or did not have qualitative data collection methods (eg, blogs) . Quality appraisal by CASP criteria resulted in varying quality (scores 16‐28 points) (Table S3).…”

“…Quality appraisal by CASP criteria resulted in varying quality (scores 16‐28 points) (Table S3). All studies clearly described the aims of the research and rationale for the qualitative methodology . The majority, however, did not adequately consider the relationship between authors and participants .…”

“…Patients were reluctant to talk about their fatigue in general which contributed to the “misrecognition” of fatigue . As patients were often not informed about CCRF by health care professionals, they did not recognise their symptoms of CCRF .…”

Representational Approach: A Conceptual Framework to Guide Patient Education Research and Practice

“…In the next study, the researchers compared the nurse-delivered WRITE Symptoms to a computer-mediated WRITE Symptoms in which an Internet-based program led women through the same process without individualization from a nurse (selfdirected WRITE). Preliminary analyses suggest that participants desired interaction with an expert who could provide advice and guidance (Hagan, Arida, Hughes, & Donovan, 2016). Current research is testing a caregiver intervention, SmartCare (based on the RA) to address the unmet needs of family caregivers of patients with a primary malignant brain tumor.…”