Fatigue in Adolescents With Cancer: A Review of the Literature

Erickson, Jeanne M.

doi:10.1188/04.cjon.139-145

Cited by 31 publications

(26 citation statements)

References 21 publications

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“…All of the participants in the feasibility trial were actively being treated for cancer. Cancer treatment is known to be physically exhausting for adolescents [31,32] and could theoretically have adversely effected pain diary completion. Despite this potential adverse impact on reporting, the adolescents completed a large majority of pain assessments on a regular basis.…”

Section: Discussionmentioning

confidence: 99%

Development and Testing of a Multidimensional iPhone Pain Assessment Application for Adolescents with Cancer

Stinson¹,

Jibb²,

Nguyen³

et al. 2013

J Med Internet Res

266

219

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BackgroundPain is one of the most common and distressing symptoms reported by adolescents with cancer. Despite advancements in pain assessment and management research, pain due to cancer and/or its treatments continues to be poorly managed. Our research group has developed a native iPhone application (app) called Pain Squad to tackle the problem of poorly managed pain in the adolescent with cancer group. The app functions as an electronic pain diary and is unique in its ability to collect data on pain intensity, duration, location, and the impact pain has on an adolescent’s life (ie, relationships, school work, sleep, mood). It also evaluates medications and other physical and psychological pain management strategies used. Users are prompted twice daily at configurable times to complete 20 questions characterizing their pain and the app transmits results to a database for aggregate reporting through a Web interface. Each diary entry represents a pain case filed by an adolescent with cancer and a reward system (ie, moving up through law-enforcement team ranks, built-in videotaped acknowledgements from fictitious officers) encourages consistent use of the diary.ObjectiveOur objective was to design, develop, and test the usability, feasibility, compliance, and satisfaction of a game-based smartphone pain assessment tool for adolescents with cancer.MethodsWe used both low- and high-fidelity qualitative usability testing with qualitative semi-structured, audio-taped interviews and iterative cycles to design and refine the iPhone based Pain Squad app. Qualitative thematic analysis of interviews using constant comparative methodology captured emergent themes related to app usability. Content validity was assessed using question importance-rating surveys completed by participants. Compliance and satisfaction data were collected following a 2-week feasibility trial where users were alarmed to record their pain twice daily on the app.ResultsThematic analysis of usability interviews showed the app to be appealing overall to adolescents. Analyses of both low- and high-fidelity testing resulted in minor revisions to the app to refine the theme and improve its usability. Adolescents resoundingly endorsed the game-based nature of the app and its virtual reward system. The importance of app pain diary questions was established by content validity analysis. Compliance with the app, assessed during feasibility testing, was high (mean 81%, SD 22%) and adolescents from this phase of the study found the app likeable, easy to use, and not bothersome to complete.ConclusionsA multifaceted usability approach demonstrated how the Pain Squad app could be made more appealing to children and adolescents with cancer. The game-based nature and built-in reward system of the app was appealing to adolescents and may have resulted in the high compliance rates and satisfaction ratings observed during clinical feasibility testing.

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Section: Discussionmentioning

confidence: 99%

Development and Testing of a Multidimensional iPhone Pain Assessment Application for Adolescents with Cancer

Stinson¹,

Jibb²,

Nguyen³

et al. 2013

J Med Internet Res

266

219

View full text Add to dashboard Cite

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“…Lack of energy has been shown to be the most common symptom in children with cancer, with children placing emphasis on a sense of physical weakness, associating fatigue with disruption of sleep. 17 TYA cancer patients also appear to suffer from significant fatigue, [18][19][20] unsurprising given that even healthy teenagers and young adults have a propensity to experience fatigue. The developmental need for longer sleep during this important phase of brain maturation is hindered by circadian rhythm shifts and a tendency to develop unhelpful sleep habits.…”

mentioning

confidence: 99%

“…In one previous review of fatigue in teenagers in cancer published a decade ago, 20 Erikson found there was minimal research focusing on fatigue in this age range. Given the number of articles published since that review, it was decided to systematically appraise the current evidence base with a focus on the TYA age group.…”

mentioning

confidence: 99%

Teenage and Young Adult Cancer-Related Fatigue Is Prevalent, Distressing, and Neglected: It Is Time to Intervene. A Systematic Literature Review and Narrative Synthesis

Spathis

Grove

Hatcher

et al. 2015

Journal of Adolescent and Young Adult Oncology

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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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“…In studies assessing quality of life of adolescent and young adult survivors of cancer, 2 quality-oflife indicators appear as consistent areas of long-term difficulty for survivors: the experience of ongoing fatigue and pain and worry over medical late effects and recurrence. 26,27 Fatigue can make performing daily routines more difficult and may coexist, although not always, with insomnia, which often occurs because of repeated exposure to stress, depressed mood, and pain. 24,25 Fatigue is considered the most commonly reported symptom of cancer and its treatment, with rates varying from 75% to 100%, depending on the diagnostic criteria.…”

Section: Pain and Fatiguementioning

confidence: 99%