Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue.

Abstract

Context-Fatigue is among the most common and distressing symptoms experienced by cancer patients.Objective-This systematic review and meta-analysis evaluates the efficacy of psychological and activity-based interventions against cancer-related fatigue in cancer patients. Data Sources-MEDLINE, PsycINFO, and CINAHL.Study Selection-Randomized controlled trials of psychological and activity-based interventions involving adult cancer patients in which fatigue was an outcome were reviewed.Extraction-Forty-one trials were reviewed and 30 were included in a meta-analysis.Data Synthesis-Fifty percent of psychological trials and 44% of activity-based trials rated fair or better in quality yielded significant findings favoring the intervention condition. Meta-analysis yielded an overall effect size of 0.09 (95% CI = .02 -.16) favoring nonpharmacological conditions. Further analysis indicated that effect sizes were significant for psychological interventions (d w = . 10, 95% CI = .02-.18) but not activity-based interventions (d w = .05, 95% CI = −.08 -.19).Conclusions-Findings provide limited support for use of nonpharmacological interventions to manage cancer-related fatigue. The lack of research with heightened fatigue as an eligibility criterion is a notable weakness of the existing evidence base. Keywordsfatigue; cancer; psychological interventions; activity-based interventions; randomized controlled trials Cancer-related fatigue has been defined as "a persistent subjective sense of tiredness related to cancer or cancer treatment that interferes with usual functioning" (Mock et al., 2000). Studies suggest it is among the most common symptoms experienced by cancer patients with advanced disease and those being treated with radiotherapy and chemotherapy (Ahlberg, Ekman, GastonJohansson, & Mock, 2003). Furthermore, fatigue does not appear to be limited to the active treatment period. Many individuals with no clinical evidence of disease continue to experience fatigue for months or even years following treatment completion (Servaes, Verhagen, & Bleijenberg, 2002). The clinical significance of fatigue has been examined primarily in terms of its impact on quality of life. Among patients treated with chemotherapy or radiotherapy, more than one third perceived that fatigue interfered with their ability to work, relationships with others, and physical and emotional well-being (Vogelzang et al., 1997). NIH Public AccessMechanisms involved in the development and persistence of cancer-related fatigue are only partially understood. Available evidence suggests that fatigue can occur as a consequence of metabolic changes associated with the underlying disease as well those induced by cancer treatments (Stasi, Abriani, Beccaglia, Terzoli, & Amadori, 2003). In addition, fatigue can occur as a concomitant of other common symptoms experienced by cancer patients (e.g., nausea, and pain; Stasi et al., 2003). A growing body of research also suggests that cognitive and behavioral factors may contribute to exacerbation and persistence...

Progressive Muscle Relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients’ receiving radiotherapy.

“…It affects the quality of life, interferes with ability to work, relationships with others, physical and emotional well-being. Now-a-days there has been growing interest in managing these symptoms with nonpharmacological treatments [8]. Piper et al conducted a study on role of oncology nurses in translating National comprehensive cancer Network (N.C.C.N) assessment guidelines into practice.…”

“…According to the cancer pain management guidelines of comprehensive cancer network, cognitive behavioral coping strategies are recommended as an adjuvant to analgesic medicines [10]. Moreover patients also prefer non pharmacological methods for management of problems over pharmacological methods [8]. Progressive muscle relaxation (P.M.R) being one of the non invasive techniques, can be of great help.…”

Selected determinants of strategies to cope with the disease among women treated for gynecological cancer

“…This attitude consists of the behavior of both the escape and confrontational type. In the literature there are reports saying that people taking the attitude of fighting spirit have a higher survival rate as well as the absence of disease with the passage of 5-10 years after the diagnosis of cancer [3,11].…”

“…The sick woman creates her own personal image of disease, ranging from diagnosis through the entire therapy. In the treatment process, it is important to learn how to function with the illness, how to attain the recovery and how to develop a style of coping with difficulties [1][2][3].…”

Meta-analysis of Psychological Interventions on Breast Cancer Patients' Immune Function

“…There are ten meta-analyses examining the effectiveness of various psychological interventions for cancer patient since the year 2000 [14][15][16][17][18][19][20][21][22][23].Overall, these meta-analyses report promising result on the effectiveness of psychological interventions for improving quality of life, alleviating anxiety and depression, controlling pain and fatigue. Only one study examined the effectiveness of various psychological interventions for enhancing immune function [22].…”