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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between July 1999 to November 2000, 115 patients undergoing radiotherapy were evaluated for the development of treatment-related fatigue, using a modified Piper's fatigue scale. The above scale determines 4 dimensions of fatigue ie behavioral severity (6 items), affective meaning (5 items), sensory (5 items), and cognitive mood (6 items). Radiotherapy was delivered to the head and neck, breast, pelvis, and miscellaneous sub-sites. The area of the radiation field ranged from 25 to 480 cm2 (median 156 cm2). Forty-three percent of patients experienced significant fatigue, which altered their work environment. The individual components of fatigue were behavioral severity 25%, affective meaning 21%, sensory 18%, and cognitive mood 16%. Significant radiotherapy-related fatigue was higher in patients treated with advanced-stage disease, large radiotherapy field area, and low pre-radiotherapy hemoglobin level.
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PMID:Prevalence of fatigue among cancer patients undergoing external radiotherapy. 1569 Nov 57

The purpose of this study was to test whether modafinil is effective in alleviating the symptoms of fatigue in postpolio patients, because it has been helpful for such symptoms in other neurologic disorders. Using a double-blind, randomized, placebo-controlled cross-over design, 14 postpolio patients with moderate to severe fatigue were assigned to receive modafinil or placebo first. Piper Fatigue Scale, Epworth Sleepiness Scale, digit span, and reaction time tests were done at baseline and then at weekly intervals. The Piper Fatigue Scale scores improved by 27 +/- 40% (mean +/- SD) following modafinil and by 43 +/- 36% following placebo. Scores for most of the other tests did not change during the study. Therefore, we conclude that modafinil was not effective in alleviating the symptoms of fatigue in postpolio patients.
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PMID:Randomized controlled trial of modafinil for the treatment of fatigue in postpolio patients. 1617 27

This study prospectively evaluated quality of life (QOL) in localized prostate cancer patients undergoing radiotherapy, and it examined the relationships between QOL, depression, fatigue, and sleep disturbance. Instruments that were used are Functional Assessment of Cancer Therapy for Prostate (FACT-P), Beck Depression Inventory (BDI), Piper Fatigue Scale (PFS), and Epworth Sleepiness Scale (ESS). We evaluated patients at preradiotherapy (PRT), midway radiotherapy (MRT), completion of radiotherapy (CRT), follow-up radiotherapy (4 to 8 wk) (FRT), and long-term follow-up radiotherapy (FRT2) (12 mo or more). Forty participants with a mean age of 67.8 yr were studied. Duration of radiotherapy was 7-8 wk. Mean long-term follow-up period post-CRT was 16.2 mo (range 12- 24 mo). All patients had clinical T1c to T2b prostate cancer. Prostate Cancer Specific (PCS) and Physical Well-Being (PWB) subscales of FACT-P, scores at MRT and CRT were significantly lower than at PRT. At FRT2, PWB scores declined further, while PCS scores increased. PFS median scores were significantly higher at CRT and at FRT2 as compared with PRT. Patients scoring higher on PFS were more likely to report a poorer QOL and PWB as measured with FACT-P questionnaire. No significant changes were noted in the BDI and ESS scores during the study periods. The PWB declined during and at CRT and worsened at FRT2. Decline in PCS subscale scores during and at CRT reflects worsening of urinary symptoms and appearance of bowel problems. The scores improved at long-term follow-up. A relationship was found to exist between physical well-being and fatigue.
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PMID:Longitudinal study of quality of life in patients with localized prostate cancer undergoing radiotherapy. 1618 51

Undergoing a course of radiation therapy for cancer does not preclude the need to work during treatment. This study examines the impact of sick leave benefits, individual characteristics, and fatigue on employment during radiation therapy. The conceptual model of nursing and health policy (CMNHP) and the Piper integrated fatigue model (IFM) guided this study. Seventy-seven study participants receiving radiation therapy were recruited from one community hospital. The study employed a prospective, longitudinal design. Data were collected at baseline prior to starting radiation therapy, weekly during treatment, and at the 1-month follow-up visit. Only 49% of study participants had paid sick leave benefits available at the start of radiation. Age, pain, gender, side effects, availability of sick leave benefits, and fatigue were associated with work along the trajectory of radiation therapy. Further research addressing the impact of paid leave policies on the relation between work and cancer-related fatigue is warranted.
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PMID:Policy implications of the relationship of sick leave benefits, individual characteristics, and fatigue to employment during radiation therapy for cancer. 1644 85

The aim of this study was to translate and culturally adapt the revised Piper Fatigue Scale to Swedish. For translation, guidelines for cross-cultural adaptation were used. Two teams independently translated the instrument and two other teams produced back-translations, after which a multidisciplinary committee decided on a Swedish version. In pre-test interviews, ten cancer patients were encouraged to think out loud while completing the Swedish version. Their verbal responses were analysed and used for a second revision. The initial translations varied in words, expressions and grammar, shown in a lack of equivalence to the original instrument after back-translation. In order to establish semantic equivalence, the committee changed some grammatical constructions, and some words were replaced for experiential and conceptual equivalence. When analysing the pre-test, obscurities due to the phrasing of some items were revealed and dealt with in the second revision. This study does not fulfil the process of validation for a translated instrument but offers a sound basis for further accumulation of evidence for validity, and facilitates the choice of an appropriate instrument for studying cancer-related fatigue in Sweden.
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PMID:Translation and cultural adaptation of the Piper Fatigue Scale for use in Sweden. 1681 6

The purpose of this study was to determine the course of the activity level, seen as a dimension of fatigue, as a function of chemotherapy within a breast cancer population receiving adjuvant chemotherapy. The second purpose of this study was to determine the course of the interference of fatigue, in general, with daily activities within a breast cancer population receiving adjuvant chemotherapy. In a prospective cohort study, a sample of 157 patients with breast cancer was interviewed, at the first, third, and fifth cycle of adjuvant chemotherapy as well as 4 and 12 weeks after the last cycle of adjuvant chemotherapy. The chemotherapy was administered with either a doxorubicin-containing schedule or cyclophosphamide, methotrexate, and 5-fluorouracil. These 2 groups were compared. The activity level was measured by the Multidimensional Fatigue Inventory. A linear multilevel model was used to analyze the course. The revised Piper Fatigue Scale was used to examine the behavioral changes in the interference of fatigue with activities of daily living. A logistic multilevel model was used to analyze the course of this interference over time. The activity level seems to be rather stable during the treatment with chemotherapy. After the completion of chemotherapy, an improvement is observed. The activity levels reported at the first and the last measurement do not significantly differ. The course of the activity level is not affected by the type of chemotherapy regimen. Age, having children, and the stage of breast cancer turn out to be important determinants of the course of activity level. At all measurement occasions, women with a mastectomy were significantly more hampered in their activity level than women that had undergone a lumpectomy. The longer the duration of radiotherapy, the less active, and the longer the time interval between the last radiotherapy session and the measurement point, the more active patients were at that measurement point. A phenomenon not easy to explain is that the activity level in women who had received, in total, more chemotherapy treatments was significantly less diminished than those who had received fewer treatments. During the study period, in approximately 15% to 35% of the sample, fatigue interferes considerably with their daily living activities. Furthermore, the interference of fatigue with activities in daily life first increases after the start of chemotherapy and decreases after the completion of chemotherapy. Fatigue definitely affects the daily living activities of patients with breast cancer receiving adjuvant chemotherapy. With this knowledge, healthcare providers can inform patients on what they can expect. Further research should include the trajectory preceding chemotherapy and a healthy control group.
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PMID:Course of the fatigue dimension "activity level" and the interference of fatigue with daily living activities for patients with breast cancer receiving adjuvant chemotherapy. 1700 5

The Revised Piper Fatigue Scale (R-PFS) is an instrument designed to measure subjective fatigue that was developed in samples with physical illness. Its psychometric properties in nonclinical samples are unknown. The purpose of this study was to examine the psychometric properties of the R-PFS in a sample of caregivers of stroke survivors. The convenience sample of 132 caregivers was primarily women (74%), White (71%), college-educated (73%), and employed (52%), with a mean age of 56.7 years (SD = 13.71). Internal consistency reliabilities for the four R-PFS subscales and the total scale were excellent, ranging from .90 to .97. Principal axis factor analysis with oblique rotation was conducted to examine construct validity of the R-PFS. A three-factor solution explained 75.9% of the common variance. Two factors totally replicated the behavioral/severity and affective meaning subscales of the R-PFS. The third factor incorporated a combination of Piper's sensory and cognitive/mood subscales and appeared to summarize how fatigue makes the caregiver feel. The R-PFS demonstrated strong internal consistency reliability and construct validity in this sample. However, data suggest that caregivers may perceive certain feelings associated with fatigue as conceptually similar when these feelings are conceptually distinct in Piper's breast cancer sample. The study supports the need for psychometric evaluation of instruments developed in clinical populations prior to their use in nonclinical populations.
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PMID:Factor analysis of the Revised Piper Fatigue Scale in a caregiver sample. 1708 81

Fatigue associated with cancer may be present at any stage of the disease; its characteristics vary depending on the type and the duration of treatment, the presence of side effects and the reactions from patients. Often associated with other symptoms (pain, nausea, vomiting, anxiety, stress etc.), fatigue affects the daily life of patients as much as or even more than pain. This multi-factored and annoying symptom is linked to physical, cognitive and affective functioning, which must be assessed (Piper fatigue scale). Beside the medical management, nursing research found four efficient interventions to reduce fatigue: educating patients and their families, programming physical conditioning and activities to restore the attention, improving diet, hydration and sleep. The pluridisciplinary management of this symptom is a key factor to a better quality of life.
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PMID:[Management of fatigue in oncology]. 1727 8

Fatigue is the most prevalent and distressing symptom experienced by patients receiving adjuvant chemotherapy for early stage breast cancer. Higher fatigue levels have been related to sleep maintenance problems and low daytime activity in patients who have received chemotherapy, but knowledge describing these relationships prior to chemotherapy is sparse. The Piper Integrated Fatigue Model guided this study, which describes sleep/wake, activity/rest, circadian rhythms, and fatigue and how they interrelate in women with Stage I, II, or IIIA breast cancer during the 48 hours prior to the first adjuvant chemotherapy treatment. The present report describes these variables in 130 females, mean age=51.4 years; the majority were married and employed. Subjective sleep was measured by the Pittsburgh Sleep Quality Index and fatigue was measured by the Piper Fatigue Scale. Wrist actigraphy was used to objectively measure sleep/wake, activity/rest, and circadian rhythms. Mean Pittsburgh Sleep Quality Index score was 6.73+/-3.4, indicating poor sleep. Objective sleep/wake results were within normal limits established for healthy individuals, except for the number and length of night awakenings. Objective activity/rest results were within normal limits except for low mean daytime activity. Circadian rhythm mesor was 132.3 (24.6) and amplitude was 97.2 (22.8). Mean Piper Fatigue Scale score was 2.56+/-2, with 72% reporting mild fatigue. There were significant relationships between subjective and objective sleep, but no consistent patterns. Higher total and subscale fatigue scores were correlated with most components of poorer subjective sleep quality (r=0.25-0.42, P< or =0.005).
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PMID:Values of sleep/wake, activity/rest, circadian rhythms, and fatigue prior to adjuvant breast cancer chemotherapy. 1739 1

The purpose of this study was to describe (a) the subjective feelings of fatigue of Thai Buddhist cancer patients undergoing radiation therapy (RT) and identify possible gender differences, (b) their beliefs about the main cause of fatigue, and (c) their ways of self-management for relief of fatigue. One hundred thirty-three voluntary and randomly selected patients, 55 men and 78 women, completed a questionnaire with a Thai version of the Revised Piper Fatigue Scale. After 1 week of treatment, the largest group (42.1%) of the patients had felt fatigue during the last few hours (from 1 to 5 hours). The patients perceived a mild level of fatigue, but the sensory/cognitive fatigue scores were high. Five categories of beliefs about the main cause of fatigue emerged: (a) receiving RT; (b) feelings of anxiety, depression, and fright/fear; (c) cancer; (d) long travel to hospital and long waiting time for RT; and (e) difficulty with sleep and weak body. For relief of fatigue, 5 categories of self-management emerged: (1) getting moral support from family and friends; (2) practicing religion, reciting prayers, doing merit, and meditating; (3) practicing self-care for symptomatic problems; (4) accepting the situation and doing the best of one's life; and (5) consulting with doctor and nurse. In conclusion, healthcare providers need to be concerned about RT patients' symptoms of fatigue, beliefs about causes of fatigue, and ways of self-management for relief of fatigue. They also need understanding of cultural and religious beliefs to plan holistic care.
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PMID:Experiences of fatigue and self-management of Thai Buddhist cancer patients undergoing radiation therapy. 1741 80


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