Evaluation of Fatigue in Cancer Patients in An Area Affected by the Great East Japan Earthquake

Objective: The objective of this study is to evaluate fatigue in cancer outpatients receiving chemotherapy using an objective system and to clarify the type of nursing support needed after a disaster. Methods: Based on the diagnostic criteria for chronic fatigue syndrome, the degree of subjective fatigue, autonomic function, and amount of physical activity were measured in cancer outpatients undergoing chemotherapy from an area affected by the Great East Japan Earthquake. Results: The study participants were ten adults (8 men [80.0%] and 2 women [20.0%]). Significant differences were seen in subjective physical fatigue (P = 0.347), mental fatigue (P = 0.128), comprehensive fatigue (P = 0.621), and comprehensive evaluations (P = 0.293); however, no significant differences were seen in the results for changes over time for any survey item. The balance between sympathetic and parasympathetic nerve function changed statistically significant with time (log low frequency [LF] [P = 0.039] and log LF/high frequency [HF] [P = 0.021]). In all participants, autonomic nervous function was enhanced in the sympathetic nervous system, and the sympathetic nervous system was dominant. Significant differences were observed between the three measurements for mean diurnal activity (P = 0.027), total sleep time (P = 0.011), sleep efficiency (P = 0.019), awakening (P = 0.032), and naps (P = 0.037). Conclusions: In the event of a disaster, in addition to self-care support for side effects caused by anticancer drugs, patients' physical and mental conditions are assessed in terms of fatigue using objective indicators, and then, appropriate nursing support is provided. The nurse grasps objective facts behind the patient's subjective data and systematically recommends adjustments to the patient's daily life. In addition, by providing appropriate information to patients, patient education specific to each patient is provided.