Cancer-related fatigue -: Suffering a different fatigue

PURPOSE: The purpose of this naturalistic inquiry was to understand, from the patient's perspective, the differences between cancer-related fatigue (GRF) and "typical" fatigue and to describe it's impact on their lives. DESCRIPTION OF STUDY: The sample consisted of 17 adult patients with cancer who agreed to participate, yielding 23 in-depth audio-taped interviews. Participants included inpatients and outpatients from a dedicated cancer center and a Veterans Affairs Hospital. Symbolic interaction was the framework used for the interviews to understand how individuals and groups construct and discover the meaning of events. Transcribed data were coded by distress category to classify the textual information and to reduce the text to more relevant and manageable bits of data. Five to 10 representative excerpts from each coding category were chosen and were coded independently by a second coder to evaluate intercoder reliability. RESULTS: GRF was found to be more rapid in onset, more energy draining, more intense, longer lasting, more severe, and more unrenting when compared with "typical" fatigue GRF caused distress in the physical, social, spiritual, psychological, and cognitive domains of the participants' lives. All participants agreed that GRF was different than the typical fatigue of everyday life. CLINICAL IMPLICATIONS: This study's findings indicate that because of this different fatigue, GRF, participants did not just experience the symptom, but they suffered with it. The current oncology literature and texts do not portray the morbidity in this study. These data can be used as part of an experiential teaching guide to assist healthcare students and practioners in understanding the CRF experience. This increased awareness will afford clinicians a better foundation for implementing management strategies. A GRF distress instrument is in development based on these data.