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Symptom Management and Supportive Care

Patient-Related Barriers to Fatigue Communication in Cancer Patients Receiving Active Treatment

Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan

Key Words. Cancer • Active treatment • Barriers • Fatigue

Correspondence: Shiow-Ching Shun, R.N., Ph.D., No. 1, Jen-Ai Road Sec. 1, Taipei 100, Taiwan. Telephone: 886-2-23123456, ext. 88439; Fax: 886-2-23219913; e-mail: scshun{at}ntu.edu.tw

Received March 16, 2009; accepted for publication August 17, 2009; first published online in THE ONCOLOGIST Express on September 8, 2009.

Disclosures: Shiow-Ching Shun: None; Yeur-Hur Lai: None; Fei-Hsiu Hsiao: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors or independent peer reviewers.

Objective. To explore barriers to reporting fatigue in cancer patients receiving active treatment and the significant factors associated with those barriers from fatigue characteristics (i.e., intensity, duration, and interference with daily life), to demographic characteristics and disease/treatment variables.

Methods. Patients with various types of cancer (n = 288) were recruited from an outpatient chemotherapy center, and from seven oncology and hematology units in a teaching hospital in northern Taiwan. Data were collected using the Fatigue Management Barriers Questionnaire to explore barriers to fatigue communication.

Results. Fear of distracting the doctor was rated as the highest barrier of reporting fatigue. The degree of fatigue interference with daily life by patients was associated with the willingness to report fatigue. Patients with gastrointestinal cancer experienced more barriers to reporting fatigue than those with hematological cancer. Patients without religion perceived the highest level of barriers to fatigue communication. Outpatients had higher levels of concern than inpatients.

Conclusions. Discussion with patients about their high level of perceived fatigue barriers before implementing patient education is recommended. Assessing fatigue interference with daily life and identifying factors associated with barriers to reporting fatigue (i.e., type of cancer, religion, and the setting for receiving treatment) are suggested in order to provide better fatigue management in clinical settings.