Predictors of the Trajectories of Self-Reported Attentional Fatigue in Women With Breast Cancer Undergoing Radiation Therapy (original) (raw)
Cancer Nursing, 2016
Breast cancer survivors (BCS) have identified attentional fatigue as a frequent and troublesome symptom during and following treatment. 1-4 The ability to pay attention is necessary to complete tasks and activities, and problem solve. Attention requires ongoing mental effort. For BCS, the prolonged or intense use of attention to address the competing mental demands associated with illness, treatment and daily life activties, can lead to attentional fatigue and result in decreased effectiveness in activity. 5 Attentional fatigue, a domain of cognitive function, is often used interchangeably with the terms cognitive dysfunction,cognitive impairment, cognitive fatigue or tiredness. Seminal research, however, delineates attentional fatigue from these other concepts by describing attentional fatigue as a measurable decrease in an individual's ability to focus and concentrate or to block out distractions when carrying out meaningful activities. 6 Hallmark indicators of attentional fatigue are: increased distractibility, difficulty following a train of thought or carrying out usual day-today activities, lapses in working memory, and increased impatience or frustration in personal interactions. 7 Although the two may coexist, physical and attentional fatigue differ in that an individual may not be physically tired but has a reduced ability to exert mental effort. 8 Researchers have noted that BCS incur attentional fatigue more than age-matched controls 9 and prostate cancer patients. 10 Merriman and colleagues, 11 found that up to 63% of
Clinical Nurse Specialist, 2018
The purpose of this study was to examine the incidence of attentional fatigue and the relationship between sleep disturbance and attentional fatigue in working long-term breast cancer survivors (BCS). Methods: A descriptive, correlation design was used. The data for this study were drawn from a larger descriptive study designed to understand the impact of cognitive dysfunction on work-related outcomes. Breast cancer survivors completed questionnaires regarding sleep disturbance, attentional fatigue, and demographic and medical characteristics. Sleep disturbance, a subscale of the Pittsburgh Sleep Quality Index, is measured by asking 9 questions about sleep disturbances. Attentional fatigue was measured by the Attentional Function Index. Descriptive statistics and multiple regression were performed to assess the impact of sleep disturbance on attentional fatigue, controlling for covariates. Results: Sixty-eight female BCS, ranging from 29 to 68 years old (mean [SD], 52.1 [8.6] years old) and, on average, 4.97 (SD, 3.36) years posttreatment, participated. Thirty-four percent of BCS had poor to moderate attention function. Sleep disturbance significantly predicted attentional fatigue (P G .05), explaining 16% of the variance, F 4,57 = 2.68, P G .04, R 2 = 0.16. Conclusions: Clinicians can assess and intervene to decrease sleep disturbance, which may also improve attentional fatigue in BCS. However, sleep disturbance is only 1 contributing factor. Further investigation into factors contributing to attentional fatigue in BCS is warranted.
Course of fatigue in women receiving chemotherapy and/or radiotherapy for early stage breast cancer
Journal of Pain and Symptom Management, 2004
Although much has been learned about the complication of fatigue during breast cancer treatment, the possibility that there are differences across treatment modalities in breast cancer patients' experience of fatigue has not yet been established. In this study, fatigue was assessed in 134 women receiving chemotherapy and radiotherapy or radiotherapy only for early stage breast cancer. Comparisons of fatigue during initial treatment indicated that women who received chemotherapy reported greater fatigue severity and disruptiveness than women receiving radiotherapy. Women not pre-treated with chemotherapy experienced increased fatigue over the course of radiotherapy. Results confirmed predictions that fatigue in women with early stage breast cancer differs as a function of the type of treatment and sequencing of treatment. Findings indicating increases in fatigue during radiotherapy only among women not pretreated with chemotherapy suggest a response shift, or a change in internal standards, in women's perceptions of fatigue as a function of prior chemotherapy treatment.
Revista brasileira de enfermagem, 2018
To evaluate the accuracy of the defining characteristics of the nursing diagnosis for "fatigue in women with breast cancer under radiotherapy". Study of diagnostic accuracy, with cross-sectional design, performed in 130 women with breast cancer under radiation treatment. A data collection instrument was used to evaluate clinical socio-demographics and to investigate the presence or absence of defining characteristics for fatigue. The latent class analysis model was applied to assess accuracy measurements of the characteristics identified. Fatigue diagnosis was present in 21.9% of the women. The characteristic which showed the highest sensitivity was "Impaired capacity in maintaining the usual level of physical activity", while "Impaired capacity in maintaining usual routines" and "Lack of interest about the surrounding environment" presented greater specificity. Accurate diagnostics allow devising an action plan directed to the patients' r...
A multidimensional examination of correlates of fatigue during radiotherapy
Cancer, 2010
BACKGROUND: Cancer-related fatigue can be measured as both a unidimensional and a multidimensional construct. Unidimensional fatigue and its symptom correlates have undergone some previous investigation; however, minimal research has considered the differential effect of correlates on individual dimensions of fatigue. The objective of the current study was to investigate cancer-related fatigue in a radiotherapy sample using a multidimensional conceptualization to determine whether correlates of fatigue are consistent across all dimensions or whether each fatigue dimension has its own unique pattern of correlates. METHODS: The study used a prospective cohort design with data collected from radiotherapy patients at 3 time points; before, after, and 6 weeks after radiotherapy treatment. RESULTS: A total of 210 participants were enrolled in the study. Results indicated the following relations. Increased general fatigue was found to be associated with lower performance status, being in a de facto relationship, depression, having treatment to the brain, and reduced vigorous physical activity. Increased physical fatigue was associated with lower performance status, depression, reduced physical activity, reduced productive hours, and nausea. Higher levels of reduced activity were associated with depression, decreased participation in activities of daily living, decreased number of productive hours, and lower performance status. Higher levels of reduced motivation were associated with radiotherapy to the brain, reduced moderate physical activity, and depression. Increased mental fatigue was associated with diagnosis of a brain tumor, anxiety, depression, and sleep problems. CONCLUSIONS: The results of the current study support the recognition of multiple dimensions of fatigue, because each dimension examined had various correlates. These findings further develop our understanding of fatigue and may help clinicians provide more targeted information to people with cancer-related fatigue. Furthermore, these results can guide the development of group or individually tailored interventions that ultimately may reduce the impact of this distressing symptom on people with cancer. Cancer 2010;116:529-37.
Factors predicting fatigue in breast cancer patients
Supportive Care in Cancer, 2003
A prospective study was designed to investigate the factors predicting fatigue in breast cancer patients using the Cancer Fatigue Scale (CFS) in addition to the Hospital Anxiety and Depression Scale (HADS) and a questionnaire containing items on demographic and clinical data, and measures of patients' physical symptoms. The CFS measures total fatigue score ranging from 0 (lowest level) to 60 (highest level) and contains three subscales namely: physical, affective and cognitive fatigue. The questionnaires were administered to a consecutive sample of breast cancer patients attending the Iranian Center for Breast Cancer either for their treatment or follow-up examination. In all, 112 patients were studied. The mean age of the respondents was 45.7 years (SD11.0). Most had stage II breast cancer (67%) and had completed their initial treatment (45%). The mean total fatigue score of the pa-
Development and Validation of the Cancer Fatigue Scale
Journal of Pain and Symptom Management, 2000
We herein describe the development and validation of the Cancer Fatigue Scale (CFS) for assessment of fatigue in cancer patients. We designed this scale specifically to reflect the nature of fatigue experienced by cancer patients, by using factor analysis; the CFS is a 15-item scale composed of 3 subscales (physical, affective, and cognitive subscales). Three hundred seven cancer patients participated in the validation phase. Construct validity, confirmed by repeating factor analysis, was good. Convergent validity, confirmed by a correlation between CFS and a visual analogue scale for fatigue, was also shown to be good (r ϭ 0.67, P Ͻ 0.001). The CFS had good stability (average test-retest reliability r ϭ 0.69, P Ͻ 0.001) and good internal consistency (Cronbach's alpha coefficient for all 15 items ϭ 0.88). The present study indicates that the CFS is a brief, valid, and feasible measure of fatigue for use with cancer patients.
Journal of Pain and Symptom Management, 2009
Fatigue is a common consequence of cancer chemotherapy and radiotherapy. Investigation of the impact of cancer treatment on fatigue is compromised by a potential ''response shift'' in fatigue ratings, involving a recalibration of a respondent's internal standard used to judge their current fatigue experience. Using a prospective, longitudinal research design, repeated assessments of most and average fatigue were obtained from women (n ¼ 102) with early stage breast cancer receiving adjuvant chemotherapy and/or radiotherapy. Thentest ratings of fatigue were also obtained and used to index the presence of a response shift in fatigue ratings. Results suggested a clinically significant response shift in ratings of most and average fatigue of approximately one-half standard deviation. Multiple regression analyses suggested larger response shifts were associated with higher pretreatment fatigue ratings, receipt of chemotherapy, and lower fatigue catastrophizing. Most importantly, consideration of the observed response shift in fatigue ratings significantly altered the conclusions drawn regarding the magnitude and persistence of fatigue during and after adjuvant therapy for breast cancer.