Ream, E., Gargaro, G., Barsevick, A., & Richardson, A. (2014). Management of cancer-related fatigue during chemotherapy through telephone motivational interviewing: Modeling and randomized exploratory trial. Patient Education and Counseling, 98, 199–206.
To report on using a fatigue intervention adapted for telephone use and the findings of an exploratory controlled trial
The Beating Fatigue intervention was delivered over the first three treatment cycles to patients starting chemotherapy. The intervention included fatigue education, fatigue assessment, self-care coaching, and emotional support. Participants were given an information packet, a fatigue diary, and a support nurse consultation with each treatment cycle. The modified version included a telephone consultation and motivation interviewing. The control group received usual care consisting of inquiring about fatigue levels. Phase 1 work was done to establish acceptability. In phase 2, patients were randomly assigned to intervention and control groups.
Mixed-method exploratory study; phase 1 to explore feasibility and acceptability of telephone-delivered version of intervention; phase 2 to measure treatment effect, patient acceptance, and treatment integrity
Fatigue intensity decreased in the intervention group and increased in the control group (effect size [ES] = 0.18). Distress and anxiety decreased in the intervention group and increased in the control group (ES = 0.62, ES = 0.31, p = 0.05), and self-efficacy increased in the intervention group and decreased in the control group (ES = -0.34, p = 0.05). Depression increased in both groups slightly.
Fatigue improvement was small based on the effect size. Interviews suggested the acceptance of telephone interventions by patients. Distress from fatigue was decreased for participants. The results of this study showed improvement in self-efficacy and anxiety with the intervention.
This nurse-delivered intervention may improve patient distress associated with fatigue and reduce fatigue severity. Motivational interviewing might be helpful in managing anxiety. Additional research to develop this evidence is needed.