Journal Critique on Fatigue 1

Running Head: JOURNAL CRITIQUE ON FATIGUE

Journal Critique on Fatigue

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Journal Critique on Fatigue

There is a general consensus among most doctors and a number of people that nurses can take

doctors’ role in case of several minor problems faced by patients. Cases of primary illness are

usually dealt by nurses with an experience and ease that is second only to a clinician. This

practice by nurses not only reduces the cost of treatment but may also helps in freeing the

doctors for more important issues to address.

What a Nurse Can Do without Doctor’s Help for a Patient Experiencing Fatigue

Summary of the Article - Clark, P, M. (2001). Exercise in Cancer-Related Fatigue

Management, 26th Congress of the Oncology Nursing Society. © 2001 Medscape Portals,

Inc.

Fatigue is a common experience for patients undergoing treatment for cancer and it has been

reported by 60% to 100% of patients. Cancer-related fatigue is different from normal

tiredness as it appears suddenly; its nature is overwhelming, and its response to rest is

refractory. Most of the oncology nurses are well aware that fatigue is a common complaint in

cancer patients but the best way to assess and treat this incapacitating symptom is still vague.

Assessment may be mystified by coupled symptoms and the etiology of fatigue in cancer

patients is still obscure. Treatments for cancer have all been linked to some extent with

fatigue when used alone or in combination. Chronic symptoms of pain, nausea, vomiting,

diarrhea, and constipation have been identified as an aggravating factor in fatigue. Certain

physiologic changes like dehydration, electrolyte imbalances, acid-base disturbances,

hypoxia, neurologic toxicities, cardiac abnormalities, dizziness, and fever, normally linked

with cancer and its treatment, may also cause fatigue include. Anemia has been identified as

one of the more common causes of fatigue.

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Exercise Intervention for Fatigue

An exercise program like a progressive moderate intensity walking program that allows

patients to reach 60% to 80 % of their maximum heart rate could be used as a primary

exercise. This usually consists of 20 to 30 minutes of walking 5 to 6 times per week

and began in tandem with chemotherapy or radiation therapy.

Strongly positive correlations were found between fatigue and exercise. Pain and fatigue as

well as sleep and fatigue were strongly and positively correlated. Emotional distress and

symptom experience had a negative correlation. Physical functioning and quality of life

improved substantially. Even a minimal level of exercise improved fatigue and overall well

being as measured by Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F)

questionnaire. Another study suggests that facilitating hope in women with breast cancer may

lessen the negative effects of fatigue on psychosocial adjustment.

Personal Views about the Article

Evidence-based interventions have been studied primarily in only small populations of breast

cancer patients. Fatigue and its treatment were explored in several research studies presented

at the 26th Congress of the Oncology Nursing Society, held May 17-20, 2001, in San Diego,

California. A significant number of women (40%) in the control group were actually

exercising at a level equivalent to the experimental group. Continued research in exercise and

fatigue management will provide clinicians with evidence-based, low-cost, easy to teach,

practical tools to share with patients who want to proactively battle the most common

symptom of cancer treatment. Ruth McCorkle, RN, PhD, Professor at Yale University School

of Nursing, New Haven, Connecticut, summed it up when she said, "These results signify a

paradigm shift from recommending that patients rest during treatment to recommending
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exercise. This is a challenge to conventional wisdom." (Mock V, Pickett M, Ropka M,

Poniatowski B, Drake B. Fatigue in patients with cancer: an exercise intervention -- report on

the FIRE® project.)

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Reference

Clark, P, M. (2001). Exercise in Cancer-Related Fatigue Management, 26th Congress of the

Oncology Nursing Society. © 2001 Medscape Portals, Inc. Retrieved October 27,

2008 at http://www.medscape.com/viewarticle/418576

Mock V, Pickett M, Ropka M, Poniatowski B, Drake B. (2001). Fatigue in patients with

cancer: an exercise intervention -- report on the FIRE® project. Program and abstracts

of the 26th Congress of the Oncology Nursing Society; May 17-20, 2001; San Diego,

California. Discussion Session.