Amanda Purcell

A multidimensional examination of correlates of fatigue during radiotherapy.

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.

Cancer-related fatigue: A review and a conceptual framework to guide therapists' understanding

Cancer-related fatigue is reported as the most common and distressing symptom experienced by people with cancer. There is limited research published to guide occupational therapists working with people with cancer to help address this distressing symptom. This article reviews literature on cancer-related fatigue and identifies several factors associated with the development of fatigue, including underlying medical factors and other factors. The underlying medical factors reported in the literature include biomedical mechanisms, such as anaemia, proinflammatory cytokines and specific cellular processes; disease-related factors; treatment-related factors; and comorbid conditions. Other factors reviewed include physical or behavioural factors, such as poor nutrition, decreased activity, sleep disturbance and pain; psychological factors, including anxiety and depression; and sociodemographic factors, such as social support, employment and education. The review identified a variety of factors associated with cancer-related fatigue, which must be considered by occupational therapists working with people with cancer. This presents a challenge to the clinical reasoning of occupational therapists attempting to treat such people. A framework of factors contributing to cancer-related fatigue is proposed in order to guide both the practice of occupational therapists working with adults with cancer and future research in this area.

Knowledge Translation in Cancer Services: Implementing the Research and Evidence in Practice Model

Occupational therapy lacks intervention effectiveness studies, which are crucial to the professions survival. Literature also describes problems in the translation of research findings into occupational therapy clinical practice. Despite this, there is limited information regarding specific organisational models of practice to facilitate both the generation and the translation of research evidence. In 2006, occupational therapists at the Princess Alexandra Hospital, Queensland, Australia, developed and implemented the Research and Evidence in Practice model. Over the past 5 years, the model has evolved to enable a more seamless and strategic approach to the generation and translation of evidence into practice. This practice analysis describes the current model, and provides a practical example from the cancer services clinical team to demonstrate its effectiveness.

Development of an Educational Intervention for Cancer-Related Fatigue

Introduction: Fatigue is one of the most common and disabling symptoms experienced during cancer treatment. Educational interventions are used by health professionals, such as occupational therapists, to manage cancer-related fatigue; however, there is a lack of information about the content, format and effectiveness of educational interventions in managing fatigue. This paper presents the development and structure of CAN-FIT, a theoretically driven cancer-related fatigue educational intervention, and a preliminary study of the interventions feasibility and acceptability. Preliminary evaluation: The CAN-FIT programme was piloted with two groups with a total of nine radiotherapy patients. Patients completed a confidential evaluation form and were asked qualitative questions to provide feedback about the programme. The results of the preliminary study indicated that the intervention was acceptable to and feasible for participants. The participants reported that they received a high level of new information and skills from the education sessions and would recommend the sessions to others. Small modifications to programme components were made based on participant feedback. Conclusion: The CAN-FIT programme provided a feasible structured educational intervention for the management of cancer-related fatigue, which was acceptable to the participant sample. A randomised controlled trial is required to provide evidence of its effectiveness among the wider radiotherapy population.

Measuring head and neck lymphedema: The “ALOHA” trial

There is no clinical assessment available to measure head and neck lymphedema. This study proposes the use of a tape measurement system and the MoistureMeterD (MMD) to evaluate head and neck lymphedema.

Compression use during an exercise intervention and associated changes in breast cancer-related lymphedema.

This study assessed the association between compression use and changes in lymphedema observed in women with breast cancer–related lymphedema who completed a 12‐week exercise intervention.

Educational interventions for the management of cancer-related fatigue in adults: A Cochrane Review

The current study aimed to improve the ecological validity of objective cognitive assessment in two ways: (1) by testing prospective memory, a type of cognition that involves remembering to carry out an action when there are distracting ongoing tasks, and (2) by using a virtual reality environment that is more similar to participants’ everyday cognitive challenges than standard neuropsychological tests. The study examined whether prospective memory (PM) performance among breast cancer survivors (BCS) exposed to chemotherapy differed from that seen in a demographically matched control group. Twenty-six female survivors of breast cancer who received chemotherapy that finished 0.5-5 years prior to the time of testing were compared with 25 age- and education-matched women with no history of cancer. Participants completed event-, time- and activity-based PM measures; standardized neuropsychological tests assessing attention and concentration, executive function and verbal memory; and self-report measures of cognitive dysfunction and PM failures. The BCS group showed significantly slower speed of processing on the test of attention and concentration as well as trends towards slower dual task performance. The BCS group reported significantly more cognitive complaints and PM failures than the control group on five of six self-report measures. The groups did not differ on other prospective memory or neuropsychological measures. PM tasks correlated significantly with both standard neuropsychological tasks and with self-reported cognitive function in everyday life. The results provide some evidence for correspondence between more ecologically valid objective measures and self-reported cognitive impairment following chemotherapy treatment. Further research into PM performance in this clinical group appears warranted.