2.50
Hdl Handle:
http://hdl.handle.net/10755/165659
Category:
Abstract
Type:
Presentation
Title:
Fatigue Management In Blood And Marrow Transplantation
Author(s):
Cohen, Marlene
Author Details:
Marlene Cohen, PhD, Distinguished Professor, University of Texas Health Science Center-Houston, School of Nursing, Houston, Texas, USA, email: Marlene.Z.Cohen@uth.tmc.edu
Abstract:
Blood and marrow transplantation (BMT) has evolved from an experimental procedure to an established and effective treatment for several types of cancer. The success of BMT, patients' survival, and quality of life are related to successful symptom control. Patients in several studies have rated their quality of life (QOL) positively, despite experiencing psychosocial and physical sequelae such as fatigue, anxiety, pain, sexual dysfunction, depression, sleep disturbances, inability to return to work, and fear of relapse or death. It is important to distinguish between symptom prevalence and perceived quality of life and to understand why patients rate QOL positively in spite of symptoms. Despite the tremendous distress that symptoms can cause, systematic and complete symptom assessment is not consistently a part of routine cancer care. Because a pilot study revealed fatigue was the most prevalent and severe symptom reported by BMT patients, an interdisciplinary team developed a fatigue management protocol. The study was based on the M.D. Anderson Pain Research Groups' symptom management framework. The protocol, based on current evidence for relief of cancer related fatigue, included education, counseling, exercise, stress management, distraction and energy conservation interventions. To assess the protocol, data were collected on 49 BMT patients before implementing the protocol and weekly for two additional weeks. Of these patients, 45% were females, 70% were married, 78% were white non-Hispanic, and 33% were not currently employed while 26% were employed full time. Lymphoma was the primary diagnosis for 38%, 55% had had an autologous transplant, 35% allogeneic and 10% a match unrelated donor transplant (MUD). The majority (86%) had not had a prior transplant. Data obtained included biographical and disease-related factors, quality of life (with the FACT-BMT QOL scale), and several symptoms (with the M.D. Anderson Symptom Inventory). All scales have acceptable reliability and validity for use in people with cancer. Patients were also interviewed about their perceptions of fatigue management. These patients at baseline reported that the most severe symptoms were fatigue, drowsiness, dry mouth, nausea, and distress. Mean severity ranged from 3 to 4.5 on a 0 to 10 scale. Interference with activity, work, sleep and enjoyment of life were also reported at about the same level of severity. Mean fatigue levels (standard deviations) were 4.5 (2.7), 4.7 (3.0), and 5.2 (3.4) for weeks 1 through 3, respectively. Prior research has shown fatigue increases as treatment progresses. However, those experiencing moderate to severe fatigue decreased from 65% to 56%, suggesting that our protocol may be effective. We will present the results of data analysis, including changes in quality of life, fatigue and other symptoms over time. The fatigue management protocol will also be described. While a variety of symptom management guidelines and protocols exist, they are not widely used. The protocol development process used in this study may be useful in improving symptom management in other settings. In addition, the data obtained also add to what is known about symptoms and quality of life in persons who have had a BMT.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2001
Conference Name:
26th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
San Diego, California, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleFatigue Management In Blood And Marrow Transplantationen_GB
dc.contributor.authorCohen, Marleneen_US
dc.author.detailsMarlene Cohen, PhD, Distinguished Professor, University of Texas Health Science Center-Houston, School of Nursing, Houston, Texas, USA, email: Marlene.Z.Cohen@uth.tmc.eduen_US
dc.identifier.urihttp://hdl.handle.net/10755/165659-
dc.description.abstractBlood and marrow transplantation (BMT) has evolved from an experimental procedure to an established and effective treatment for several types of cancer. The success of BMT, patients' survival, and quality of life are related to successful symptom control. Patients in several studies have rated their quality of life (QOL) positively, despite experiencing psychosocial and physical sequelae such as fatigue, anxiety, pain, sexual dysfunction, depression, sleep disturbances, inability to return to work, and fear of relapse or death. It is important to distinguish between symptom prevalence and perceived quality of life and to understand why patients rate QOL positively in spite of symptoms. Despite the tremendous distress that symptoms can cause, systematic and complete symptom assessment is not consistently a part of routine cancer care. Because a pilot study revealed fatigue was the most prevalent and severe symptom reported by BMT patients, an interdisciplinary team developed a fatigue management protocol. The study was based on the M.D. Anderson Pain Research Groups' symptom management framework. The protocol, based on current evidence for relief of cancer related fatigue, included education, counseling, exercise, stress management, distraction and energy conservation interventions. To assess the protocol, data were collected on 49 BMT patients before implementing the protocol and weekly for two additional weeks. Of these patients, 45% were females, 70% were married, 78% were white non-Hispanic, and 33% were not currently employed while 26% were employed full time. Lymphoma was the primary diagnosis for 38%, 55% had had an autologous transplant, 35% allogeneic and 10% a match unrelated donor transplant (MUD). The majority (86%) had not had a prior transplant. Data obtained included biographical and disease-related factors, quality of life (with the FACT-BMT QOL scale), and several symptoms (with the M.D. Anderson Symptom Inventory). All scales have acceptable reliability and validity for use in people with cancer. Patients were also interviewed about their perceptions of fatigue management. These patients at baseline reported that the most severe symptoms were fatigue, drowsiness, dry mouth, nausea, and distress. Mean severity ranged from 3 to 4.5 on a 0 to 10 scale. Interference with activity, work, sleep and enjoyment of life were also reported at about the same level of severity. Mean fatigue levels (standard deviations) were 4.5 (2.7), 4.7 (3.0), and 5.2 (3.4) for weeks 1 through 3, respectively. Prior research has shown fatigue increases as treatment progresses. However, those experiencing moderate to severe fatigue decreased from 65% to 56%, suggesting that our protocol may be effective. We will present the results of data analysis, including changes in quality of life, fatigue and other symptoms over time. The fatigue management protocol will also be described. While a variety of symptom management guidelines and protocols exist, they are not widely used. The protocol development process used in this study may be useful in improving symptom management in other settings. In addition, the data obtained also add to what is known about symptoms and quality of life in persons who have had a BMT.en_GB
dc.date.available2011-10-27T12:22:38Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:22:38Z-
dc.conference.date2001en_US
dc.conference.name26th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationSan Diego, California, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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