A Randomized Controlled Trial of an Educational Intervention for Managing Fatigue in Women Receiving Adjuvant Chemotherapy for Early-Stage Breast Cancer

PURPOSE: To evaluate the efficacy of a psychoeducational intervention in improving cancer-related fatigue. PATIENTS AND METHODS: A randomized controlled trial involving 109 women commencing adjuvant chemotherapy for stage 1 or 2 breast cancer in five day-chemotherapy treatment centers. Intervention group patients received an individualized fatigue education and support program delivered in the clinic and by phone over three 10-20 minute sessions one week apart. Instruments included: a numeric rating scale assessing confidence with managing fatigue; 11-point numeric rating scales measuring fatigue at worst, average, and best; FACT-F and Piper Fatigue Scales; Cancer Self-efficacy Scale; EORTC QLQ-C30; and the Hospital Anxiety and Depression Scale. For each outcome, separate analyses of covariance of change scores between baseline (T1) and the three follow-up time points (T2,T3,T4) were conducted, controlling for the variable’s corresponding baseline value. RESULTS: Compared to the intervention group, mean difference scores between baseline (T1) and immediate post-test (T2) assessments increased significantly more for the control group for worst and average fatigue, FACT-F and Piper fatigue severity and interference measures. These differences were not observed between baseline and T3 and T4 assessments. No significant differences were identified for any pre-post test change scores for confidence with managing fatigue, cancer self-efficacy, anxiety, depression, or quality of life. CONCLUSION: Preparatory education and support has the potential to assist women to cope with cancer-related fatigue in the short term. However, further research is needed to identify ways to improve the potency and sustainability of psychoeducational interventions for managing cancer-related fatigue