Effects of a Culturally Sensitive Exercise Program on Fatigue, Sleep, Mood, and Symptom Distress among Thai Women with Breast Cancer Receiving Adjuvant Chemotherapy:

ii Breast cancer is a disease with a global burden for women. In Thailand, a Southeast Asian country, the total number of Thai women with newly diagnosed breast cancer patients makes up 47.8 % of all new cancer patients (National Cancer Institute- Thailand, 2011). Cancer-related fatigue is a distressing multidimensional symptom associated with cancer diagnosis and treatment. Fatigue, sleep disturbance, mood disturbance, and symptom distress were chosen for evaluation in the present study. In Western culture, evidence has shown that exercise decreases fatigue for women with breast cancer during adjuvant chemotherapy. Unique Thai cultural beliefs and health practices affect symptom management. The purpose of this pilot study was to develop a 12-week culturally sensitive exercise program (CSEP) and to preliminarily examine the program’s effects on fatigue, sleep disturbance, mood disturbance, and symptom distress at baseline, 4, 7 and 10 weeks in Thai women with breast cancer during active adjuvant chemotherapy. Twenty-three eligible women from the oncology outpatient clinic of a cancer center i