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A typology of fatigue in children with cancer
Betty Davies1, Stan F Whitsett, Anne Bruce
1Department of Family Health Care Nursing, University of California, San Francisco, 94143-0606, USA.
Insights
Children with cancer experience distinct fatigue types: typical tiredness, treatment fatigue, and shutdown fatigue. Understanding these helps improve nursing interventions for pediatric cancer patients.
Area of Science:
- Pediatric Oncology
- Nursing Science
- Qualitative Research
Background:
- Cancer-related fatigue is a significant concern in adult patients.
- Fatigue in pediatric cancer patients is under-researched and poorly understood.
- Nursing interventions for adult cancer fatigue are established, but not for children.
Purpose of the Study:
- To explore and describe the phenomenon of fatigue in children with cancer.
- To identify distinct types of fatigue experienced by pediatric cancer patients.
- To understand the strategies children use to manage fatigue.
Main Methods:
- Qualitative study using grounded theory analysis.
- Interviews with 20 children (ages 5-15) with cancer and 18 parents.
- Data collected from three regional children's hospitals.
Main Results:
- Energy was identified as a core concept in pediatric cancer fatigue.
- Three distinct types of fatigue were described: typical tiredness, treatment fatigue, and shutdown fatigue.
- Children employed strategies of replenishing, conserving, and preserving energy, influenced by personal and environmental factors.
Conclusions:
- Pediatric cancer fatigue is complex and characterized by different energy levels.
- Identifying specific fatigue types can guide tailored nursing interventions.
- Further research is needed to optimize management strategies for children with cancer fatigue.
Abstract:
Fatigue in adults with cancer has received considerable attention as a troublesome symptom that requires nursing intervention. Fatigue in children with cancer, however, has received considerably less focus. The first phase of the present study used qualitative methods to generate a detailed description of fatigue in children with cancer. Thirteen children (ages 5 to 15) and 12 parents from the oncology service in two regional children's hospitals participated in the initial interviews; a validation sample comprised another 7 children and 6 parents from a third site. Transcribed interviews were subjected to grounded theory analysis. Energy, as an overriding phenomenon, was a core concept in the descriptions of fatigue. Findings suggest that children with cancer may experience three subjectively distinct types of fatigue that represent different levels of energy: typical tiredness, treatment fatigue, and shutdown fatigue. Children managed their dwindling energy and minimized further energy loss through strategies of replenishing, conserving, and preserving. Children's use of these strategies was influenced by temperament, lifestyle, environmental factors, and treatment modalities. Knowledge of the specific types of fatigue in children can offer direction for optimal intervention and for further research.