Nurses' knowledge and attitudes towards cancer-related fatigue

Fatigue is the most common symptom associated with cancer and cancer treatment and is now widely recognized as a significant problem for patients with cancer (Ream & Richardson 1999). Although the profile of cancer-related fatigue has grown over the past few years within the specialty of oncology, not all patients with cancer receive care from cancer specialists. As a result of restructuring of cancer services, the majority of patients within the UK receive their cancer treatment outwith a cancer centre and are supported by District General Hospitals and community-based services. Consequently, it is appropriate to evaluate nurses' fatigue knowledge and attitudes across a range of clinical settings caring for patients with cancer. Nurses were recruited from community, general medical, general surgical and oncology clinical settings (n=470). A postal questionnaire to evaluate fatigue knowledge and attitudes was administered. A response rate of 43% was achieved. Data were analysed descriptively. Underestimation of fatigue incidence (by 28% of respondents), poor knowledge and practice regarding fatigue assessment and management, and poor fatigue communication practices were common throughout all clinical areas. However, nurses from all settings consistently demonstrated a good understanding of the impact of fatigue on patients with cancer and an appreciation of the importance of the role of the nurse in fatigue management. While oncology nurses demonstrated the greatest fatigue knowledge, these were not significantly better than the other specialties. A significant proportion of nurses caring for patients with cancer are unaware of fatigue's incidence, assessment and management. As cancer incidence rates are set to rise and the spectrum of clinical settings in which patients receive their care is increasing, it is imperative that this common and debilitating symptom receives appropriate recognition from health-care professionals. A number of strategies to enhance knowledge and information dissemination should be initiated to ensure that patient outcomes in relation to cancer-related fatigue are improved.