The symptom cluster of fatigue, pain and psychological distress and its impact on the quality of life in Chinese patients with breast cancer undergoing cancer treatment

• Main Author: So, Kwok-Wei
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2007
• Subjects: Breast cancer; Fatigue; Health care; Mental health; Nursing; Oncology; Quality of life; Stress
• ISBN: 9780549329046; 0549329048

This study was to examine the symptom cluster of fatigue, pain and psychological distress and its effect on the quality of life (QOL) of breast cancer patients receiving chemotherapy or radiotherapy. The Revised Model for Symptom Management was used to guide this study. A descriptive design including correlational descriptive and exploratory descriptive components was used. In the descriptive phase, a convenient sample of 283 subjects was recruited from four public hospitals. A self-reported survey consisted of the Chinese version of Brief Fatigue Inventory, Hospital Anxiety & Depression Scale, Brief Pain Inventory, Functional Assessment of Chronic Illness Therapy for Breast Cancer, and Medical Outcomes Study Social Support Survey was used. In the exploratory phase, a purposive sample of 12 participants was invited for a semi-structured interview to examine their experience during chemotherapy or radiotherapy. Results of the descriptive study showed that participants perceived fatigue, pain, and psychological distress with low intensity levels. The three symptoms were moderately correlated with each other (r = .316–.557, p < .01), supported the existence of the symptom cluster. Participants, who were receiving chemotherapy, had inadequate social support and experienced higher levels of symptoms were more likely to have poorer level of QOL (R 2= 68.6%, p < .05). The findings reflected the symptom cluster had detrimental effects on the QOL of participants. Results of the exploratory study revealed that participants were unaware of associations between the three symptoms. They agreed that social support, especially family support, helped them to get through the cancer treatment. They adopted various strategies to cope with the treatment ordeal. The cultural beliefs and characteristics attached to the participants' perception of health and illness were identified as: (1) a balance of yin and yang, (2) use of Chinese medicine, (3) reliance on family, and (4) preparation of nutritious food. These beliefs and characteristics affected patients' responses to their cancer treatment and daily activities. This study shed light on a contemporary approach of grouping and treating several related symptoms together. Results of the study enhance nurses' clinical sensitivity when identifying patients in high-risk groups, and provide useful information for designing and prioritizing symptom-management strategies.