Cécile Charles1,2, Antonio Di Meglio3, Monica Arnedos4, Johanna Arvis5, Giulia Baciarello4, Pierre Blanchard4, Nardjes Djehal4, Agnès Dumas6, Antoine Hollbecque4, Elise Martin3, Margarida Matias4, Gwenn Menvielle7, Anna Zingarello4, Sarah Dauchy8, Ines Vaz-Luis3,4. 1. Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, F-94805, Villejuif Cedex, France. cecile.charles@gustaveroussy.fr. 2. Laboratoire de Psychopathologie et Processus de Santé (EA 4057), Université Paris Descartes, Sorbonne Paris Cité, 71 avenue Edouard Vaillant, 92100, Boulogne-Billancourt, France. cecile.charles@gustaveroussy.fr. 3. Inserm, Biomarqueurs prédictifs et nouvelles stratégies thérapeutiques en oncologie, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. 4. Département d'Oncologie Médicale, Gustave Roussy, Université Paris-Saclay, F-94805, Villejuif, France. 5. Ligue nationale contre le cancer, 75013, Paris, France. 6. INSERM (National Institute for Health and Medical Research), Université de Paris, ECEVE UMR 1123, F-75010, Paris, France. 7. Institut Pierre Louis d'Epidémiologie et Santé Publique, Sorbonne Université, Inserm, 75012, Paris, France. 8. Gustave Roussy, Université Paris-Saclay, 114 Rue Edouard Vaillant, F-94805, Villejuif Cedex, France.
Abstract
PURPOSE: International guidelines recommend specific interventions to reduce cancer-related fatigue (CRF). Evidence suggests underutilization of these interventions among breast cancer survivors. The QualFatigue study aimed to explore the potential factors influencing the use of specific interventions, for relief, in patients with CRF through qualitative analyses. METHODS: Patients with stage I-III breast cancer, and CRF ≥4 on a 10-point numerical scale were recruited within 6-24 months at the end of their primary treatment. Semi-structured interviews were performed. Emergent themes were identified using a stepped content analysis (QDA Miner software). RESULTS: Data saturation was achieved with 15 interviews. Four main themes emerged as potential sources of influence in the participants' use of specific interventions: (1) expectations regarding the management of CRF, (2) representations of the benefits provided by the interventions, (3) individual physical and psychological conditions, and (4) social and environmental situations. Six key levers came out transversally to optimize the use of specific interventions to relieve CRF: (1) listening and recognition of the individual difficulties and needs; (2) individual and global health assessments; (3) information and advice on how to manage CRF; (4) discussion groups focused on the management of CRF; (5) group activities; and (6) professional and personalized guidance. CONCLUSION: This study calls for multi-level action to address many persistent barriers and exploit levers in the management of CRF.
PURPOSE: International guidelines recommend specific interventions to reduce cancer-related fatigue (CRF). Evidence suggests underutilization of these interventions among breast cancer survivors. The QualFatigue study aimed to explore the potential factors influencing the use of specific interventions, for relief, in patients with CRF through qualitative analyses. METHODS:Patients with stage I-III breast cancer, and CRF ≥4 on a 10-point numerical scale were recruited within 6-24 months at the end of their primary treatment. Semi-structured interviews were performed. Emergent themes were identified using a stepped content analysis (QDA Miner software). RESULTS: Data saturation was achieved with 15 interviews. Four main themes emerged as potential sources of influence in the participants' use of specific interventions: (1) expectations regarding the management of CRF, (2) representations of the benefits provided by the interventions, (3) individual physical and psychological conditions, and (4) social and environmental situations. Six key levers came out transversally to optimize the use of specific interventions to relieve CRF: (1) listening and recognition of the individual difficulties and needs; (2) individual and global health assessments; (3) information and advice on how to manage CRF; (4) discussion groups focused on the management of CRF; (5) group activities; and (6) professional and personalized guidance. CONCLUSION: This study calls for multi-level action to address many persistent barriers and exploit levers in the management of CRF.
Entities:
Keywords:
Barriers; Breast cancer; Cancer-related fatigue; Specific interventions; Survivors
Authors: Rebecca R Turner; Liz Steed; Helen Quirk; Rosa U Greasley; John M Saxton; Stephanie Jc Taylor; Derek J Rosario; Mohamed A Thaha; Liam Bourke Journal: Cochrane Database Syst Rev Date: 2018-09-19