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Helping Chemotherapy Patients Manage Pain and Fatigue Also Reduces Other Symptoms

Helping Chemotherapy Patients Manage Pain and Fatigue Also Reduces Other Symptoms

WASHINGTON, DC—A nurse-directed intervention to help chemotherapy
patients manage pain and fatigue not only relieved those symptoms but also
reduced the number of other symptoms patients suffered, according to Barbara
Given, PhD, RN, professor of nursing at Michigan State University in East
Lansing. She reported results on behalf of researchers at that institution,
as well as at the University of Michigan in Ann Arbor and Yale University in
New Haven, Connecticut.

Results of this randomized, controlled clinical trial "support the
need for targeted interventions to assist patients undergoing chemotherapy
to manage pain and fatigue," Dr. Given concluded.

Varied Tumor Sites

The National Cancer Institute-funded study, which is now in its fifth
year, included patients undergoing chemotherapy for breast, colon, lung, or
other solid tumors who reported pain and fatigue at baseline. Patients
entered the study within 56 days of their first chemotherapy cycle. Patients
were randomized either to conventional care (n = 60) or to conventional care
plus the nursing intervention (n = 53). The study endpoints were severity of pain and fatigue, limitations
caused by pain and fatigue, and number of other symptoms reported at 20
weeks.

The nursing intervention was a 20-week, 10-contact program for patients
and family caregivers. The program included problem solving approaches to
symptom management, techniques for improving physical functioning, and
strategies for maintaining emotional health. All of these areas were dealt
with at each of the 10 contacts, and patients were interviewed about
symptoms at baseline and again at 10, 20, and 32 weeks.

Key to applying nursing intervention was building it into the
computerized documentation system. If pain and fatigue were present at
"threshold levels," that fact was posted to the plan of care and
had to be dealt with before the computerized record would advance to the
next screen.

Symptom Clusters

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