Graduate Thesis Or Dissertation

“It’s a tired that sleep won't fix” : Strategies and Barriers to Managing Cancer-related Fatigue in Diverse Hematologic Cancers

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  • Cancer-related fatigue (CRF) disproportionately effects hematologic cancers when compared to solid tumor malignancies. Self-management of CRF has received increasing attention in solid tumor cancers, however, fatigue self-management in hematologic cancers has received significantly less systematic investigation. The purpose of this research was to determine effective strategies for self-managing fatigue across diverse hematologic cancers and common barriers to effective management strategies across two studies. In the first study, we used a thematic analysis approach to identify strategies, facilitators, and barriers to fatigue management using real world data. Messages posted to a large online health community (N = 483) revealed three overarching themes: Managing Fatigue, Perceived Contributors of Fatigue, and Daily Impacts of Fatigue. Individuals employed diverse strategies to manage their fatigue, including energy conservation strategies, napping, distraction, medication adjustment, and physical activity. Further, they described how both treatments and co-occurring symptoms exacerbated their fatigue and the subsequent cognitive, physical, and emotional impacts. Study 2 assessed how different fatigue self-management strategies and barriers to engaging in effective strategies related to fatigue severity. Findings from an online survey of adults with diverse blood cancers (N = 248) found activity consistency predicted less fatigue over and above other strategies, while more time spent napping predicted worse fatigue. Engaging in distracting tasks and increasing physical activity were both unrelated to fatigue. Less knowledge of effective fatigue management strategies and beliefs that fatigue was uncontrollable predicted less use of activity consistency as a self-management strategy. However, activity consistency did not mediate the relationship between either of these factors and fatigue. Results indicate that individuals with blood cancers employ diverse—though largely ineffective—strategies to manage their fatigue, putting them at greater risk for severe fatigue and resulting functional impacts. Applications of these findings and future directions are discussed.
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