You are on page 1of 5

Journal Critique on Fatigue 1

Running Head: JOURNAL CRITIQUE ON FATIGUE

Journal Critique on Fatigue

[name of the writer]

[name of the institution ]

[name of the Professor]

[Course]

.
Journal Critique on Fatigue 2

Journal Critique on Fatigue

There is a belief, commonly shared by most doctors and a number of people that if provided

with opportunity and laden with responsibility nurses can make doctors redundant in most of

the problems faced by patients. In cases of rudimentary illness and conditions of not feeling

well nurses are poised to fulfill the roles of a supporter and an advocate for the patient and

family facing life-threatening illness. This not only decreases the cost of treatment but also

helps in optimizing the scarce man power of skilled professionals i.e., the doctors.

What a Nurse Can Do without Doctor’s Help for a Patient Experiencing Fatigue

Summary of the Article - de Nijs, Ellen, J. M.; Ros, W.; Grijpdonck, M., H. (2008). Nursing

Intervention for Fatigue During the Treatment for Cancer, Cancer Nursing 2008; Volume 31,

Number 3, p191-206. ©2008 Lippincott Williams & Wilkins.

Fatigue is a common symptom in patients treated for cancer. Patients receiving chemotherapy

have 75% to 90% prevalence of fatigue; in those receiving radiation, the prevalence is 65%.

The purpose of this review is to identify interventions that can be used by nurses successfully

to reduce fatigue during cancer treatment.

Interventions to be Used by Nurses

A total of 18 studies were used for this purpose, exercise (10), education and counseling (5),

distraction and relaxation (2), and sleep promotion (1). The results are as follows:

Exercise
The kind of exercise may vary from a seated video exercise program to an aerobic exercise

program, frequency from 2 to 6 times a week, and the duration, from 15 to 90 minutes. The

exercise programs should be individualized according to previous condition, percentage of

the maximum heart rate, and aggravation of symptoms and/or patients preference for an
Journal Critique on Fatigue 3

activity. The participants are advised to increase the intensity gradually. All the studies

conducted showed a significant improvement in patients’ state. Usually patients experience

an increase of physical activity and also an increase in their energy level. (For Further

Reading: Watson, T. (2002). Cancer-related fatigue and the need for regular exercise,

Rehabilitation Oncology, 2002.)

Education and Counseling
The information can be provided on tape, by telephone, and/or in person. Topics may range

from explanation of the feelings of fatigue, causes, pattern, and consequences and actions

how to deal with fatigue such as exercising, balancing activity and rest, prioritizing and

delegating activities, dietary supplements, relaxation, diversion, sleep-enhancement

techniques, and pharmacological management. Written material can also be used. Talking to

someone is the aspect of the educational program that patients find most important.

Distraction and Relaxation
A relaxation breathing exercise is usually suggested by nurses to perform every day. Another

method often used is distraction, using virtual reality to treat fatigue, anxiety, and distress.

Most common way of doing is providing the patient with a headset projecting images with

corresponding sounds. A significant effect on fatigue level is found in both cases. But there is

no information available about the long-term effect of both these interventions.

Sleep Promotion

Nurses can help in making an individual sleep promotion plan including interventions and

advice on sleep hygiene, relaxation therapy, sleep restriction and stimulus control. During the

treatment period the mean daily fatigue intensity usually decreases, albeit not significantly.

Personal Views about the Article
Journal Critique on Fatigue 4

A search of the medical (PubMed) and nursing (CINAHL) literature (1995 to February 2005)

produced 18 studies. In approximately two-thirds of the studies, the populations were breast

cancer patients. Nearly half of the studies had a sample size of less then 30 patients. In 4 of

the 5 studies regarding instruction and education these sessions did not focus on fatigue

alone. They also included information about other symptoms like anxiety, nutrition, as well

as the management of side effects. In Exercise studies sample sizes used were mostly small,

ranging from 22 to 119 patients. Noteworthy effects were found in studies encouraging

exercise. For interventions on sleep promotion and on education and counseling, though a

positive result was found but this was not significant. For distraction and relaxation, only an

effect until a few hours after the intervention was found.
Journal Critique on Fatigue 5

Reference

de Nijs, Ellen, J. M.; Ros, W.; Grijpdonck, M., H. (2008). Nursing Intervention for Fatigue

During the Treatment for Cancer, Cancer Nursing 2008; Volume 31, Number 3, p191-

206. ©2008 Lippincott Williams & Wilkins. Retrieved October 27, 2008 at

http://www.medscape.com/viewarticle/574716

Watson, T. (2002). Cancer-related fatigue and the need for regular exercise, Rehabilitation

Oncology, 2002. Retrieved October 27, 2008 at

http://findarticles.com/p/articles/mi_qa3946/is_200201/ai_n9036895?tag=rbxcra.2.a.1