Effect Of Self-management On Cancer-related Fatigue With Gastric Cancer During Chemotherapy

Objective To investigate the characteristics of the patients with gastric cancer during chemotherapy and evaluate effect of self-management on cancer-related fatigue.Methods Step-1:Cross sectional survey method:by using convenient sampling,Cancer patients at the First Affiliated Hospital of Anhui Medical University between January and June in 2014 underwent chemotherapy,exclusion of repeated admissions were were surveyed with questionnaires in this study. The demographic variables questionnaire/The cancer fatigue scale(CFS)/ digital level of Fatigue evaluation scale /functional assessment of cancer therapy scale(FACT-G) for measurements was carried out for patients on 1st day after admitting hospital. Through a cross-sectional survey, to make clear the relationship between fatigue and quality of life and disease related symptoms caused by cancer.Step-2 Experimental study: Cancer patients at the First Affiliated Hospital of Anhui Medical University between July and December in 2014 underwent chemotherapy,exclusion of repeated admissions were were surveyed in this study. The object of study: 1. Inclusion criteria: clinical and pathological diagnosis of gastric carcinoma; fatigue numerical rating scale = 3; 18 years of age or older; informed consent of patients and are willing to participate in the study; patients with primary school and above, good communication and understanding ability. 2The exclusion criteria: Patients with cognitive or mental disorder; patient communication barriers; serious life-threatening diseases; repeated hospital admissions were excluded.A total of 67 patients met the inclusion criteria were divided into intervention group and control group, The 32 patients between July and September in 2014 included in the intervention group, 35 patients between October and December in 2014 as control group. Twogroups of patients are collected baseline data on the first day of patients receiving chemotherapy, intervention group joined in self managing symptoms model on the basis of routine nursing: individual solve individual problems, common problems were solved by group meetings 2-4 person / group(1 nurse, 2 graduate students, 1 doctors) form, with the aid of PPT.In the end, each distributed self-management manuals. Telephone intervention and evaluation manual use agreed during home period( the seventh days of discharge). At the same time, patients were readmitted time of chemotherapy. All the data were collected by The Cancer Fatigue Scale(CFS) and the Functional Assessment of Cancer Therapy- General version(FACT-G). The control group was given conventional nursing, the time of collecting data and evaluation tools for measuring the same as intervention group, distribution the self-management manuals at the end of the experimental research, but different from experimental group. The statistical data were analyzed by SPSS10.0 software. The amount of data is described by general statistics, Normal distribution using the mean and standard deviation to describe, non normal distribution is to describe the median and four percentile interval; using one sample K-S test of cancer-related fatigue and quality of life scale for each dimension obeys normal distribution. Therefore, the intervention group and the control group before and after the intervention of cancer because of t test method of fatigue and quality of life differences test using two independent samples; the intervention group and the control group before and after their own intervention of cancer using t test of paired samples test for detection of fatigue and quality of life.Results Cross-sectional survey: chemotherapy in cancer patients with cancer-related fatigue occurred in 76.7%. According to the scoring average, the dimensions of CFS were sorted as following: affective subscales, cognitive subscales and physical subscales.The study shows Cancer-related fatigue especially affective subscales affects is serious but physical subscales is light,Cancer-related fatigue management measuresshould pay more attention to the emotional fatigue. The impact Cancer related fatigue analysis on quality of life using multiple regression, the results showed affective subscales, cognitive subscales and physical subscales is led to affects quality of life,especially physical subscales. Experimental study showed: The two groups before the intervention with demographic data and disease related information score composition had no statistical significance differences in(P>0.05). Cancer-related fatigue dimensions and total score was statistically significant in the two groups after the intervention(P<0.01), the intervention group cancer-related fatigue in all dimensions and total score were significantly less than that in control group. There were significant differences in the quality of life in the two groups after the intervention in all dimensions and total scores(P<0.01), the intervention group quality of life in all dimensions and total score were higher than the control group. on cancer related fatigue and quality of life scale dimensions and total score difference was statistically significant in the intervention group before and after the intervention(P<0.01). Compared with before intervention, cancer-related fatigue scores were reduced, the quality of life scores were improved after intervention. Compared with before intervention,, body fatigue, cognitive fatigue and CFS total score decreased with statistical significance(P<0.01) in addition to emotional fatigue(P>0.05). Compared with before intervention, control group after invention increased social dimension scores(P<0.05),but no significant differences in other dimensions and total score(P>0.05). This suggest conventional nursing plays a role in cancer related fatigue and quality of life, but not effective in the intervention group.Conclusion This study shows the incidence of cancer-related fatigue are high in cancer patients with chemotherapy. Cancer-related fatigue affects quality of life to considerable degree. Mainly based on self-management management intervention model,cancer-related fatigue symptoms can effectively alleviated and the quality of life was improved in gastric cancer patients. clinical medical personnel should pay attention to evaluated cancer-related fatigue, adopting effective measures, such as cognitive behavior intervention, health education, effective prevention and controlling of cancer-related fatigue, improving their quality of life.