A QUALITATIVE STUDY TO EXPLORE THE CONCEPT OF FATIGUE TIREDNESS IN CANCER-PATIENTS AND IN HEALTHY-INDIVIDUALS

Interest in fatigue research has grown since the finding that fatigue/ tiredness is the most frequently reported symptom of cancer and its tr eatment. But even though several authors have tried to conceptualise f atigue, its mechanisms are still poorly understood. The aim of this st udy was twofold: (a) to explore fatigue in cancer patients inductively , and (b) to compare experiences of fatigue/tiredness of healthy indiv iduals with those of cancer patients to identify cancer-specific fatig ue/tiredness and related concepts. A qualitative research strategy was adopted using a grounded-theory approach. The prospective study took place in the oncology department of the Kantonsspital, St. Gallen, Swi tzerland, with samples of 20 cancer patients and 20 healthy individual s. Unstructured, tape-recorded interviews were conducted to collect da ta. The transcripts of the interviews were analysed using content anal ysis and constant comparison. Different themes emerged between the two groups although both fitted a classification system that categorised fatigue into physical, affective and cognitive expressions of fatigue/ tiredness. Physical signs were more frequent than affective and cognit ive signs in both groups, In the cancer patients, fatigue involved dec reased physical performance, extreme, unusual tiredness, weakness and an unusual need for rest, which was distinctly different for healthy p ersons. Affective and cognitive distress was also more prominent in ca ncer patients. Interestingly, the concept of malaise was not identifie d by either sample and not understood as an expression of fatigue by t his German-speaking population. Linguistic differences in the descript ion of fatigue/tiredness between healthy and ill individuals revealed different perceptions of the phenomenon. A step-like theory, explainin g the production of fatigue/tiredness was tentatively put forward invo lving nociception, perception and expression of tiredness. The emergin g concepts break tiredness/fatigue into an expression of physical, aff ective and cognitive tiredness/fatigue. The experience is different be tween healthy individuals and cancer patients, Care must be taken when drawing generalised conclusions but the results of the study identify and clarify ideas that might form an important basis for further, con trolled studies.