Comparing patient, parent, and staff descriptions of fatigue in pediatric oncology patients

Fatigue in children and adolescents with cancer is a disruptive symptom mer iting clinical intervention by nurses, but has eluded definition, measureme nt, and intervention. Fatigue in these patients exists within a greater con text of illness, treatment, and child and family development. Any effort to define, measure, and intervene with fatigue needs to take into considerati on the major components of these children and adolescents' treatment contex t. The purpose of this descriptive study was to learn from three perspectiv es (patient, parent, and staff) how fatigue is identified and defined in 7- to 12-year-old children and in 13- to 18-year-old adolescents with cancer and what factors contribute to or alleviate this fatigue. To elicit this in formation, separate focus groups were conducted with patients, parents, and staff at two pediatric oncology centers. Resulting interview data were ana lyzed using pragmatic and semantic content analysis techniques and the Wils on concept analysis process. Findings clearly indicated that children, adol escents, parents, and staff define patient fatigue differently. The concept ual definition from the child data emphasizes the physical sensation of the fatigue; alternating and at times merging physical and mental tiredness ar e emphasized in the adolescent's definition. Parents and staff view themsel ves as responsible for alleviating patient fatigue; patients viewed rest an d distraction as their primary sources of improving fatigue. The conceptual definitions of fatigue as rendered by our three groups of participants can assist pediatric oncology patients, their parents, and staff in identifyin g fatigue. Factors identified by these participants as contributing or alle viating fatigue could be the basis for future interventions designed to red uce fatigue in pediatric oncology patients.