Exploring Cancer-Related Fatigue and its Impact on Function and Work-Related Outcomes

• Author / Creator

  Dolgoy, Naomi

• Abstract
  The purpose of this dissertation is to explore, describe, and investigate cancer-related fatigue (CRF) in the context of functional work-related outcomes, with specific focus on physical exercise and work-related activities. The studies capture the perspective of individual cancer survivors and include stakeholder-driven data in the findings. The overall aim of this work is to inform current practice, and offer alternative approaches to the current systems in place.

  PILLAR I. Exploration of CRF (from experiential and clinical perspectives).
  Chapters two and three present explorations of CRF. The first study (Chapter Two), known as the “JARS” study, presents an exploratory descriptive research study gathering information on CRF. The descriptors from 84 respondents, including cancer survivors, their support networks, and healthcare professionals were gathered across various clinical settings in Melbourne, Australia. The emergent themes of this study, namely “uncertainty” and “sense-of-self”, offer novel targets for healthcare professionals to address in the management of CRF. The second study (Chapter Three), known as “TARGETing CRF”, presents an exploratory descriptive research study gathering information on CRF from the perspective of 25 head and neck cancer survivors. The two emergent themes of this study, “CRF as a barrier to daily function”, and “uncontrollable and unpredictable energy fluctuations”, point to the day-to-day impacts of CRF on function, and call for a different approach to managing CRF. From the findings of this study, an ‘energy cultivation’ approach to CRF management is proposed.

  PILLAR II. CRF in the Context of Work-Related Rehabilitative Opportunities (using the platform of a cancer-specific physical activity program).
  The final section of this dissertation consists of two sequential studies known as “ACE@Work”; results are presented across three chapters (Chapters Four, Five, and Six). The first study (presented in Chapter Four) involved interviews, wherein 12 participants explored and described their experiences with CRF, work-related outcomes, and rehabilitative programming. The interview data were analyzed using a social theory framework, with the lens of a Person Environment Occupation model and a Social Ecological model, to consider the experiences of these individuals, who had already participated in cancer-specific physical exercise programming (which is beyond standard care for cancer). Three themes emerged specific to CRF and work-related outcomes, namely: valuing physical wellness, perceived cognitive impacts of CRF on function and workability, and the lack of transition from physical exercise to functional work-related activities. These themes guided the subsequent proof-of-concept feasibility study presented in Chapter Five. The ACE@Work pilot study presented in Chapter Five examined the feasibility of implementing tailored work-related functional activities to a cancer-specific exercise program, and the feasibility of exploring work self-efficacy as measured through components of performance and satisfaction. The results showed meaningful changes (2-point improvement) across all participants’ Canadian Occupational Performance Measure scores of performance and satisfaction, improvement across all physical lift tests, and support further exploration of the value of work self-efficacy. Chapter Six is a knowledge translation article that shares the processes and challenges of carrying out the implementation study.

  To summarize, the sequential studies presented in this dissertation first explore and describe current approaches to CRF management (Pillar I), and the final studies present a work-related intervention that proved feasible to implement (Pillar II). As this dissertation presents small-scale and pilot research, the findings of these studies call for further research, and larger-scale trials to continue to explore potential opportunities for managing CRF symptoms in the context of work-specific issues.

• Subjects / Keywords

  • cancer related fatigue
  • occupational therapy
  • return to work
  • Cancer rehabilitation

• Graduation date

  Fall 2020

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-xqde-em89

• License

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