Effect of a Structured Nurse-Led Intervention on Cancer-Related Fatigue During Adjuvant External Beam Radiation Therapy for Breast Cancer: A Randomized Controlled Trial.

BACKGROUND

Cancer-related fatigue is a prevalent and distressing symptom among patients receiving adjuvant external beam radiation therapy (EBRT) for breast cancer. Persistent cancer-related fatigue adversely affects physical functioning, psychological well-being, quality of life, and treatment adherence. Structured nurse-led interventions have the potential to alleviate cancer-related fatigue and improve supportive care outcomes.

OBJECTIVE

This study aimed to evaluate the effectiveness of a structured nurse-led intervention compared with usual care in reducing cancer-related fatigue among patients with breast cancer undergoing adjuvant EBRT over a six-month follow-up period.

MATERIALS AND

METHODS

Eighty-eight women with breast cancer receiving adjuvant EBRT participated in a randomized controlled trial at the Cancer Research Institute, Swami Rama Himalayan University. The Sequentially Numbered Opaque Sealed Envelope (SNOSE) approach was used to randomly assign participants to a control group (n = 44) and an experimental group (n = 44). While the control group received only usual care, the experimental group also received a structured nurse-led intervention. Cancer-related fatigue was assessed using the Revised Piper Fatigue Scale at baseline and at 11 days, 21 days, and one, three, and six months after adjuvant EBRT.

RESULTS

The sociodemographic characteristics, clinical variables, and baseline cancer-related fatigue scores were similar between the experimental and control groups. Compared with the control group, the experimental group showed significantly lower cancer-related fatigue scores at 11 days (p = 0.01), 21 days of adjuvant EBRT (p = 0.01), and at one, three, and six months following completion of adjuvant EBRT (all p = 0.001). Repeated within-group analysis also demonstrated a significantly greater reduction in cancer-related fatigue among participants in the experimental group (F = 142.36, p < 0.001) than in the control group. Significant reductions were also observed across cancer-related fatigue domains, for example, behavioral, affective, sensory, and cognitive/mood.

CONCLUSIONS

The structured nurse-led intervention significantly reduced cancer-related fatigue across all domains among patients undergoing adjuvant EBRT for breast cancer, supporting its incorporation into usual oncology nursing practice. Oncology nurses should integrate this nurse-led intervention into usual radiation care for patients with breast cancer undergoing adjuvant EBRT to reduce their cancer-related fatigue symptoms and improve outcomes.