Impact of the Multidisciplinary Education Program in Self-Care on Fatigue in Lung Cancer Patients Receiving Chemotherapy

Kotchukorn Wangnum APN*, Thanyaluck Thanarojanawanich BSc**, Kwanta Chinwatanachai MSc**, Lawan Jamprasert MSc***, Onarmon Maleehuan MSc Management*, Vachira Janthakun BSc*

Affiliation : * Department of Nursing, Rajavithi Hospital, Bangkok, Thailand ** Department of Rehabilitation, Rajavithi Hospital, Bangkok, Thailand *** Department of Nutrition, Rajavithi Hospital, Bangkok, Thailand

Background : Lung cancer has high mortality rates, with up to 90% of patients dying within one to two years of its onset. It is essential to carry out research to attempt to solve the problems. Most patients suffer serious fatigue resulting from various symptoms and its long-term treatment. Furthermore, the other related complications such as underlying disease, anemia, malnutrition, nausea, and vomiting can reduced tolerance of chemotherapy. Study showed that nurses are the only hospital staff involved in managing fatigue. As it remains unclear to how fatigue should be managed, it is important to devise a strategy for providing a better service to help these patients survive longer.
Objective : To examine fatigue scores in patients with lung cancer after chemotherapy treatment, and to compare the scores of the group receiving the multidisciplinary education program in self-care group with those of the control group. Material and Method: A randomized controlled trial was conducted in two groups. The control group and the trial group were 30 patients in each. Studied aged from 45 to 65 years old who were receiving chemotherapy at the Chemotherapy Unit in the Out-Patients Department, Rajavithi Hospital. For a nine-week period, the control group received the hospital’s normal care program while the trial group received the multidisciplinary education program in self-care on fatigue. Scores were allocated to each individual to reflect their levels of fatigue, nutrition, physical fitness, and depression, compared using Independent t-test, Fisher exact test, and Mann-Whitney U-test.
Results : Sixty patients were enrolled into the study (mean age = 56.10 (45-65), male = 68.33%). The basic characteristics of each individual were not significantly different between the two groups. The mean (SD) fatigue scores were 2.981.96 and 3.991.64 for the control and the trial group respectively, and these figures were statistically significant (p = 0.036). Nutrition scores were significantly higher in the trial group than in the control group (p = 0.002), but the other scores weight, albumin, physical fitness, and depression were not significantly different between the two groups.
Conclusion : The multidisciplinary education program in self-care results in decreased fatigue in patients with lung cancer who are receiving chemotherapy. Therefore, it is recommended that more health professionals and specialists participate actively in patient care to respond directly to patients’ needs. This strategy should be adopted as the standard guideline for caring for patients with cancer who are receiving chemotherapy, and for patients with other conditions.

Keywords : Chemotherapy, Cancer, Fatigue, Multidisciplinary, Self-care, Education programs

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