A Study to Assess the Effectiveness of Moderate Intensity Exercise on Radiation Related Fatigue among patients with Breast Cancer in selected hospitals at Kanyakumari District

 

S. Jebalinu¹, Mrs. V. M. Fabha Gifty², Dr. Reeta Jebakumari³

¹M.Sc Nursing Student, Medical Surgical Nursing, Thasiah College of Nursing, Marthandam, Tamil Nadu.

²Professor, HOD of Medical Surgical Nursing, Thasiah College of Nursing, Marthandam, Tamil Nadu.

³Principal, Thasiah College of Nursing, Marthandam, Tamil Nadu.

 

ABSTRACT:

Aim: To assess the effectiveness of moderate intensity exercise on radiation related fatigue among patients with breast cancer. Materials and methods: Quasi experimental pre and post-test control design was used. The sample size consisted of 60 breast cancer patients. The conceptual framework set up for the study was modified Stuffle Beam’s evaluation model. Consecutive sampling technique was used. The tool used for data collection was Fatigue Assessment Scale. Patients in experimental group were given home based walking for about 100 steps per minute performed for 30 minutes per day, 5 days per week, for 4 weeks, during radiation therapy. The data were analysed by using descriptive and inferential statistics. Results: Half of them (50%) in experimental group had severe fatigue whereas after exercise only 4 (13.3%) of them had severe fatigue. There was a significant improvement in mean post-test level of fatigue 22.87 in experimental group (MD=8.56, t=9.24, p<0.05) which was lesser than the mean pre-test level of fatigue score 31.43. Conclusion: The study concluded that moderate intensity exercise was effective in reducing radiation related fatigue among patients with breast cancer.

 

 

 

BACKGROUND OF THE STUDY:

Fatigue is a complex, multifactorial disorder with physical, mental and psychological dimensions that has been associated with diminished quality of life in patients with cancer. Radiation therapy is frequently used in the treatment of early stage of breast cancer. Radiotherapy induced fatigue is a common early and chronic side effects of radiation, reported in up to 80% and 30% of patients during radiation therapy and at follow up visits, respectively.

 

 

Early identification of clients with more fatigue, sorrow, stress, depression, problems with scheduling and finances and difficulty with family support may help to identify person at a greater risk for physical health issue in the continuing care role.

 

Globally breast cancer is the most common cancer in women both in the developed and less developed world. It is estimated that worldwide over 508,000 women died in 2011 due to breast cancer (Global Health Estimates, WHO 2013). Although breast cancer is thought to be a disease of the developed world, almost 50% of breast cancer cases and 58% of deaths occur in less developed countries (GLOBOCAN 2008). Incidence rates vary greatly worldwide from 19.3 per 100,000 women in Eastern Africa to 89.7 per 100,000 women in Western Europe. In most of the developing regions the incidence rates are below 40 per 100,000 (GLOBOCAN 2008).

 

Regionally breast cancer is the most frequent cancer among women, impacting 2.1million women each year, and also causes the greatest number of cancer-related deaths among women. In 2018, it is estimated that 627,000 women died from breast cancer (i.e.) approximately 15% of all cancer deaths among women. While breast cancer rates are higher among women in more developed regions, rates are increasing in nearly every region globally.

 

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of moderate intensity exercise on radiation related fatigue among patients with breast cancer in selected hospitals at Kanyakumari district.

 

OBJECTIVES:

·       To assess the pre-test and post- test level of radiation related fatigue among patients with breast cancer.

·       To find out the effectiveness of moderate intensity exercise on level of radiation related fatigue among patients with breast cancer.

·       To determine the association between the pre-test levels of radiation related fatigue among patients with breast cancer and selected demographic variables such as age, education, occupation, marital status, religion, food habits, number of children, duration of breast feeding and type of inner garments used.

·       To determine the association between the pre-test levels of radiation related fatigue among patients with breast cancer and selected clinical variables such as dose per fractions, stages of cancer and co-morbidities.

 

HYPOTHESES:

H1      The mean post test score of radiation related fatigue will be significantly lower than the mean pre- test score of radiation related fatigue in the experimental group.

 

H2      The mean post-test score of radiation related fatigue among patient with breast cancer in experimental group will be lower than the mean post - test score of radiation related fatigue in the control group.

H3      There will be a significant association between the pre-test score of radiation related fatigue among patients with breast cancer and selected variables such as age, education, occupation, marital status, religion, food habits, number of children, duration of breast feeding, and type of inner garments used.

H4      There will be a significant association between the pre- test score of radiation related fatigue among patients with breast cancer and selected clinical variables such as dose per fraction, stages of cancer and co-morbidities.

 

METHODOLOGY:

The research design used in this study was quasi experimental pre-test post-test control group design. The tool consists of demographic variables, clinical variables and fatigue assessment scale. Consecutive sampling technique was used to select the study participants for this study. The total number of participants were 60 (i.e.,) 30 in each group.

 

The data collection tool was done by using Fatigue Assessment Scale. The tool was given to the experts for content validity and was validated by five experts. Reliability was tested by test re test method. Pilot study was conducted on 6 participants to find out the feasibility of the study. In main study, to assess the effectiveness of moderate intensity exercise on radiation related fatigue among patients with breast cancer pre-test was done. The study was found to be feasible to proceed with the main study. The main study was conducted among 60 patients with breast cancer having radiation related fatigue who met the inclusion criteria. After the pre-test, selected intervention home based walking taught for about 100 steps per minute performed for 30 minutes per day, 5 days per week, for 4 weeks, during radiation therapy. Post-test assessment of radiation related fatigue was done by using fatigue assessment scale. The data were collected and analysed using descriptive and inferential statistic.

 

 

Table-1: Comparison of pre-test and post-test level of fatigue among respondents with breast cancer in both experimental and control group.

 

 

 

 

 

 

Table-2: Comparison of post-test level of fatigue among respondents with breast cancer in both experimental and control group.

Variables	Group	Mean	Standard deviation	DF	Unpaired ‘t’ Value
Level of fatigue	Experimental group n=30	22.87	6.67	59	3.16*
	Control group n=30	29.6	9.55

 

RESULTS AND DISCUSSIONS:

To compare the mean pre-test and post-test level of fatigue among respondents with breast cancer there was a significant improvement in mean post-test level of fatigue 22.87 in experimental group (MD=8.56, t=9.24, p<0.05) which was lesser than the mean pre-test level of fatigue score 31.43. This shows that the mean difference 8.56 is a true difference which is significant at 0.05 level and the findings support the research hypothesis. In control group the mean pre-test level of fatigue among respondents with breast cancer is 30.03 and the mean post-test level of fatigue among respondents with breast cancer is 29.6. The obtained “t” value is 0.86 with mean difference 0.43 and not significant at 0.05 levels. The study identified that there was a significant improvement in radiation related fatigue of experimental group after moderate intensity exercise than control group. So, the selected intervention, moderate intensity exercise was an effective nursing intervention for radiation related fatigue among patients with breast cancer.

 

CONCLUSIONS:

The following conclusions were drawn from the study:

·       Patients used moderate intensity exercise to overcome radiation related fatigue after the procedure.

·       The results revealed that moderate intensity exercise is very effective in reducing the radiation related fatigue.

·       The results indicated that there is significant association between the levels of fatigue with the selected demographic variables such as duration of breast feeding.

·       Moderate intensity exercise is found to have no side effects when compared with other pharmacological therapies.

 

REFERENCES:

1.     Basavanthappa, B.T, (2007) Nursing Research. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.654.

2.     Cramp F, Daniel J. 2008. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst. Rev. 11(2).

3.     Denise, F. Polit., Bernadette, P. Hungler, (1997). Essentials of Nursing Research, Methods, Appraisal and Utilization. (4th Ed.) Philadelphia: Lippincott. 149.

4.     Suresh Sharma, K., (2011). Nursing Research and Statistics. (I Ed.) New Delhi: Elsevier.

5.     Wang XS. 2008. Pathophysiology of cancer-related fatigue. Clinical Oncology. Nursing. 12(5): 11-20.

6.     Reference No: IJANM-732

 

 

 

 

Received on 20.01.2021          Modified on 14.02.2021

Accepted on 12.03.2021     ©AandV Publications All right reserved