Effect of a Self-Management Program on Fatigue Among Colorectal Cancer Patients Receiving Chemotherapy
Keywords:
Self-management program, Fatigue, Colorectal cancer, ChemotherapyAbstract
Fatigue is a common symptom among colorectal cancer patients receiving chemotherapy. However, effective self-management can alleviate it. This quasi-experimental two-group pretest-posttest research aimed to investigate the effect of a self-management program on fatigue among colorectal cancer patients receiving chemotherapy. Fifty-two participants were purposively selected and divided equally into control (n = 26) and experimental (n = 26) groups. The control group received routine nursing care, while the experimental group underwent a self-management program. The research instruments included the self-management program based on Creer’s self-management concept, and the instruments for measurement were 1) a personal data, disease, and treatment questionnaire and 2) a fatigue assessment form developed by Piper and colleagues and translated into Thai by Piangjai Dalopakarn. The latter was tested for reliability and yielded a Cronbach’s alpha coefficient of 0.85. Data were analyzed using descriptive statistics, paired t-test, and independent t-test.
The results revealed that after receiving the self-management program, the experimental group had a statistically significant lower mean fatigue score (M = 3.75, SD = 0.28) than before receiving the program (M = 4.08, SD = 0.19) (t = 6.83, p < .001). In addition, the experimental group had a statistically significant lower mean fatigue score (M = 3.75, SD = 0.28) than that of the control group (M = 4.44, SD = 0.21) (t = 10.06, p < .001).
These findings support the idea that the self-management program based on Creer’s self-management concept can enhance self-management for reducing fatigue among colorectal cancer patients receiving chemotherapy. Therefore, integration of this program with routine nursing care for this group of patients should be encouraged.
References
Aapro, M., Scotte, F., Bouillet, T., Currow, D., & Vigano, A. (2017). A practical approach to fatigue management in colorectal cancer. Clinical Colorectal Cancer, 16(4), 275-285. https://doi.org/10.1016/j.clcc.2016.04.010
Bumrungsuk, S., Wattana, C., & Kitsripisarn, S. (2013). The effects of a self-management training program on fatigue and well-being among cervical cancer receiving radiotherapy. Nursing Journal, 40(1), 49-61. (in Thai)
Burns, N., & Grove, S. (2009). The practice of nursing research: Appraisal, synthesis and generation of evidence (6th ed.). Saunders Elsevier.
Clark, N. M., Becker, M. H., Janz, N. K., Lorig, K., Rakowski, W., & Anderson, L. (1991). Self-management of chronic disease by older adults: A review and questions for research. Journal of Aging and Health, 3(1), 3-27. https://doi.org/10.1177/089826439100300101
Creer, T. L. (2000). Self-management of chronic illness. In M. Bockaert, O. R. Pintrich, & M. Zeidner (Eds.), Handbook of self-regulation (pp. 601-649). Academic Press.
Dalopakarn, P. (2003). Factors related to fatigue in breast cancer patients receiving chemotherapy. Journal of Nursing Science Chulalongkorn University, 15(3), 59-71. (in Thai)
Guida, A. M., Franceschilli, M., Leonetti, G., Bellato, V., Pirozzi, B. M., Fiorani, C., Siragusa, L., & Sica, G. S. (2024). Pathophysiology of metabolic changes and malnutrition in colorectal cancer’s patients. AME Medical Journal, 10, 1-22. https://dx.doi.org/10.21037/amj-23-154
Jang, J. H., Park, H. Y., Lee, U. S., Lee, K. J., & Kang, D. H. (2017). Effects of mind-body training on cytokines and their interactions with catecholamines. Psychiatry Investigation, 14(4), 483-490. https://doi.org/10.4306/pi.2017.14.4.483
Kuakarn, J., Isaramalai, S., & Baltip, Q. (2015). Impacts of a self-management program for nutritional enhancement on the fatigue conditions of cancer patients undergoing radiotherapy. Thai Journal of Nursing Council, 30(2), 20-32. https://he02.tci-thaijo.org/index.php/TJONC/article/view/39655 (in Thai)
National Cancer Institute. (2021a). Hospital base cancer registry 2021. https://www.nci.go.th/th/cancer_record/download/HOSPITAL-BASED_2021.pdf (in Thai)
National Cancer Institute. (2021b). Screening, diagnosis, and treatment of colorectal cancer (3rd ed.). Kosis Printing. (in Thai)
National Comprehensive Cancer Network [NCCN]. (2024). NCCN clinical practice guidelines in oncology: Cancer-related fatigue version 2.2024. https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf
Nguyen, L. T., Dang, A. K., Duong, P. T., Phan, H. B. T., Pham, C. T. T., Nguyen, A. T. L., & Le, H. T. (2021). Nutrition intervention is beneficial to the quality of life of patients with gastrointestinal cancer undergoing chemotherapy in Vietnam. Cancer Medicine, 10(5), 1668-1680. https://doi.org/10.1002/cam4.3766
Piper, B. F., Dibble, S. L., Dodd, M. J., Weiss, M. C., Slaughter, R. E., & Paul, S. M. (1998). The revised Piper Fatigue Scale: Psychometric evaluation in women with breast cancer. Oncology Nursing Forum, 25(4), 677-684.
Polit, D. F., & Hungler, B. P. (1999). Nursing research: Principles and methods. JB Lippincott.
Röhrl, K., Guren, M. G., Småstuen, M. C., & Rustøen, T. (2019). Symptoms during chemotherapy in colorectal cancer patients. Supportive Care in Cancer, 27(8), 3007-3017. https://doi.org/10.1007/s00520-018-4598-y
Vardy, J. L., Dhillon, H. M., Pond, G. R., Renton, C., Dodd, A., Zhang, H., Clarke, S. J., & Tannock, I. F. (2016). Fatigue in people with localized colorectal cancer who do and do not receive chemotherapy: A longitudinal prospective study. Annal Oncology, 27(9), 1761-1767. https://doi.org/10.1093/annonc/mdw252
Wairit, S., Khamboon, T., & Khunrat, J. (2021) Effectiveness of progressive muscle relaxation program on cancer related fatigue in hepatocellular carcinoma patients receiving transarterial chemoembolization. Journal of Nursing and Health Sciences, 15(1), 100-114. (in Thai)
Wei, J. N., & Li, S. X. (2018). The relationship between nutritional risks and cancer-related fatigue in patients with colorectal cancer fast-track surgery. Cancer Nursing, 41(6), E41–E47. https://doi.org/10.1097/NCC.0000000000000541
World Health Organization. (2023). Colorectal cancer. https://www.who.int/news-room/fact-sheets/detail/colorectal-cancer
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Nursing Journal CMU
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลสาร
ข้อความที่ปรากฏในบทความแต่ละเรื่องในวารสารวิชาการเล่มนี้เป็นความคิดเห็นส่วนตัวของผู้เขียนแต่ละท่านไม่เกี่ยวข้องกับมหาวิทยาลัยเชียงใหม่ และคณาจารย์ท่านอื่นๆในมหาวิทยาลัยฯ แต่อย่างใด ความรับผิดชอบองค์ประกอบทั้งหมดของบทความแต่ละเรื่องเป็นของผู้เขียนแต่ละท่าน หากมีความผิดพลาดใด ๆ ผู้เขียนแต่ละท่านจะรับผิดชอบบทความของตนเองแต่ผู้เดียว
