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Cancer fatigue assessment tool, cure for ringing ears concert - PDF Review

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Practice guidelines can facilitate the adoption of evidence-based assessment and interventions for adult cancer patients experiencing fatigue. To ensure the currency of the evidence, a broad systematic search of the literature identified guidelines and systematic reviews for fatigue.
Consistent across guidelines was a recommendation to use a valid intensity scale for screening and assessment of fatigue. 6 noted that, if patients are unable to assign a numeric value to their fatigue, they can rate the fatigue as mild, moderate, or severe, and that family members may also provide useful information about the effect of fatigue on the patient’s functioning over time. Descriptions of fatigue by patients in their own words can be helpful to reflect subjective experience, and the patient should be asked to describe their pattern of fatigue41. The National Cancer Institute document reported that, based on limited experience, psychostimulants may be considered only in the treatment of severe fatigue31. Care map—cancer-related fatigue in adults with cancer (please see the full guideline for copyright and disclaimer before use).
More important, it must be recognized that, as part of knowledge translation efforts, patients are responsible for the daily monitoring and management of fatigue.
ABSTRACT: This article examines the relationships between chemotherapy-induced anemia, fatigue, and psychological distress among anemic cancer patients with solid tumors. Routine screening and assessment are essential so that best practices for management of fatigue can be initiated early in the course of treatment to minimize negative effects6–8. To ensure that the views of consumers also informed the final guideline, two members of the group were cancer survivors. Additional criteria for inclusion were patients 18 years of age or older, any cancer type, published after 2003, English, and systematic reviews (with or without meta-analyses) published during 2004–2009.

Screening includes asking patients “How would you rate your fatigue on a scale of 0–10 over the past 7 days” (0 = no fatigue, 10 = worst fatigue you can imagine), with the use of cut-off scores of 0–3 (none to mild), 4–6 (moderate), and 7–10 (severe). Regardless of tool or approach, comparable data to reliably detect changes over time is critical. It can include tiredness or exhaustion disproportionate to recent activity, impairment in important areas of functioning (for example, daily tasks, work, social life, other), diminished concentration or attention, significant distress or negative mood related to feeling fatigued (for example, sad, frustrated, irritable), sleep disturbance (insomnia or hypersomnia, sleep as non-restorative or not refreshing), decreased motivation or interest in engaging in usual activities, or disturbance in quality of life6. Overall, fatigue reduction was more pronounced and effective with interventions targeting fatigue as a primary outcome (for example, education about fatigue and activity management).
Based on an internationally endorsed methodology for adapting guideline evidence17,21, we developed a pan-Canadian practice guideline and algorithm for use in cancer programs.
Evidence report on the occurrence, assessment, and treatment of fatigue in cancer patients. Prevalence of cancerrelated fatigue in a population-based sample of colorectal, breast and prostate cancer survivors [abstract 9131].
Putting Evidence into Practice: evidence-based interventions for fatigue during and following cancer and its treatment. Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition.
Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors.
The Edmonton Symptom Assessment System (esas): a simple method for the assessment of palliative care patients. Psychosocial health care needs assessment of adult cancer patients: a consensus-based guideline.

Cancer-related fatigue and its association with depression and anxiety: a systematic review. Tailoring of guidelines to local health care environments is a critical step in guideline implementation17,40, and as part of that process, a determination of who is accountable for screening for and assessing fatigue should be clarified.
A focused assessment of fatigue to determine its onset, duration, pattern, change over time, associated or alleviating factors, and interference with function was also recommended. The clinician must be knowledgeable concerning the variance of fatigue patterns with clinical status and specific treatment regimens. The questionnaire included four psychological distress outcomes: Brief Symptom Inventory (BSI) Depression and Anxiety, Functional Assessment of Cancer Therapy (FACT)-Emotional Well-Being, numeric rating scale of Overall Health, and the FACT-Fatigue subscale.
Taken together, the two main sources of guideline evidence and the supporting documents were consistent in the parameters of fatigue assessment that should follow a positive screen (Table iii). For example, fatigue often peaks near the end of radiation therapy and tapers off over several months, but patients receiving cytotoxic chemotherapy may experience daily variation in fatigue and increasing severity of fatigue with each subsequent treatment cycle, with gradual tapering of fatigue in the first year after treatment42,43.
As noted in the framework, further tailoring of the guideline to each practice setting may still be necessary based on local health care resources and organizational cultures with incorporation of expectations or standards of the clinical team, including processes that delineate the person responsible for assessing fatigue, the scope of practice for management of fatigue, and clear pathways for referral to fatigue specialists.

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