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Effects of a Nurse-Led Cognitive-Behavior Therapy on Fatigue and Quality of Life of Patients With Breast Cancer Undergoing Radiotherapy: An Exploratory Study

Lee, Haejung PhD, MSN, BSN, RN; Lim, Yeonjung BSN, RN; Yoo, Myung-Sook MSN, BSN, RN; Kim, Yongsuk PhD, MSN, BSN, RN

Cancer Nursing:
doi: 10.1097/NCC.0b013e31820d1734
Articles: Online Only
Abstract

Background: Radiotherapy can have multiple adverse effects, including patient complaints of persistent fatigue and low quality of life. Cognitive-behavior therapy (CBT) has alleviated fatigue and improved QOL of cancer patients; however, little is known about the effects of nurse-led CBT on breast cancer patients undergoing radiotherapy.

Objective: The purpose of this study was to analyze the effects of a nurse-led CBT program on fatigue and QOL of patients with breast cancer undergoing radiotherapy.

Methods: This study was performed using a quasi-experimental pretest/posttest design, with a nonequivalent control group. The participants were patients with breast cancer (N = 71: experimental group = 35, control group = 36) undergoing radiotherapy at P University Hospital in Korea. The experimental group received a 6-week intervention program that included cognitive restructuring, education about the disease and medical treatment, relaxation therapy, and rehabilitation exercise.

Results: After the 6-week intervention, the level of fatigue increased in patients in both groups. However, the increase in the experimental group was lower than that in the control group. Quality of life of the experimental group was significantly higher than that of the control group.

Conclusions: The nurse-led CBT seemed to control fatigue level and improve QOL. Therefore, the use of nurse-led CBT for patients with breast cancer undergoing radiotherapy must be promoted.

Implications for Practice: Active involvement of experienced nurses in the counseling program should be considered. In addition, further research must be conducted into the implementation of the nurse-led cognitive-behavioral intervention to a broader spectrum of patients.

In Brief

Background: Radiotherapy can have multiple adverse effects, including patient complaints of persistent fatigue and low quality of life. Cognitive-behavior therapy (CBT) has alleviated fatigue and improved QOL of cancer patients; however, little is known about the effects of nurse-led CBT on breast cancer patients undergoing radiotherapy. Objective: The purpose of this study was to analyze the effects of a nurse-led CBT program on fatigue and QOL of patients with breast cancer undergoing radiotherapy. Methods: This study was performed using a quasi-experimental pretest/posttest design, with a nonequivalent control group. The participants were patients with breast cancer (N = 71: experimental group = 35, control group = 36) undergoing radiotherapy at P University Hospital in Korea. The experimental group received a 6-week intervention program that included cognitive restructuring, education about the disease and medical treatment, relaxation therapy, and rehabilitation exercise. Results: After the 6-week intervention, the level of fatigue increased in patients in both groups. However, the increase in the experimental group was lower than that in the control group. Quality of life of the experimental group was significantly higher than that of the control group. Conclusions: The nurse-led CBT seemed to control fatigue level and improve QOL. Therefore, the use of nurse-led CBT for patients with breast cancer undergoing radiotherapy must be promoted. Implications for Practice: Active involvement of experienced nurses in the counseling program should be considered. In addition, further research must be conducted into the implementation of the nurse-led cognitive-behavioral intervention to a broader spectrum of patients.

Author Information

Author Affiliations: College of Nursing, Pusan National University, Yangsan (Dr Lee and Mss Lim and Yoo); and Department of Nursing, Taegu Science College, Daegu (Dr Kim), Korea.

The authors have no funding or conflicts of interest to disclose.

Correspondence: Haejung Lee, PhD, MSN, BSN, RN, College of Nursing, Yangsan Campus of Pusan National University, Beomeo-ri, Mulgeum-eup, Yangsan-si, Gyeongsangnamdo 626-870, Korea (haejung@pusan.ac.kr).

Accepted for publication December 23, 2010.

© 2011 Lippincott Williams & Wilkins, Inc.