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Comparing the Meanings of Fatigue in Individuals With Cancer in Thailand and Canada

Pongthavornkamol, Kanaungnit PhD; Olson, Karin PhD; Soparatanapaisarn, Nopadol MD; Chatchaisucha, Sirirat MSN; Khamkon, Aphorn MSN; Potaros, Darussanee MSN; Kirshbaum, Marilyn N. PhD; Graffigna, Guendalina PhD

doi: 10.1097/NCC.0b013e3182331a7c

Background: Illness is experienced in social contexts; its meaning is rooted in local beliefs and values as well as one’s personal and family situation. Health professionals are steeped in knowledge of disease but know much less about illness.

Objectives: The objective of the study was to learn more about the social construction of illness by comparing the meanings of fatigue in Thai and Canadian individuals with cancer.

Methods: Using an ethnoscience design, 10 Thai adults receiving chemotherapy for advanced lung cancer or colorectal cancer were interviewed twice. They were asked to sort words and phrases about fatigue from their first interview using Q-sort, triadic, and dyadic approaches; to name each pile; and to describe the similarities and differences between the piles. The card sorts were used to understand the relationships among key ideas in each interview. A table summarizing the card sorts was constructed, and patterns in the data were identified.

Results: Two segregates in the Thai data were identified: essential/constant and intermittent, with essential/constant including 2 segregates (feeble and altered cognition), and intermittent including 2 segregates (loss of mental strength and difficulty sleeping). The primary meanings of fatigue in the Thai data were related to temporality, whereas the primary meanings of fatigue in the Canadian data were related to the location of the fatigue (mind/body).

Conclusion: These findings help us understand the social construction of fatigue, a common symptom in cancer.

Implications for Practice: Further research in relation to links between fatigue and other related-symptoms is needed with the goal of developing cross-cultural interventions for managing fatigue in the future.

Author Affiliations: Faculty of Nursing, Mahidol University (Dr Pongthavornkamol and Mss Chatchaisucha, and Khamkon), and Division of Medical Oncology, Faculty of Medicine at Siriraj Hospital (Dr Soparatanapaisarn), Bangkok, Thailand; Faculty of Nursing, University of Alberta, Edmonton, Canada (Dr Olson and Ms Potaros); University of Huddersfield, West Yorkshire, England (Dr Kirshbaum); and Catholic University of the Sacred Heart, Milan, Italy (Dr Graffigna).

Dr Pongthavornkamol received a grant from the International Society of Nurses in Cancer Care for this study.

The authors have no conflicts of interest to disclose.

Correspondence: Kanaungnit Pongthavornkamol, PhD, Faculty of Nursing, Mahidol University, 2 Prannok Rd, Bangkoknoi, Bangkok 10700, Thailand (

Accepted for publication August 14, 2011.

© 2012 Lippincott Williams & Wilkins, Inc.