Nutritional, Functional, and Emotional Characteristics Related to Fatigue in Patients During and After Biochemotherapy

Purpose/Objectives: To test Winningham's psychobiologic entropy hypothesis in patients receiving biochemotherapy for melanoma.

Design: Descriptive, correlational, cross-sectional study.

Setting: Midwest cancer center.

Sample: 25 male and female patients who were receiving biochemo-therapy or who had completed treatment 6-12 months prior.

Methods: Data were collected using a series of questionnaires and diet recall.

Main Research Variables: Fatigue, anxiety, depression, distressing symptoms, nutritional intake, and weight.

Findings: Moderate fatigue was significantly related to physiologic and psychological symptoms but not to nutrient intake. The sample was overweight, and a significant number of participants were obese. High caloric intakes were evident. Depression was a significant problem.

Conclusions: Fatigue was not as severe as expected, but problems with responses to the fatigue scale may explain this. Nutritional status and nutrient intake were not correlated to fatigue in this sample. Activity levels were related to fatigue, and treatment reduced activity. On average, activity returned to pretreatment levels 6-12 months after treatment. Winningham's hypothesis held and will be useful for understanding fatigue in this population.

Implications for Nursing: Depression needs to be assessed and treated as a side effect of biotherapy. Assessing the impact of nutrition when patients are overweight or obese is difficult. A scale specifically designed to test Winningham's hypothesis is needed.