Efficacy of a new multi-modal fatigue management (MMF) programme for Breast cancer survivors.

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Affiliation :
Occupational Therapy Department, Prince of Wales Hospital
Introduction :
Breast cancer is the commonest cancer among females in Hong Kong. Among different symptomatic post treatment side effects, cancer Related Fatigue (CRF) is one of the most common lingering symptoms after breast cancer treatment, affecting as many as 40% of survivors, and often hindering recovery. Evidences showed that breast cancer survivors can be benefit from various group interventions on reducing fatigue and improving physical, psychological, social well-being as well as quality of life (QOL). Hence, there are emerging needs for a newly developed multi-modal program focusing on fatigue management for breast cancer survivors in Prince of Wales Hospital.
Objectives :
To evaluate the efficacy of a multi-modal fatigue management (MMF) management program for its impact on persistent fatigue, physical, psychological, and social well-being as well as QOL in breast cancer survivors.
Methodology :
Breast cancer survivors with current follow up on lymphoedema management but not undergoing raidotherapy were recruited. 40 patients were randomly allocated to join control group of usual treatment and intervention group that contained 6 sessions focusing on 1) active coping strategies for fatigue; 2) active life engagement activities for healthy lifestyle; 3) body-mind activity (Health Qigong); 4) psychosocial education on energy conservation; Fatigue and QOL were assessed at baseline and 6 weeks and post 3 months by the following assessment tools. A)Fatigue status by Visual Analog Fatigue Scale (VAS) and Functional Assessment of Chronic Illness Therapy - Fatigue (FACIT-F) B)Functional and QOL status by Functional Assessment of cancer Therapy–Breast (FACT-B) and Global (FACT-G) C)Patient feedback by Satisfaction Questionnaire
Result & Outcome :
A)Among the 20 clients recruited in the multi-modal fatigue management(MMF)group, they showed significant improvement in fatigue status in VAS (mean=1.8, p=0.006*) and FACIT (mean=40.8, p=0.026*). No much worsening in fatigue status during post 2 months follow up. B)In FACT-B and FACT-G ,the intervention group demonstrated positive outcomes in sub-scales of physical well-being, emotional and social well-being (mean=76.17, p=0.015*). Both group had reported improved QOL. Clients in the treatment group noted significant changes in global well-being in FACT-G (mean=76.17, p=0.015*) and disease specific well-being in FACT-B (mean=109, p=0.007*). Effectiveness was maintained during post 3 months follow up. Conclusion All patients in the intervention group are satisfied with the treatment effect. They treasure the new skills acquired and were motivated to explore own life engagement activities to cope with fatigue and life afterwards.

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