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Understanding the meaning of fatigue at th end of life: An ethnoscience approach

Kirshbaum, Marilynne, Olsen, Karin, Pongthavornkamol, Kanaungnit and Graffigna, Guendalina (2013). Understanding the meaning of fatigue at th end of life: An ethnoscience approach. European Journal of Oncology Nursing,17(2):146-153.

Document type: Journal Article
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Title Understanding the meaning of fatigue at th end of life: An ethnoscience approach
Author Kirshbaum, Marilynne
Olsen, Karin
Pongthavornkamol, Kanaungnit
Graffigna, Guendalina
Journal Name European Journal of Oncology Nursing
Publication Date 2013
Volume Number 17
Issue Number 2
eISSN 1532-2122
Start Page 146
End Page 153
Total Pages 8
Place of Publication United Kingdom
Publisher Churchill Livingstone
Field of Research MEDICAL AND HEALTH SCIENCES
Abstract Purpose
Fatigue is a devastating state of body and mind associated with distress at the end of life. We report the results of the third in a series of papers outlining a novel approach we have developed for understanding the meaning of fatigue by exploring how this meaning is shaped by beliefs and values. The aims of the study were to examine the perception and experiences of fatigue held by patients attending a hospice in England; identify the behavioural patterns that distinguish fatigue from tiredness and exhaustion; provide conceptual definitions of tiredness, fatigue and exhaustion.
Method
An Ethnoscience design was selected. The sample comprised nine people who attended a hospice between May and December 2009. Inclusion criteria included: at least 18 years of age, experiencing fatigue, able to provide informed consent and resident in the selected city in northern England for 10 years. Data were collected from two consecutive semi-structured interviews for each participant.
Results
We found that tiredness, fatigue and exhaustion are markers of progressive functional decline. Fatigue had two dimensions: 1) Mental Challenge, which included: emotional effects, cognitive realisation of decline and mental tenacity and 2) Physical Challenge, which included: limitations in leisure activities, limitations in functional roles and re-patterning routines.
Conclusions
This study provides evidence that symptom experience is socially constructed, which has potential implications for the development of effective interventions.

Keywords Fatique
End of life care
Cancer
Ethnoscience
Ethnography
Hospice
DOI http://dx.doi.org/10.1016/j.ejon.2012.04.007   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Description for Link Link to publisher's version
URL http://www.ejoncologynursing.com/article/S1462-3889(12)00036-1/abstract
 
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Created: Mon, 19 Jan 2015, 16:01:39 CST by Marion Farram