NUR 601 Evidence-Based Practice in Nursing
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The effectiveness of Yoga Exercise Program in Improving Cancer Patients Fatigue
Cancer and its treatment often lead to several physical and psychological problems that do not go away with time and can have negative side effects on the quality of life of cancer survivors. Often, cancer patient patients experience pain, depression, anxiety, and fatigue, which always continue even after the treatment is complete (Yang et al., 2019). In most cases, cancer patients frequently report fatigue as one of the most distressing side effects of chemotherapy with potentially significant long-term implications. According to Fabi et al. (2020), cancer-related fatigue (CRF) is the distressing, persistent, subjective sense of physical, emotional, and cognitive tiredness or exhaustion associated with cancer or cancer-related treatment not proportional to recent activity and interferes with normal functioning. Fabi et al. (2020) also state that CRF is different from other categories of fatigue due to its severity and persistence and the inability to eradicate it via resting or sleeping. Moreover, evidence suggests that CRF begins in the skeletal muscles because of a progressive decline in physical activity. However, research also indicates that yoga interventions on self-reported fatigue can produce invigorating effects on physical and mental energy and consequently improve levels of fatigue (Tolia et al., 2018). This study, therefore, assesses whether yoga intervention improves cancer-related fatigue among cancer patients who report fatigue at diagnosis or during cancer treatment.
Cancer-related fatigue has become a common problem among cancer patients, especially at diagnosis and during treatment. CRF is characterized by excessive and persistent exhaustion that interferes with an individual’s daily activity and function (Fabi et al., 2020). In most cases, CRF starts before one is diagnosed with cancer, gets worse during treatment, and may persist for a long duration ranging from months to years after completing treatment (Yang et al., 2019). Unlike other types of fatigue that a normal person may experience from time to time, CRF is more severe, and some people experience muscle weakness and difficulty concentrating. Statistics indicate that approximately 40 percent of patients report fatigue at cancer diagnosis, and 80 to 90 percent during chemotherapy and radiotherapy (Fabi et al., 2020).
In some cases, hormonal therapy, targeted therapy, as well as immunotherapy can contribute to CRF. Moreover, most patients with cancers find CRF as more distressing and disabling than other cancer-related or treatment-related symptoms like pain, depression, or nausea. Notably, research shows that exercise can improve CRF. As a result, scholars have questioned whether yoga intervention can help cancer patients combat CRF and live a satisfying life. Therefore, a PICO question that can be designed to investigate the effectiveness of yoga intervention in improving CRF among cancer patients would be: When caring for cancer patients with self-reported CRF, what is the effectiveness of yoga intervention as compared to usual care helps in combating CRF in 3 months? This PICO question can further be illustrated as follows:
PICOT Question: When caring for cancer patients with self-reported CRF, what is the effectiveness of yoga intervention as compared to usual care in combating CRF in 3 months?
Population/Patient (P): Cancer patients
Intervention (I): Yoga
Comparison (C): Usual care
Outcome (O): improving CRF by 60 percent.
Time (T): 3 months
Overall, CRF has severe consequences on the quality of life of cancer patients at diagnosis, during the course of treatment, and even after treatment. The effects of CRF include reduced ability to carry out daily activities, sleep disruption, depression, and anxiety. However, scholars believe that nurses caring for cancer patients can use yoga intervention to combat CRF. This topic is important in the field of nursing because it focuses on improve patients’ quality of life and achieve the desired treatment effect, which is the key objective of nursing. The PCOT question developed can therefore, assist nurses to find evidence-based practices to combat CRF and educate cancer patients about managing their fatigue.
Fabi, A., Bhargava, R., Fatigoni, S., Guglielmo, M., Horneber, M., Roila, F., ... & Ripamonti, C. I. (2020). Cancer-related fatigue: ESMO Clinical Practice Guidelines for diagnosis and treatment. Annals of Oncology, 31(6), 713-723.
Kessels, E., Husson, O., & Van der Feltz-Cornelis, C. M. (2018). The effect of exercise on cancer-related fatigue in cancer survivors: a systematic review and meta-analysis. Neuropsychiatric disease and treatment, 14, 479.
Tolia, M., Tsoukalas, N., Nikolaou, M., Mosa, E., Nazos, I., Poultsidi, A., ... & Kardamakis, D. (2018). Utilizing Yoga in oncologic patients treated with radiotherapy. Indian journal of palliative care, 24(3), 355.
Yang, S., Chu, S., Gao, Y., Ai, Q., Liu, Y., Li, X., & Chen, N. (2019). A Narrative Review of Cancer-Related Fatigue (CRF) and Its Possible Pathogenesis. Cells, 8(7), 738. https://doi.org/10.3390/cells8070738