The patient experience of an OT intervention for fatigue in advanced cancer.

People with cancer and other advanced diseases often develop fatigue, which has a significant impact on their quality of life and those around them (Purcell et al 2009, Cramp and Daniel (2009). It is disruptive, impacts social roles, causes distress to patients for the burden of care it imposes and to carers for the meaning of difficult symptoms (Lindqvist et al 2004, Givens et al 2005). It may have no identifiable cause, making management a primarily supportive approach, yet evidence for available interventions, often provided by a variety of HCPs, is limited for this multi-factorial symptom (Yennurajaligam and Bruera 2010). Relaxation techniques have been used to support symptoms like anxiety and pain, often provided by OTs. This has been offered at RMH for some time, but the current 'Tool Kit' approach, with additional fatigue management advice, had not been evaluated. The impact on carer's lives and their relationships is vast, but little evidence is available about intervention impacts, considering psycho-social perspectives from patient and carers (NCCN 2007, Barsevick et al 2008). A 'grounded theory' approach study was undertaken to ask: What is the experience of a fatigue management programme at the end of life for patients and carers? Additional objectives were identified to explore the experience of fatigue. Ethical approval was granted (13/LO/0810). By the end of the study 9 patients (from a possible 13) and 2 carers were recruited to the study and interviewed after completion of the intervention, reflecting challenges researching palliative populations. Analysis has highlighted the programme value held by participants, particularly the therapeutic relationships developed with the OT's and relaxation. Other aspects were less valued by participants, suggesting adjustments to the programme. This process and developments will be discussed in detail, adding to the evidence base for complex OT interventions. [ABSTRACT FROM AUTHOR]