A mixed-methods study of how cancer-related fatigue affects occupational participation and engagement, and is managed in daily life.
Brooks Charlotte, Rossiter Laura
Cancer-related fatigue hit leisure and social activities hardest, leaving participants with only basic daily tasks.
Most had low confidence in managing it, and the loss of valued activities caused grief and a sense of losing their identity.
Key findings
1The activity checklist showed the largest participation drops in social/cultural activities (71.79% of usual activities retained) and high-demand leisure (72.35% retained), while low-demand leisure was least affected (93.64% retained).
280% of participants reported low self-efficacy for managing fatigue (score 6 or below out of 10), and many felt healthcare professionals did not discuss or adequately address their fatigue. Those who did access occupational therapy or physiotherapy reported structured strategies as helpful, but professional input was often delayed or patient-initiated.
3Losing or changing meaningful activities produced feelings of frustration, guilt, and a loss of self-identity. Participants described themselves as 'not me,' mourned their former active selves, and experienced a sense of personal failure from being disconnected from who they used to be.
Still to come
How it was doneWhat they foundWhat it means for OTs
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What it does not show
Small sample of 17, purposefully heterogeneous but not generalisable; the authors state this directly. 15 out of 17 participants were White British, no lung cancer participants were recruited, and all were England-based. Conducted during the COVID-19 pandemic, which meant recruitment was limited to social media and the ACS-UK was completed in a paper-based adaptation rather than the standard format, with potential validity implications. Both interviewers were occupational therapists, which the authors acknowledge could have introduced assumptions about occupational impact. No respondent validation was conducted, which the authors attributed to the time-sensitive nature of data collection and the burden on participants managing CRF. Some participants felt the pandemic itself restricted their activities in addition to their fatigue, so the two effects are not separable in the data.
Declared interests
No conflicts of interest declared. Funded by the Royal College of Occupational Therapists Constance Owens early career researcher award and supported by the University of Southampton, where one of the authors holds a substantive position.
The easy way to misread this
Do not read these themes as evidence that a specific fatigue management programme works. This is a qualitative study of 17 people's experiences, not a trial of any intervention. The sample was 15 out of 17 White British, England-based, and recruited during the pandemic, so the findings describe a particular group in a particular context. The authors themselves frame this as a first step toward intervention development, not as a test of one.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →