The Effectiveness of Nursing Education as an Intervention to Decrease Fatigue in Turkish Patients Receiving Chemotherapy

Oncol Nurs Forum. 2009 Jul;36(4):E215-22. doi: 10.1188/09.ONF.E215-E222.


Purpose/objectives: To determine whether a nurse-led educational intervention decreased the perception of fatigue in patients diagnosed with gastrointestinal (GI) cancers (colon, stomach, liver, rectum, pancreas) who were receiving chemotherapy for the first time.

Design: Quasi-experimental, descriptive.

Setting: Outpatient department in a large university hospital in Izmir, Turkey.

Sample: 35 patients receiving chemotherapy for GI cancers.

Methods: Baseline demographic data were collected using a personal information form developed by the researchers. Fatigue and quality of life (QOL) were then assessed using the Brief Fatigue Inventory, the Piper Fatigue Scale, and the European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ C-30) scale before their first cycle of chemotherapy, on the 10th day after (T1), and again 10 days after the second cycle of chemotherapy (T2). Patients received an individual educational intervention at baseline, T1, and T2 based on the results of their fatigue assessment in accordance with the National Comprehensive Cancer Network (NCCN) cancer-related fatigue guidelines. Patients were given an educational booklet on fatigue prior to treatment and symptom specific booklets as required at T1 and T2.

Main research variables: Subjective reports of patients' fatigue and QOL.

Findings: Patients' mean fatigue scores showed a statistically significant decrease and their EORTC QLQC-30 scores were better at T1 and T2 compared with baseline.

Conclusions: Nurse-led educational interventions have the potential to reduce fatigue in patients with GI cancer receiving chemotherapy for the first time.

Implications for nursing: The administration of chemotherapy should be preceded by a formal fatigue assessment and the provision of individually tailored educational interventions to reduce the severity of fatigue and improve QOL.

MeSH terms

  • Adult
  • Antineoplastic Agents / adverse effects
  • Fatigue / chemically induced
  • Fatigue / nursing*
  • Female
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / nursing*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Oncology Nursing / methods*
  • Outpatients
  • Pamphlets
  • Patient Education as Topic / methods*
  • Qualitative Research
  • Quality of Life
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Turkey


  • Antineoplastic Agents