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    Comparing the meanings of fatigue in individuals with cancer in Thailand and Canada
    (2012-09-01) Kanaungnit Pongthavornkamol; Karin Olson; Nopadol Soparatanapaisarn; Sirirat Chatchaisucha; Aphorn Khamkon; Darussanee Potaros; Marilyn N. Kirshbaum; Guendalina Graffigna; Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University; University of Alberta; University of Huddersfield; Universita Cattolica del Sacro Cuore
    Background: Illness is experienced in social contexts; its meaning is rooted in local beliefs and values as well as one's personal and family situation. Health professionals are steeped in knowledge of disease but know much less about illness. Objectives: The objective of the study was to learn more about the social construction of illness by comparing the meanings of fatigue in Thai and Canadian individuals with cancer. Methods: Using an ethnoscience design, 10 Thai adults receiving chemotherapy for advanced lung cancer or colorectal cancer were interviewed twice. They were asked to sort words and phrases about fatigue from their first interview using Q-sort, triadic, and dyadic approaches; to name each pile; and to describe the similarities and differences between the piles. The card sorts were used to understand the relationships among key ideas in each interview. A table summarizing the card sorts was constructed, and patterns in the data were identified. Results: Two segregates in the Thai data were identified: essential/constant and intermittent, with essential/constant including 2 segregates (feeble and altered cognition), and intermittent including 2 segregates (loss of mental strength and difficulty sleeping). The primary meanings of fatigue in the Thai data were related to temporality, whereas the primary meanings of fatigue in the Canadian data were related to the location of the fatigue (mind/body). Conclusion: These findings help us understand the social construction of fatigue, a common symptom in cancer. Implications for Practice: Further research in relation to links between fatigue and other related-symptoms is needed with the goal of developing cross-cultural interventions for managing fatigue in the future. © 2012 Lippincott Williams & Wilkins.
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    Understanding the meaning of fatigue at the end of life: An ethnoscience approach
    (2013-04-01) Marilynne N. Kirshbaum; Kärin Olson; Kanaungnit Pongthavornkamol; Guendalina Graffigna; University of Huddersfield; University of Alberta; Mahidol University; Universita Cattolica del Sacro Cuore
    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. © 2012 Elsevier Ltd.