An overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work at usual level
Stress; anxiety; boring lifestyle; depression
Noise; lights; humidity; temperature
Occupation; negative life events
Increased physical exertion; sleep deprivation Pregnancy; disease states; malnutrition; anemia Poor physical condition [Altered body chemistry (e.g., medications, drug withdrawal, chemotherapy)]
Verbalization of an unremitting and overwhelming lack of energy; inability to maintain usual routines/level of physical activity Perceived need for additional energy to accomplish routine tasks; increase in rest requirements Tired; inability to restore energy even after sleep Feelings of guilt for not keeping up with responsibilities Compromised libido Increase in physical complaints
Lethargic or listless; drowsy Compromised concentration Disinterest in surroundings/introspection Decreased performance, [accident-prone]
The patient will
· Identify and employ measures to prevent or modify fatigue.
· Explain relationship of fatigue to disease process and activity level.
· Verbally express increased energy.
· Articulate plan to resolve fatigue problems.
Interventions And Rationales:
Assess usual patterns of sleep and activity to establish a baseline.
Conserve energy through rest, planning, and setting priorities to prevent or alleviate fatigue. Alternate activities with periods of rest. Avoid scheduling two energy-draining procedures on the same day. Encourage activities that can be completed in short periods. These measures help to avoid overexertion and increase stamina.
Reduce demands placed on patient (e.g., ask one family member to call at specified times and relay messages to friends and other family members) to reduce physical and emotional stress.
Structure environment (e.g., set up daily schedule on the basis of patient needs and desires) to encourage compliance with treatment regimen. Postpone eating when patient is fatigued, to avoid aggravating condition. Provide small, frequent feedings to conserve patient’s energy and encourage increased dietary intake.
Establish a regular sleeping pattern. Getting 8–10 hr of sleep nightly helps reduce fatigue.
Discuss effect of fatigue on daily living and personal goals. Explore with patient relationship between fatigue and disease process to help increase patient compliance with schedule for activity and rest.
Encourage patient to eat foods rich in iron and minerals, unless contraindicated to help avoid anemia and demineralization.
Encourage patient to explore feelings and emotions with a supportive counselor, clergy, or other professional to help cope with illness and avoid aggravating fatigue
Barsevick, A. M., et al. (2006, September–October). Cancer-related fatigue, depressive symptoms, and functional status: A mediation model. Nursing Research, 55(5), 366–372.