Effect of a Structured Nurse-Led Intervention on Cancer-Related Fatigue During Adjuvant External Beam Radiation Therapy for Breast Cancer: A Randomized Controlled Trial.

BACKGROUND: Cancer-related fatigue is a prevalent and distressing symptom among patients receiving adjuvant external beam radiation therapy (EBRT) for breast cancer. Persistent cancer-related fatigue adversely affects physical functioning, psychological well-being, quality of life, and treatment adherence. Structured nurse-led interventions have the potential to alleviate cancer-related fatigue and improve supportive care outcomes. OBJECTIVE: This study aimed to evaluate the effectiveness of a structured nurse-led intervention compared with usual care in reducing cancer-related fatigue among patients with breast cancer undergoing adjuvant EBRT over a six-month follow-up period. MATERIALS AND METHODS: Eighty-eight women with breast cancer receiving adjuvant EBRT participated in a randomized controlled trial at the Cancer Research Institute, Swami Rama Himalayan University. The Sequentially Numbered Opaque Sealed Envelope (SNOSE) approach was used to randomly assign participants to a control group (n = 44) and an experimental group (n = 44). While the control group received only usual care, the experimental group also received a structured nurse-led intervention. Cancer-related fatigue was assessed using the Revised Piper Fatigue Scale at baseline and at 11 days, 21 days, and one, three, and six months after adjuvant EBRT. RESULTS: The sociodemographic characteristics, clinical variables, and baseline cancer-related fatigue scores were similar between the experimental and control groups. Compared with the control group, the experimental group showed significantly lower cancer-related fatigue scores at 11 days (p = 0.01), 21 days of adjuvant EBRT (p = 0.01), and at one, three, and six months following completion of adjuvant EBRT (all p = 0.001). Repeated within-group analysis also demonstrated a significantly greater reduction in cancer-related fatigue among participants in the experimental group (F = 142.36, p < 0.001) than in the control group. Significant reductions were also observed across cancer-related fatigue domains, for example, behavioral, affective, sensory, and cognitive/mood. CONCLUSIONS: The structured nurse-led intervention significantly reduced cancer-related fatigue across all domains among patients undergoing adjuvant EBRT for breast cancer, supporting its incorporation into usual oncology nursing practice. Oncology nurses should integrate this nurse-led intervention into usual radiation care for patients with breast cancer undergoing adjuvant EBRT to reduce their cancer-related fatigue symptoms and improve outcomes.