Researchers from the University of Wisconsin School of Nursing in Madison evaluated the feasibility and potential efficacy of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance, during treatment for advanced cancer.  

This one group pre- and post-test design consisted of 30 adults with advanced (recurrent or metastatic) colorectal, lung, prostate, or gynecologic cancer receiving chemotherapy or radiotherapy.

Participants completed baseline measures (demographics and symptom inventory) and received education and training to use an MP3 player loaded with 12 cognitive-behavioral strategies (e.g., relaxation exercises, guided imagery, nature sound recordings, etc).

Participants used the strategies as needed for symptom management for two weeks, keeping a log of symptom ratings with each use. Following the two-week intervention, participants completed a second symptom inventory and an evaluation of the intervention.

Thirty of 43 eligible patients (73%) agreed to participate; of these, 27 (90%) completed the study. Most reported that they enjoyed the intervention, had learned useful skills, and perceived improvement in their symptoms.  Although symptom scores at two weeks did not differ significantly from baseline, significant reductions in severity of pain, fatigue, and sleep disturbance were found in ratings made immediately before and after the use of a cognitive-behavioral strategy.

The patient-controlled cognitive-behavioral intervention appears to be feasible for additional study and could reduce day-to-day severity of co-occurring pain, fatigue, and sleep disturbance. A randomized, controlled trial is needed to test efficacy of the intervention for co-occurring pain, fatigue, and sleep disturbance. Meanwhile, based on previous efficacy studies, cognitive-behavioral strategies can be recommended for certain individual symptoms.

Citation: Kwekkeboom KL, Abbott-Anderson K, Wanta B. Feasibility of a patient-controlled cognitive-behavioral intervention for pain, fatigue, and sleep disturbance in cancer. Oncology Nursing Forum. 2010 May; 37 (3): pages E151-9. [email protected]