Graduation Year


Document Type




Degree Granting Department


Major Professor

Cindy Tofthagen, Ph.D., ARNP

Committee Member

Susan C. McMillan, Ph.D., ARNP

Committee Member

Joan Gregory, Ph.D., ARNP


Chemotherapy, Malignancy, Gender, Women, Measures of fatigue


Fatigue is the most prevalent and distressing symptom experienced by patients with advanced lung cancer and especially among those patients undergoing therapy. Advanced lung cancer and its associated symptoms can significantly impact the quality of life (QOL) of those who have the disease. The primary purpose of this study was to measure fatigue levels, characterize the fatigue experience, and assess for gender differences in perceptions of fatigue and QOL in patients with advanced lung cancer receiving chemotherapy. The secondary purpose of the study was to examine practice patterns in the ambulatory setting regarding the routine assessment of fatigue.

The study was a secondary analysis of a larger study being conducted in the ambulatory clinics of a large, National Cancer Institute-designated comprehensive cancer center. The study sample consisted of fifty advanced lung cancer patients, 25 men and 25 women. Two self-report questionnaires, the Short-Form 36® (SF-36) Acute Version 1 and Fatigue Symptom Inventory (FSI), were completed by the subjects after receiving a single cycle of chemotherapy. A chart audit of the 50 subjects was performed assessing for provider documentation of fatigue assessment and method(s) utilized.

Subjects ranged in age from 40 to 80, with a mean age of 62.4 years. Of the 50, 26 patients had Stage IV non-small cell lung cancer. A majority of the patients were receiving chemotherapy alone and had not received prior chemotherapy.

The results of this study revealed no significant gender differences in fatigue severity, frequency, or interference levels. The study results also failed to confirm gender differences in QOL measures. The chart audit did reveal that the providers in this study did not consistently assess and document fatigue levels, with the nurses documenting less frequently than the physicians.

The results of this study did suggest that fatigue levels and QOL are problematic for patients treated for lung cancer. In an effort to better assist patients and tailor plans of care, it is vital that practitioners, especially nurses, assess for fatigue in advanced lung cancer patients.