Background: Managing cancer-related fatigue requires individuals to adopt a range of self-management behaviours, and thus quality self-management support is critical. Clinicians report that lack of clear guidance on self-management support practices hinders their provision of supportive care. This framework is the first step towards improving supportive care for cancer-related fatigue, one of the most prevalent symptoms experienced by cancer patients and survivors.
Aim: To develop consensus on a framework of core practices required by health professionals to deliver effective self-management support to cancer patients and survivors experiencing cancer-related fatigue.
Methods: A preliminary practice framework of 47 practice items (14 Key Practices, 33 Practice Components) was derived from a systematic review of cancer-related fatigue support programs, and a self-management support capability framework for primary care professionals. Key practices describe the proposed activities health professionals are required to undertake to provide best practice self-management support for cancer-related fatigue. Practice components describe the steps needed to complete a key practice. This preliminary practice framework was presented for consensus rating and comment in a two-round modified Delphi study conducted with an international panel of health professionals, research academics, and cancer consumers.
Results: Fifty-two panel participants comprising consumers (n=25), health professionals (n=19), and researchers (n=16) were included in Round 1 of the modified Delphi study. Feedback from the panel produced consensus on retaining 27 of 47 original practice items without change. After incorporating qualitative feedback, seventeen items (including 12 modified, and 5 newly created practices items) were sent to the panel for rating in Round 2. In Round 2, thirty-six panel participants produced consensus on retaining all 17 practice items. The final practice framework comprised 44 items (13 Key Practices, 31 Practice Components).
Conclusions: The practice framework offers an evidence- and consensus-based model of best practice for health professionals providing self-management support for cancer-related fatigue.