The Subject of Cancer Related Fatigue, Article Critique Example

In understanding the subject of cancer related fatigue(CRF), it is necessary to define cancer. Cancer is not just one single disease. Cancer is a multiple of disease causing abnormalities in the genetics of a person’s cells. These abnormalities may be caused by heredity, radiation, and smoke, various chemical and deadly infectious diseases. Cancer is known as the number 2 cause of deaths in the United States.The start of cancer begins in the cells. The cells that are healthy become cancer cells. The body has thousands of different types of cells. These cells actively grow while dividing and producing more cells to keep the body in good health. The cells will live but when they become damaged they die and the body replaces old cells with new cells. The trouble begins when the order of growing new cells go awry or the DNA of a cell becomes changed that cause’s abnormal cell growth. In layman’s terms, the bad cells do not die and the body keeps generating new cells when the body does not need them. When this happens those extra cells develop tumors.

The journal article makes the argument that CRF can be at different levels depending on the mental and physical state of the patient. The patients have several stages of emotional response that determines how they react to treatment including lingering CRF issues. While cancer is a deadly disease killing thousands of men and women daily, the article discussed what cancer does to patient’s wellbeing. According to authors, they have categories for the type of personal they become when dealing with cancer fatigue: mute suffering, expressive suffering or they develop a new outlook in life or a new identity to deal with the cancer fatigue. The altering state of mental and physical responses to CRF, often leave the patient without hope because they never have a moment to gather their thoughts. The spend hours and days awake with pain, weakness and severe fatigue. This is not the type of fatigue from running around the track, we are talking about the type of fatigue that does not allow you to walk or sleep.  The author shared that the patients in the study describe the CRF as a devastating blow to their daily life routines. They indicated that the CRF leaves them emotionally damaged mentally.

Main Points

The author’s primary point is the patients perceptions of CRF were manly negative causing a wide range of emotional responses. The patients have a plethora of symptoms along with some excellent moments or days of energy, however, the majority of the time is spent in hospital or home with long-lasting periods of exhaustion. The point was made that the patients experience is sometimes misunderstood as small bouts with weakness, however, the CRF brings more than just exhaustion it brings emotional damage. CRF based on patients responses indicate they never have time to sleep because of the pain,depression,lethargic and exhausting days. Most important point is the patient suffers because they have to watch their family members suffer as well.

Secondary Points

The authors pointed out that the patients study gain insight concerning what treatments helped the patient. It was found that the cancer treatment providers need to rethink what truly helps the patient outside of medicine. The patients indicated that both exercise and counseling really helped with dealing with the constant CRF, however they would prefer to spend more time building energy and strength with physical activities. Patients believe that the extra exertion help the patient’s body respond to vigorous physical activity versus responding to CRF. The literature discussed the importance of the patient’s diet because the patients named the diet as one the most important experiences during the daily CRF experiences. In addition, the patients want less activity surrounded around when the meals are served. They feel must better when they eat then rest for a few hours. The author indicated that non-vigorous activities help the patient such as meditation, knitting or reading which helps relieved the problems with  CRF.

The Study

The author did an excellent job of explaining why the patient’s perceptions were reality because sometimes the cancer industry believes they know what treatments can help CRF. It’s actually the patient who is the best gauge for what treatment works and which treatments do not work as well for that patient. It was shared that not all patients need to be prescribed the medication or same activities based on a fixed way of treating CRF patients. The authors study brought to light that the patients believe in some clinical intervention however, the direct relief comes from activities directed in relieving the devastating effects of CRF. The author analyzed the results of the survey with clarity concerning the spiritual well-being of the patients. The study found that the patient did not always rely on medicine or therapy for pain. The relied on prayer and the belief in God to ease the daily CRF pain. The author brought to light the meaning of suffering to the patient as an acceptance of the CRF pain but finding peace while the suffering because unbearable. In addition, to explaining that CRF has a sizeable impression on the physical, mental, and divine well-being.

Authors Audience

The audience of the author is the oncology nurses, oncology researchers and oncology clinicians. They all serve a direct and indirect roles in understanding CRF and the patient’s wellness programs. The oncology nurses learn from the patient’s perception about what they perceive as the best treatment. The nurses are on the front line living in the same space with the patient. They understand the battles of the patient and how they can make an impact.  The nurses have the best observation of the daily battles with CRF by patients. Nurses recognize that patients with CRF need all the support from those at the cancer centers or doctor’s office. The more nurses understand the patients CRF illness, the better they can assist the patient will dealing with CRF problems. The weight of grief from CRF can effect patients’ attempts to deal with the CRF illness on a daily basis.

Authors Argument

The author used the clinical research for CRF and the patient’s results to acknowledge the plight of the patient. The patients made a point of sharing that the assessment of their pain with CRF is difficult to quantify sometimes because of the contact pain of CRF. However, the authors point is the industry must address the other needs such as spiritual, mental and psychological support. The patient must be understood that they rely on the spiritual aspect to deal with the pain. The author suggest making the spiritual aspect part of the healing or well-being treatment modules.The patient is already at the point of uselessness while wanting for the pain or CRF to end that the authors believe those feelings of wanting to die should be addressed in their daily clinical treatment plans. The author indicated the National Comprehensive Cancer Network’s (NCCN’s) is one the best evidence based guidelines for the oncology industry. The NCCN mirrors the thoughts of the authors that the patient lives in different stages of well-being that must be recognize to understand the experience of CRF.

The industry must understand the patient may be difficult because they are trying to find that inner voice inside them to deal with the CRF pain. The author agrees with the NCCN that there are three phases of suffering which are suffering in silence, openly expressive suffering and the patient becoming a new or different personal because of the CRF illness. The main point that is made concerning CRF patients is they are constant developing and changing their perception of their illness in stages. It depends on how well they treatment is working or how well they feel less pressure from the CRF and family members.

Authors Supporting Argument

The author pointed towards the busy clinical settings that is responsible for planning the type of CRF care for the patient. The protocols are based on test, doctor’s observation, therapy and other medical treatment plans. However, the authors indicate the industry needs to look at the entire experience of spiritual, mental and emotional problems with these patients.The survey results supported the author’s argument because the patients are requesting for the nurses and physicians to look at the spiritual aspect as part of the treatment plan. Instead, the patients has to enter that spiritual realm of changes without the support of the treatment team. The patients shared in the studies that they experience up and down peaks that make it difficult to get relief from just one or two treatment plans. According to the author, the CRF patients experience the severe pain over 80% percent of the time and 20% feeling better. The pattern of pain last from spurts of 8 weeks then the CRF pain alternates from weeks to days to months.

The author makes a lot sense about treatment including the spiritual aspect of the patients CRF experience. This is not to say the treatment has to be of religious nature but treatment needs to include modules for the patient’s spiritual well-being. There were a few problems with the text concerning the CRF. At times, the text was too technical for the audience, which the messages of the patients experience get lost in translations. It was confusing because the jargon would get so technical that the average nurse would need a medical dictionary, however, overall the information that was presented by the authors were invaluable.

Reference

Borneman,T.,Piper,B.,Fliegel,Koczywas,M.,Munevar,C.Sun,C., &Ferrell,B.(2012). A qualitative analysis of cancer-related fatigue in ambulatory Oncology. Clinical Journal of Oncology Nursing, 16, 26-32