A qualitative study of the characteristics and representation of fatigue in a French speaking population of cancer patients and healthy subjects.

The aim of this study was to explore the differences in the representation of fatigue between cancer patients and healthy subjects; identify the concepts, dimensions and terminology of fatigue specific to patients with cancer-related fatigue (CRF) and healthy persons; examine some of the strategies used in illness and in health to overcome fatigue. A qualitative research design, using grounded theory was used. Twenty-four cancer patients were recruited in outpatients or the wards of a cancer institute and 24 healthy subjects among the hospital personnel or the investigator's entourage. Data were collected through individual audio-taped, open-ended interviews. The transcripts of the interviews were reviewed, and the participants' responses analysed thematically and grouped into major categories and sub-categories. This study demonstrated differences in the intensity, variability, duration and temporality of fatigue between patients and healthy subjects. Analysis resulted in the categorisation of fatigue into three major dimensions, physical, affective and cognitive, common to both patients and healthy subjects, although the frequency and occurrence of themes within these categories differed slightly in the two groups. A fourth category, distress, was identified in the patient group. The linguistic descriptions of fatigue confirmed the differing perceptions of fatigue between patients and healthy individuals and a heightened concern for the negative aspects of fatigue and suffering among patients. A four-step conceptual model for fatigue was developed explaining the different stages in individual responses to fatigue.