Hostname: page-component-77c89778f8-cnmwb Total loading time: 0 Render date: 2024-07-20T03:23:36.389Z Has data issue: false hasContentIssue false
  • English
  • Français

Making the most out of life: Exploring the contribution of attention restorative theory in developing a non-pharmacological intervention for fatigue

Published online by Cambridge University Press:  17 October 2013

Marilynne N. Kirshbaum  and
Joanne Donbavand
Marilynne N. Kirshbaum*
Affiliation:
School of Human and Health Sciences, Division of Health and Rehabilitation, University of Huddersfield, United Kingdom
Joanne Donbavand
Affiliation:
School of Human and Health Sciences, Division of Health and Rehabilitation, University of Huddersfield, United Kingdom
*
Address correspondence and reprint requests to: Dr Marilynne N Kirshbaum, Reader in Nursing, Institute for Research in Citizenship and Applied Human Sciences (IRCAS), School of Human and Health Sciences, Division of Health and Rehabilitation, University of Huddersfield, Queengate Campus, Ramsden Building, Huddersfield HD1 3DH, United Kingdom. E-mail: m.kirshbaum@hud.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

This study investigates an approach based on Kaplan's Attention Restorative Theory (ART) to develop a non-pharmacological intervention to help individuals manage the distressing effects of illness related fatigue. The study aims to: identify activities perceived as being enjoyable by individuals who have moderate to severe fatigue related to advanced illness; determine the core attributes of potentially beneficially interventions; analyse reported ‘enjoyable’ experiences within the ART framework by mapping emergent themes to attributes of attention restoration; and develop the prototype for a self-management intervention tool.

Methods:

A purposive sample of 25 individuals who experienced moderate to severe fatigue was selected from the local hospice and community. Focused semi-structured interviews probed the questions: What do you enjoying doing? What is it about the activity that you particularly enjoy? Framework analysis was used to manage responses.

Results:

Seventy-five ‘enjoyable experiences’ were identified, including artistic pursuits, voluntary work, socialising and learning. These activities were organised into four conceptual themes: Belonging, Expansive, Nurturing and Purposeful. When mapped against attributes of restorative activities specified in ART, there was some congruence and variation. It was clear that the participants expressed a great need to be safe and in a nurturing environment. Some participants placed a high value in and received great joy from contributing to the community; this was not noted in previous ART literature.

Significance of results:

This study has extended Kaplan's insightful work on restorative behaviours by revealing the value that purposeful, engaging and safe activities hold for people who live with fatigue. ART has inspired the research team to develop a self-management intervention tool to guide health care practitioners in promoting a non-pharmacological approach to manage fatigue through exploring, discovering and promoting experiences which engage, excite, nurture and challenge the person. Further research is needed to integrate this approach into clinical practice.

Keywords

fatiguecancer fatiguepalliative carehospiceAttention Restorative Theory
Type
Original Articles
Information
Palliative & Supportive Care , Volume 12 , Issue 6 , December 2014 , pp. 473 - 480
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Abernathy, A.P., Herndon, J.E., Coan, A.T., Staley, S., Wheeler, J.L., Rowe, K., Smith, S. & Lyerly, H.K. (2010). Phase 2 pilot study of Pathfinders: a psychosocial intervention for cancer patients. Supportive Care in Cancer, 18, 893–898.CrossRefGoogle Scholar
Berto, R. (2007). Assessing the restorative value of the environment: A study on the elderly in comparison with young adults and adolescents. International Journal of Psychology, 41, 331–341.CrossRefGoogle Scholar
Berto, R. (2008). Exposure to restorative environments helps restore attentional capacity. Journal of Environmental Psychology, 25, 249–259.CrossRefGoogle Scholar
Berto, R., Baroni, M.R., Zainaghi, A. & Bettella, S. (2010). An exploratory study of the effect of high and low fascination environments on attentional fatigue. Journal of Environmental Psychology, 30, 494–500.CrossRefGoogle Scholar
Braun, V. & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.Google Scholar
Bruera, E., Kuehn, N. & Miller, M.J. (1991). The Edmonton Symptom Assessment System (ESAS): A simple method of assessment of palliative care patients. Journal of Palliative Care, 7, 6–9.CrossRefGoogle ScholarPubMed
Cimprich, B. (1993). Development of an intervention to restore attention in cancer patients. Nursing Research, 16, 83–92.Google Scholar
Cooper, J., Reynolds, F. & Bateman, A. (2009). An evaluation of a fatigue management intervention for people with acquired brain injury: an exploratory study. British Journal of Occupational Therapy, 72, 174–179.Google Scholar
Cramp, F. J. & Byron-Daniel, J. (2012). Exercise for the management of cancer-related fatigue in adults. Cochrane Database of Systematic Reviews Issue 11. Art. No.: CD006145. DOI: 10.1002/14651858.CD006145.pub3.Google Scholar
Curt, G. A. (2000). The impact of fatigue on patients with cancer: Overview of FATIGUE 1 and 2. The Oncologist, 5, 9–12.CrossRefGoogle Scholar
Demiralp, M., Oflaz, F. & Komurcu, S. (2010). Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. Journal of Clinical Nursing, 19, 1073–1083.CrossRefGoogle ScholarPubMed
Jacobsen, P.B., Donovan, K.A., Vandaparampil, S.T. & Small, B.J. (2007). Systematic review and meta-analysis of psychological and activity-based interventions for cancer-related fatigue. Health Psychology, 26, 660–7.Google Scholar
Kaplan, S. (1995). The Restorative Benefits of Nature: Toward an Integrative Framework Journal of Environmental Psychology, 15, 169–82.Google Scholar
Kaplan, S. (2001). Meditation, Restoration and the Management of Mental Fatigue. Environment and Behaviour, 33, 480–506.Google Scholar
Kirshbaum, M., Olson, K., Pongthavornkamol, K. and Graffigna, G. (2012). Understanding the Meaning of Fatigue at the End of Life: An Ethnoscience Study. European Journal of Oncology Nursing, 17, 146–153.CrossRefGoogle Scholar
Kirshbaum, M. (2010) Cancer related Fatigue: A review of nursing interventions. British Journal of Community Nursing, 15, 220–224.Google Scholar
Kirshbaum, M. (2007). A review of the benefits of whole body exercise during and after treatment for breast cancer. Journal of Clinical Nursing, 6, 104–21.Google Scholar
Korpela, K.M., Ylén, M., Tyrväinen, L. & Silvennoinen (2008). Determinants of restorative experiences in everyday favourite places. Health & Place, 14, 636–652.Google Scholar
Magill, L. & Berenson, S. (2008). The conjoint use of music therapy and reflexology with hospitalized advanced stage cancer patients and their families. Palliative and Supportive Care, 6, 289–96.Google Scholar
Miles, M.B. & Huberman, A.M. (1994). Qualitative Data Analysis (2nd edition). Thousand Oaks: Sage.Google Scholar
Norling, J.C., Sibthorp & Ruddell, E. (2008). Perceived Restorativeness for Activities Scale (PRAS): Development and Validation. Journal of Physical Activity and Health, 5, 184–195.Google Scholar
Peuckmann-Post, V., Elsner, F., Krumm, N., Trottenberg, P., Radbruch, L. (2010) Pharmacological treatments for fatigue associated with palliative care. Cochrane Database of Systematic Reviews, Issue 11. Art. No.: CD006788. DOI :10.1002/14651858.CD006788.pub2.Google Scholar
Purcell, A., Fleming, J., Bennett, S. & Haines, T. (2010) Development of an educational intervention for cancer-related fatigue. British Journal of Occupational Therapy, 73, 327–333.Google Scholar
Radbrusch, L., Strasser, F., Elsner, F., Gonçalves, J.F., Løge, J., Kassa, S., Nauck, F. & Stone, P. (2008). Fatigue in palliative care patients – an EAPC approach. Palliative Medicine, 22, 13–32.Google Scholar
Ritchie, J. & Spencer, E. (1994). Qualitative data analysis for applied policy research. In Analyzing Qualitative Data, Bryman, A. and Burgess, R.G. (eds.). London: Routledge.Google Scholar
Scopelliti, M. & Guilian, M.V. (2004). Choosing Restorative Environments Across the Lifespan: A Matter of Place Experience. Journal of Environment Psychology, 24, 423–437.Google Scholar
Staats, H., Van Germerden, E. & Hartig, T. (2010). Preference for Restorational Situations: Interactive Effects of Attentional State, Activity-in-Environment and Social Context. Leisure Sciences, 32, 401–417.CrossRefGoogle Scholar
van Weert, E., May, A.M., Korstjens, I., Post, W.J., van der Schans, C.P., van Borne, B., Mesters, I., Ros, W.J.G., Hoeskstra-Weebers, J.E.H.M. (2010). Cancer-related fatigue and rehabilitation: a randomized controlled multicentre trial comparing physical training combined with cognitive-behavioural therapy with physical training only and with no intervention. Physiotherapy Therapist, 90, 1413–1425.Google Scholar
Wagner, L.I. & Cella, D. (2004). Fatigue and cancer: causes, prevalence and treatment approaches. British Journal of Cancer, 94, 822–828.CrossRefGoogle Scholar