Date of Award

2008-10-16

Degree Name

PhD Nursing

Dissertation Committee

Cynthia D. Connelly, PhD, RN, FAAN (Chair); Linda Robinson, PhD, RN; Kevork M. Peltekian, MD, FRCPC; Jane M. Georges, PhD, RN

Keywords

Fatigue, healing touch, Hepatitis C, Interferon, nursing, Ribavirin

Abstract

In the United States, an estimated 3.2 million individuals are infected with hepatitis C virus (HCV) the nation's most common chronic blood-borne viral infection. The number of deaths from HCV was predicted to triple within the next two decades. The most effective treatment for HCV is a combination of interferon and ribavirin; however, as many as 92% of patients experienced fatigue as a side effect. The severity of this symptom caused some patients to skip dosages or even stop the required medication regimen before it was completed. The primary purpose of this pilot study was to test the feasibility of a protocol using a Healing Touch (HT) intervention for fatigue in adults with chronic HCV who were receiving combination pegylated interferon and ribavirin treatment. Specific aims were to determine the acceptance and, the attrition rate, to describe fatigue over 4 weeks for the overall group and to compare the level of fatigue between patients receiving HT compared to a control group receiving a mock touch (MT) intervention. Using an experimental randomized controlled design with repeated measures 17 subjects who met the inclusion criteria were recruited and randomly assigned to receive one of two treatment conditions, HT or MT. The setting was a hepatology clinic in eastern Canada. The entire sample included 17 subjects, with 10 in the experimental HT group and 7 in the MT group. All sessions lasted 30 minutes and were provided over 3 consecutive weeks after the baseline measures had been completed. Measures were a Demographic Data Form, the Centers for Epidemiologic Studies Depression Scale (CES-D), the Schwartz Cancer Fatigue Scale (SCFS) and the Fatigue Impact Scale (FIS). The dependent variable, fatigue was measured over 4 weeks to test for differences over time and between groups. It was proposed that HT would effect a change to decrease self-reported fatigue. The acceptance rate was 31% and the attrition rate was 29%. Overall group depression measured by the CES-D at baseline indicated 82% scored above 16 which may suggest clinical depression. Statistical significance for reduction of fatigue was not achieved, however; with the FIS there was a greater decrease in fatigue in the physical and psychosocial domains over time in the HT group when compared to the MT group. Small sample size is the major limitation of this study, a future study with a larger sample is recommended. In conclusion, this study provided preliminary promising data and the protocol with suggested revisions is feasible to guide a future larger study for use of a HT intervention for fatigue among patients with HCV receiving interferon and ribavirin treatment.

Document Type

Dissertation: Open Access

Department

Nursing

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