Background
Methods/design
Step 1: Needs assessment
Step 2: Matrices of change objectives
PO 1
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Manage daily tasks efficiently
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PO 1.1 | Alternate mental and physical activities |
PO 1.2 | Take small moments of rest divided over the day |
PO 1.3 | Take adequate measures so not to exceed personal limits |
PO 1.4 | Say “no” to a request when it is too much to handle |
PO 1.5 | Make a structured plan of daily activities |
PO 2
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Turn non-helpful thoughts about fatigue into helpful thoughts
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PO 2.1 | Recognize common non-helpful thoughts about fatigue |
PO 2.2 | Identify personal non-helpful thoughts |
PO 2.3 | Generate helpful thoughts |
PO 2.4 | Replace non-helpful thoughts with helpful thoughts |
PO 2.5 | Implement personal strategies to cope with rumination |
PO 2.6 | Use relaxation or mindfulness techniques |
PO 3
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Take sleep hygiene measures
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PO 3.1 | Identify the type of sleeping problem one is experiencing |
PO 3.2 | Go to bed and get out of bed at set times every day of the week |
PO 3.3 | Take care of optimal sleeping conditions |
PO 3.4 | Identify behaviors that interfere with sleep and replace these with helpful behaviors |
PO 3.5 | Use relaxation or mindfulness techniques |
Reduce cancer-related fatigue
| Knowledge | Awareness | Attitude | Skills and Self-Efficacy | Perceived Behavior of Others | Outcome Expectations |
---|---|---|---|---|---|---|
PO.1. Manage daily tasks efficiently | Aw.1. Become aware of planning and structure of own daily activities | At.1. Feel positive about reorganizing daily activities | SSE.1. Feel confident about managing daily activities | PBO.1. See fellow survivors acknowledging the importance managing daily activities | OE.1. Expect that managing daily tasks efficiently can reduce feelings of fatigue | |
PO.1.1. Alternate mental and physical activities | K.1a. Describe the importance of alternating mental and physical activities | Aw.2. Become aware whether mental and physical activities are alternated in own daily scheme | OE.2. Expect that alternating mental and physical activities can reduce experiences of fatigue | |||
K.1b. Recall advice on alternating activities | ||||||
PO.1.2. Take small moments of rest divided over the day | K.2a. Describe the importance of taking small moments of rest | Aw.3. Become aware whether daily rest is divided in small moments over the day | OE.3. Expect that taking small moments of rest divided over the day can reduce experiences of fatigue | |||
K.2b. Recall advice on taking rest | ||||||
PO.1.3. Take adequate measures to not exceed personal limits | K.3a. Recall possible signals of exceeding personal limits | At.2. Feel positive about guarding personal boundaries | SSE.2. Feel confident about recognizing signals and taking adequate measures | PBO.2. See fellow survivors acknowledging the importance of not exceeding personal limits | OE.4. Expect that taking adequate measures when exceeding limits can reduce experiences of fatigue | |
K.3b. Recall effective measures when exceeding limits | ||||||
PO.1.4. Say “no” to a request when it is too much to handle | K.4. Describe steps to undertake to effectively say “no” to others | At.3. Feel positive about saying “no” to others | SSE.3. Feel confident about saying “no” to others | PBO.3. See fellow survivors acknowledging the importance of saying “no” to others | OE.5. Expect that others generally accept when receiving “no” to a request | |
PO.1.5. Make a structured plan of daily activities | K.5. Summarize advice on making a structured plan | SSE.4. Demonstrate ability of making an efficient plan by incorporating advice in the new plan | OE.6. Expect that making a new plan will help in dealing with fatigue |
Step 3: Selecting theoretical methods and practical applications
Determinant | Theoretical methods | Practical applications |
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Knowledge | Chunking | Advice provided is divided in several topics and is summarized when participants make their own planning. |
Elaboration | After providing advice, personally relevant messages encourage participants to incorporate this advice with their situation. | |
Cues | Cues are provided that help saying “no” to a request and to recognize when personal limits are exceeded. | |
Awareness | Consciousness raising | Cancer survivors are encouraged to register their daily activities for five to seven days. After registration, survivors are given advice on effectively planning their day, asked to compare their plan with the advice received, and encouraged to adjust their plan to meet this advice. |
Self-monitoring of behavior | ||
Attitude | Arguments | Cancer survivors are given arguments why efficiently planning daily activities is beneficial for reducing fatigue, why guarding personal boundaries is important, and why saying “no” to some requests is important. |
Skills and Self-Efficacy | Active learning | Cancer survivors are encouraged to make their own weekly plan using the advice given. |
Action planning | Cancer survivors are encouraged to make a list of personal signals indicating that limits are exceeded and select adequate measures for each signal. | |
Cancer survivors are encouraged to make their own action plan for when they are in a situation in which they want to say “no” to a request. | ||
Perceived Behavior of Others | Modeling | Cancer survivors are provided with narratives of other survivors who are further along in their recovery process. In these narratives the importance and effectiveness of planning daily activities, setting personal boundaries, and saying “no” to others is explained. |
Outcome Expectations | Persuasive communication | By providing information from different sources (e.g., peers) on managing daily activities and by making assignments, cancer survivors are encouraged to expect that fatigue can be dealt with when taking adequate measures. |
Active learning | ||
Modeling |