A mixed-methods study of how cancer-related fatigue affects occupational participation and engagement, and is managed in daily life

Abstract

Introduction: cancer-related fatigue (CRF) is a persistent, debilitating symptom that disrupts daily life and occupational participation. Understanding its impact is vital for developing effective interventions that support fatigue management and meaningful engagement. This study examined CRF’s impact on occupational participation and how individuals manage it.

Method: a mixed-methods design combined semi-structured interviews with the Activity Card Sort-UK. Seventeen participants with CRF (7 men, 10 women) and diverse cancer types were recruited using purposive, maximum variation sampling. Interviews were analysed using framework analysis, guided by the Canadian Model of Occupational Performance and Engagement.

Findings: quantitative data showed 59% experienced severe fatigue and 80% reported low fatigue self-efficacy. Leisure, social and high-demand activities were most affected. Three qualitative themes emerged: loss of enjoyment and engagement in meaningful occupations; coping through reactive and proactive strategies; and emotional consequences related to disrupted identity and reduced occupational participation. Participants described trade-offs, diminished spontaneity and altered roles. Gender, age and social context influenced both the impact and coping strategies, and many felt unsupported.

Conclusion: CRF impairs occupational engagement and identity. Occupational therapists and multidisciplinary teams should routinely assess CRF and provide tailored, occupation-focused interventions that support fatigue self-management and preserve meaningful participation. Research should further develop these interventions.

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Identifiers

ORCID for Charlotte Brooks: orcid.org/0000-0002-4461-1247

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