The effects of mastery on pain and fatigue resolution

Elizabeth A Byma, Barbara A Given, Charles W Given, Mei You
Oncology Nursing Forum 2009, 36 (5): 544-52

PURPOSE/OBJECTIVES: To determine whether mastery, the personal control felt over occurrences perceived to have an important effect on one's life, influences the resolution of pain and fatigue severity.

DESIGN: Secondary data analysis of two randomized clinical trials.

SETTING: Accrual from two comprehensive cancer centers, one community oncology program, and six hospital-affiliated ambulatory oncology centers.

SAMPLE: 330 patients with solid tumors who were undergoing chemotherapy and receiving a nurse-presented, six-contact, eight-week intervention for symptom management.

METHODS: Analysis included baseline and interventional data. Logistic regression and survival analysis methods were used to explain relationships between mastery and time to resolution and resolution of pain and fatigue severity.

MAIN RESEARCH VARIABLES: Mastery, pain and fatigue severity resolution, and time to resolution.

FINDINGS: No significant differences in mastery were found among key socioeconomic and cancer-related variables. Mastery was a significant predictor of pain resolution status but did not significantly decrease time to resolution. Mastery did not have a significant effect on fatigue resolution status or time to fatigue resolution after adjusting for other covariates.

CONCLUSIONS: Mastery was symptom specific, predicting pain resolution but not fatigue. Cancer may have an equalizing effect on mastery early in diagnosis and treatment.

IMPLICATIONS FOR NURSING: Nurses should develop interventions that increase mastery in patients with cancer, which may lead to improved resolution of pain. Additional research is needed to explore how mastery may affect resolution of pain severity and other symptoms experienced by people with cancer.

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