What are the potential causes of fatigue in a person with advanced disease, and what should nurses do to assess and manage it?

Potential causes of fatigue in advanced disease include emotional concerns, pain, sleep disturbance, depression, dehydration, and medications; secondary causes such as anaemia or infection may also contribute. Nurses should acknowledge the symptom, explore reversible causes, work with the multidisciplinary team to treat secondary causes and consider drug therapy, help the person set priorities and goals, plan activities and rest, consider a fatigue diary, and monitor and review the impact of interventions.

Fatigue in advanced disease is described as an intense, subjective feeling of weakness, tiredness, and loss of energy that can affect function and cause emotional and psychological distress. The source stresses that effective and empathic communication is essential to understand the person's experience and its impact on quality of life and everyday activities. Assessment should explore potential causes such as emotional concerns, pain, sleep disturbance, depression, dehydration, and medications. It should also include liaison with the multidisciplinary team to identify and treat secondary causes such as anaemia or infection and to consider whether drug therapy might help. Nursing management involves acknowledging fatigue and expressing willingness to support the person, helping establish the person's priorities and goals, and developing a plan for appropriate activities, exercise, and rest throughout the day. A fatigue diary may be considered, and any interventions should be monitored, reviewed, and documented for their impact.