Skip to main content Accessibility help

How does fatigue management education impact radiographer competence and confidence in supporting patients during radiotherapy?

  • L. Tolson (a1) and A. Jessop (a2)



The primary outcome of this study is to establish whether fatigue management education impacts on radiographers’ perceived competence and confidence in supporting patients undergoing radiotherapy.

Materials and methods

A single-centre mixed method study was conducted. Participants completed a questionnaire determining baseline fatigue support practice, undertook an education package, then repeated the questionnaire to determine any change in their competence and confidence. Semi-structured interviews were used to gain insight into practice and perceived barriers.


In all, 17 radiographers (100%) participated. Some areas of practice were affected significantly by the education package, namely highlighting the need for training, perceived competence and confidence in providing support, knowledge of effective treatment options and risk factors, the effect of fatigue on the patient and greater agreement that their professional qualification means they are qualified to support patients with fatigue.


Fatigue management education impacts on radiographers’ perceived competence and confidence in supporting patients during their radiotherapy. Interviews highlighted that knowledge of cancer-related fatigue is built up through day-to-day practice. Although there is greater awareness and support of fatigue, barriers exist, including patient compliance, lack of practical training, provision to monitor patients and unclear referral pathways.


Corresponding author

Correspondence to: L. Tolson, Radiotherapy Department, Royal United Hospitals Bath NHS Foundation Trust, Combe Park, Bath BA1 3NG, UK. Tel: 01225 824564. E-mail:


Hide All
1. Society and College of Radiographers. Consent to Imaging and Radiotherapy Treatment Examinations. London: Society and College of Radiographers, 2007.
2. Cowan, D. Research Issues in Health and Social Care. Keswick: M&K Update Ltd, 2009.
3. Jereczek-Fossa, B, Marsiglia, H, Orrechia, R. Radiotherapy-related fatigue. Crit Rev Oncol Hematol 2002; 41 (3): 317325.
4. Wagner, L, Cella, D. Fatigue and cancer: causes, prevalence and treatment approaches. Br J Cancer 2004; 91: 822828.
5. Noal, S, Levy, C, Hardouin, A et al. One-year longitudinal study of fatigue, cognitive functions, and quality of life after adjuvant radiotherapy for breast cancer. Int J Radiat Oncol Biol Phys 2011; 81 (3): 795803.
6. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. Cancer-Related Fatigue. Version 1. Fort Washington, MD: National Comprehensive Cancer Network, 2009.
7. Dilhuydy, J, Dilhuydy, M, Ouhtatou, F, Laporte, C, Nguyen, T, Vendrely, V. Fatigue et radiothérapie: Revue de la litterature. Cancer Radiothér 2001; 11 (5): 131138.
8.National Cancer Survivorship Initiative. Living with and beyond cancer, 2013. Accessed on 4th April 2016.
9. Society and College of Radiographers. The Scope of Practice. London: Society and College of Radiographers, 2013.
10. Kuchinski, A, Reading, M, Lash, A. Treatment-related fatigue and exercise in patients with cancer: a systematic review. Medsurg Nurs 2009; 18 (3): 174180.
11. Society and College of Radiographers. Positioning Therapeutic Radiographers Within Cancer Services: Delivering Patient-Centred Care. London: Society and College of Radiographers, 2006.
12. Eddy, A. Advanced practice for therapy radiographers – a discussion paper. Radiography 2008; 14 (1): 2431.
13.Health and Care Professions Council. Continuing Professional Development and Your Registration. London, 2015.
14. Society and College of Radiographers. Roles and Responsibilities in Clinical Education. London: Society and College of Radiographers, 2011.
15. Henwood, S, Flinton, D. 5 years on: have attitudes towards continuing professional development in radiography changed? Radiography 2012; 18 (3): 179183.
16. Mackenzie, N, Knipe, S. Research dilemmas: paradigms, methods and methodology. Issues Educ Res 2006; 16: 193205.
17. Griffiths, D, Hodgson, D. A study investigating professional attitudes and confidence in providing sexuality information to prostate cancer patients. J Radiother Pract 2011; 18: 215227.
18. Magnan, M, Reynolds, K, Galvin, E. Barriers to addressing patient sexuality in nursing practice. Medsurg Nurs 2005; 14: 282289.
19. Rattray, J, Jones, M. Essential elements of questionnaire design and development. J Clin Nurs 2007; 16 (2): 234243.
20. Connelly, LM. Pilot studies. Medsurg Nurs 2008; 17 (6): 411412.
21. Accessed on 1st February 2016.
22. NHS Health Research Authority. 2013. Accessed on 12th May 2016.
23. Braun, V, Clarke, V. Using thematic analysis in psychology. Qual Res Psychol 2006; 3 (2): 77101.
25. Windsor, P, Nicol, K, Potter, J. A randomized, controlled trial of aerobic exercise for treatment-related fatigue in men receiving radical external beam radiotherapy for localized prostate carcinoma. Cancer 2004; 101: 550557.
26. Velthuis, M, Agasi-Idenburg, S, Aufdemkampe, G, Wittink, H. The effect of physical exercise on cancer-related fatigue during cancer treatment: a meta-analysis of randomised controlled trials. Clin Oncol 2010; 22 (3): 208221.
27. Berger, A, Mitchell, S, Jacobsen, P, Pirl, W. Screening, evaluation, and management of cancer-related fatigue: ready for implementation to practice? CA Cancer J Clin 2015; 65 (3): 190211.
28. Borneman, T, Koczywas, M, Sun, V, Piper, B, Uman, G, Ferrell, B. Reducing patient barriers to pain and fatigue management. J Pain Symptom Manage 2010; 39 (3): 486501.
29. Lees, L. The role of the ‘on treatment’ review radiographer: what are the requirements? J Radiother Pract 2008; 7: 113131.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of Radiotherapy in Practice
  • ISSN: 1460-3969
  • EISSN: 1467-1131
  • URL: /core/journals/journal-of-radiotherapy-in-practice
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed