An Ethnoscience Approach to Develop a Cross-Cultural Understanding of Fatigue

Fatigue attributable to the disease process and to treatment is a common cause of distress in individuals who have advanced cancer. The conceptualisation of fatigue presented in the Fatigue Adaptation Model (Olson 2007) and the Edmonton Fatigue Framework (Olson et al. 2008) centres upon fatigue as a behavioural marker for the inability to adapt to stressors. More specifically, fatigue is associated with a decline in cognitive functioning (manifested by decreased ability to concentrate), anxiety, gradual decrease in stamina, difficulty sleeping, limitation of social interactions and decreased control over body processes. Depression is viewed as a consequence and as an important contributor to exhaustion, a related but distinctly different state.
However, from a global perspective, it is interesting to note that most research on fatigue to date has been conducted in one culture only i.e. North America. According to ethnoscience, people "make sense" to their world, using behavioural patterns that are consistent and shared through language (Evanesko & Kay, 1975). Since language is the primary symbol system used to convey cultural meaning, the variation in language used to describe fatigue across cultures suggests that the nature and meaning of fatigue may also vary across cultures. Understanding these differences, if they exist, is important since they have implications for the translation of interventions across cultures.
If nature and meaning of fatigue varies across cultures, approaches to the management of fatigue developed in one culture may not be effective in other cultures. This presentation will describe how a cross-cultural, multinational research team representing Canada, Thailand, Italy and England, have developed strategies utilising ethnoscience methods to advance understanding of cancer-related fatigue and thereby contribute to the development of a globally relevant conceptual framework addressing fatigue. It is envisioned that the study will stimulate discussion surrounding the ways culture shapes the meaning of illness and thereby influence directions toward culturally sensitive nursing interventions.