BACKGROUND: Radiotherapy can have multiple adverse effects, including patient 
complaints of persistent fatigue and low quality of life. Cognitive-behavior 
therapy (CBT) has alleviated fatigue and improved QOL of cancer patients; 
however, little is known about the effects of nurse-led CBT on breast cancer 
patients undergoing radiotherapy.
OBJECTIVE: The purpose of this study was to analyze the effects of a nurse-led 
CBT program on fatigue and QOL of patients with breast cancer undergoing 
radiotherapy.
METHODS: This study was performed using a quasi-experimental pretest/posttest 
design, with a nonequivalent control group. The participants were patients with 
breast cancer (N = 71: experimental group = 35, control group = 36) undergoing 
radiotherapy at P University Hospital in Korea. The experimental group received 
a 6-week intervention program that included cognitive restructuring, education 
about the disease and medical treatment, relaxation therapy, and rehabilitation 
exercise.
RESULTS: After the 6-week intervention, the level of fatigue increased in 
patients in both groups. However, the increase in the experimental group was 
lower than that in the control group. Quality of life of the experimental group 
was significantly higher than that of the control group.
CONCLUSIONS: The nurse-led CBT seemed to control fatigue level and improve QOL. 
Therefore, the use of nurse-led CBT for patients with breast cancer undergoing 
radiotherapy must be promoted.
IMPLICATIONS FOR PRACTICE: Active involvement of experienced nurses in the 
counseling program should be considered. In addition, further research must be 
conducted into the implementation of the nurse-led cognitive-behavioral 
intervention to a broader spectrum of patients.