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Yang XM, Yang XY, Wang XY, Gu YX. Influence of transcatheter arterial embolization on symptom distress and fatigue in liver cancer patients. World J Gastrointest Oncol 2024; 16:810-818. [PMID: 38577467 PMCID: PMC10989373 DOI: 10.4251/wjgo.v16.i3.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/22/2023] [Accepted: 02/07/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a prevalent malignancy, and transcatheter arterial embolization (TAE) has emerged as a pivotal therapeutic modality. However, TAE may induce symptom distress and fatigue, adversely affecting the quality of life of patients. AIM To investigate symptom distress, fatigue, and associated factors in HCC patients undergoing TAE. METHODS We used a cross-sectional design and purposive sampling to enroll HCC patients who underwent TAE at our institution from January to December 2022. Questionnaires were utilized to collect data on symptom distress and fatigue scores from the first to the third day after TAE. RESULTS Our study revealed a significant reduction in fatigue and symptom distress among patients after TAE. Pain, fatigue, insomnia, fever and abdominal distension were the most common symptoms troubling patients during the first 3 d post-TAE. Marital status, presence of family support, physical functional status, age, and symptom distress were identified as predictors of fatigue in patients. CONCLUSION Healthcare professionals should educate HCC patients on symptom distress and fatigue, offering personalized relief strategies to lessen their psychological burden.
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Affiliation(s)
- Xu-Min Yang
- Department of Nursing, The First Affiliated Hospital of Naval Medical University (Changhai Hospital), Shanghai 200433, China
| | - Xu-Yan Yang
- Department of Nursing, The First Affiliated Hospital of Naval Medical University (Changhai Hospital), Shanghai 200433, China
| | - Xin-Yu Wang
- Department of Thyroid, Breast and Vascular Surgery, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
| | - Yue-Xia Gu
- Department of Nursing, Shanghai Fourth People’s Hospital Affiliated to Tongji University School of Medicine, Shanghai 200434, China
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Bade BC, Faiz SA, Ha DM, Tan M, Barton-Burke M, Cheville AL, Escalante CP, Gozal D, Granger CL, Presley CJ, Smith SM, Chamberlaine DM, Long JM, Malone DJ, Pirl WF, Robinson HL, Yasufuku K, Rivera MP. Cancer-related Fatigue in Lung Cancer: A Research Agenda: An Official American Thoracic Society Research Statement. Am J Respir Crit Care Med 2023; 207:e6-e28. [PMID: 36856560 PMCID: PMC10870898 DOI: 10.1164/rccm.202210-1963st] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Background: Fatigue is the most common symptom among cancer survivors. Cancer-related fatigue (CRF) may occur at any point in the cancer care continuum. Multiple factors contribute to CRF development and severity, including cancer type, treatments, presence of other symptoms, comorbidities, and medication side effects. Clinically, increasing physical activity, enhancing sleep quality, and recognizing sleep disorders are integral to managing CRF. Unfortunately, CRF is infrequently recognized, evaluated, or treated in lung cancer survivors despite more frequent and severe symptoms than in other cancers. Therefore, increased awareness and understanding of CRF are needed to improve health-related quality of life in lung cancer survivors. Objectives: 1) To identify and prioritize knowledge and research gaps and 2) to develop and prioritize research questions to evaluate mechanistic, diagnostic, and therapeutic approaches to CRF among lung cancer survivors. Methods: We convened a multidisciplinary panel to review the available literature on CRF, focusing on the impacts of physical activity, rehabilitation, and sleep disturbances in lung cancer. We used a three-round modified Delphi process to prioritize research questions. Results: This statement identifies knowledge gaps in the 1) detection and diagnostic evaluation of CRF in lung cancer survivors; 2) timing, goals, and implementation of physical activity and rehabilitation; and 3) evaluation and treatment of sleep disturbances and disorders to reduce CRF. Finally, we present the panel's initial 32 research questions and seven final prioritized questions. Conclusions: This statement offers a prioritized research agenda to 1) advance clinical and research efforts and 2) increase awareness of CRF in lung cancer survivors.
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Maki Y, Horiuchi K, Okamoto T. Fatigue and quality of life among thyroid cancer survivors without persistent or recurrent disease. Endocr Connect 2022; 11:EC-21-0506.R1. [PMID: 35107083 PMCID: PMC8942325 DOI: 10.1530/ec-21-0506] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Cancer-related fatigue is one of the most important issues for patients, but research on this topic is sparse. This study aimed to determine the prevalence of fatigue in postoperative patients with papillary thyroid carcinoma (PTC) and to identify the clinical features associated with fatigue. METHODS We conducted a cross-sectional study on 292 thyroid cancer survivors. Fatigue and quality of life were the study outcomes, measured using the Cancer Fatigue Scale (CFS) and the SF-36 version 2.0. Furthermore, correlations of demographic characteristics and hormonal data with the CFS scores were assessed by univariable and multivariable analyses. RESULTS The prevalence of fatigue was 41.8% (95% CI: 36.1, 47.5). The CFS score was significantly correlated with the free T3 level (Pearson's r = -0.123, 95% CI: -0.234, -0.008). Multiple regression analysis revealed that the free T3 level and having a job were significant predictors of the CFS score, with unstandardized regression coefficients of -2.52 (95% CI: -4.94, -0.09) and 2.85 (95% CI: 0.49, 5.20), respectively. The median Z-scores were negative for General Health (-0.28) and Vitality (-0.15) subscales of the SF-36. The CFS score was a significant predictor of summary scores of the SF-36. The free T3 level was significantly associated with the physical component summary score with an unstandardized coefficient of 3.20 (95% CI: 0.77, 5.63). CONCLUSIONS Fatigue was prevalent and associated with poor quality of life among PTC survivors. Thyroid functional status, particularly the level of free T3, may be worth to be considered in alleviating the burden.
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Affiliation(s)
- Yukari Maki
- Department of Pediatric Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kiyomi Horiuchi
- Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
- Correspondence should be addressed to K Horiuchi:
| | - Takahiro Okamoto
- Department of Endocrine Surgery, Tokyo Women’s Medical University, Shinjuku-ku, Tokyo, Japan
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Azam M, Aslam M, Basharat J, Mughal MA, Nadeem MS, Anwar F. An empirical study on quality of life and related factors of Pakistani breast cancer survivors. Sci Rep 2021; 11:24391. [PMID: 34937873 PMCID: PMC8695584 DOI: 10.1038/s41598-021-03696-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 12/08/2021] [Indexed: 12/01/2022] Open
Abstract
A comprehensive understanding of the quality of life (QoL) is essential to establish long-term survivor care plans. The present study was aimed at the assessment of QoL of BC survivors with special emphasis on post-treatment physical, emotional, social, and spiritual challenges. We have assessed the QoL of 250 female BC survivors of all age groups through demographic factors. Volunteer BC survivors were registered in the present study who had got treatment from the Institute of Nuclear Medicine and Oncology (INMOL) hospital and Mayo hospital Lahore. An informed consent form was signed by each participant. The physical, psychological, and spiritual well-being was evaluated by a questionnaire filled with the help of respondents. The average age of BC survivors was 52 ± 7.8 years. Most of them (83%) complained of fatigue during daily life activities, 75.1% body pain or headache, 77.1% had problems with appetite, 63.2% reported weight loss, 77.1% had sleep problems, and 90.5% were feeling general weakness. Only 16.2% were satisfied with their physical health and 2% were not satisfied with their medication. Psychologically, 74.4% were feeling different levels of anxiety, only 10% of them were hoping to achieve a desired life. Age group 21 to 40 years reported better physical health, those with 40-50 years of age and family history of BC have shown better mental strength. The physical and psychological health of survivors from rural areas was comparatively better than those from urban areas. The BC survivor women have to face several physical, psychological and social challenges. The majorities of them complain of anxiety, body pain, fatigue, sleep problems, general weakness, and fear about the future. Our findings suggest the need for psychological support, physical activity a comprehensive post-diagnosis and post-treatment physical and mental health assistance plan for all BC survivors. Implications for Cancer Survivors. Survivors of breast cancer experience various challenges including anxiety, sleep problems, body pain, fatigue, and fear about the future. The psychological, physical and social factors make a great difference in their quality of life.
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Affiliation(s)
- Muhammad Azam
- grid.412967.f0000 0004 0609 0799Department of Statistics and Computer Science, University of Veterinary and Animal Sciences, Lahore, 54000 Pakistan
| | - Muhammad Aslam
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia.
| | - Javeria Basharat
- grid.444922.d0000 0000 9205 361XDepartment of Statistics, Kinnaird College for Women, 93-Jail Road, Lahore, 54000 Pakistan
| | - Muhammad Anwar Mughal
- grid.444905.80000 0004 0608 7004Department of Statistics, Forman Christian College (A Chartered University), Ferozepur Road, Lahore, 54600 Pakistan
| | - Muhammad Shahid Nadeem
- grid.412125.10000 0001 0619 1117Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
| | - Firoz Anwar
- grid.412125.10000 0001 0619 1117Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, 21589 Saudi Arabia
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Al Maqbali M, Al Sinani M, Al Naamani Z, Al Badi K, Tanash MI. Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2021; 61:167-189.e14. [PMID: 32768552 DOI: 10.1016/j.jpainsymman.2020.07.037] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/25/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer. OBJECTIVES The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer. METHODS The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ2 = 0.0000; I2 = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue. CONCLUSION This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.
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Affiliation(s)
| | - Mohammed Al Sinani
- Reproductive and Developmental Biology Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - Zakariya Al Naamani
- School of Nursing and Midwifery, Queen's University Medical Biology Centre, Belfast, Northern Ireland
| | - Khalid Al Badi
- Al Khawarizmi International College, Abu Dhabi, United Arab Emirates
| | - Mu'ath Ibrahim Tanash
- Department of Adult Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Lee MK. Relationships of Symptom Groups and Functioning Domains in Patients with Advanced-Stage Non-Small Cell Lung Cancer Undergoing Treatment: A Cross-Sectional Study. Healthcare (Basel) 2020; 9:28. [PMID: 33396797 PMCID: PMC7823599 DOI: 10.3390/healthcare9010028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/22/2020] [Accepted: 12/28/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to describe the symptoms experienced by patients with non-small cell lung cancer (NSCLC), examine whether different symptom groups significantly affected different functioning domains in these patients, and determine the effect of the "lack of energy" and "pain" symptom groups on the different functioning domains of health-related quality of life (HRQOL). From a single tertiary institution, this cross-sectional study enrolled 135 consecutive NSCLC patients who were mostly undergoing chemotherapy and were in the advanced stage (National University Hospital, Daegu, South Korea). Clinical and self-reported demographic information and data on different functioning domains (from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30)), symptom experience (from the EORTC QLQ-LC13), and the Symptom Distress Scale (SDS) were examined. The four most common symptoms were fatigue (69%), pain (47%), dyspnea (38%), and lack of appetite (36%). The "pain" symptom group was negatively associated with physical, emotional, cognitive, and role functioning. The "lack of energy" symptom group was negatively associated with physical, role, emotional, social, and cognitive functioning. The "lack of energy" symptom group explained the most variance for physical and role functioning, and the "pain" symptom group explained the most variance for emotional functioning. Impaired concentration explained the most variance for cognitive functioning.
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Affiliation(s)
- Myung Kyung Lee
- College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu 41944, Korea
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Ma Y, He B, Jiang M, Yang Y, Wang C, Huang C, Han L. Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. Int J Nurs Stud 2020; 111:103707. [DOI: 10.1016/j.ijnurstu.2020.103707] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 06/02/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
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Kogure E, Hara T. Factors associated with fatigue one month after surgery in patients with gastrointestinal cancer. Phys Ther Res 2020; 23:53-58. [PMID: 32850279 DOI: 10.1298/ptr.e10003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 11/26/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the factors associated with the occurrence of cancer-related fatigue (CRF) one month after surgery in patients with gastrointestinal cancer. METHOD The study included 96 patients with gastrointestinal cancer (50 males and 46 females, mean age 62.7 ± 11.4 years). Data of the Cancer Fatigue Scale (CFS), 6-minute walk distance (6MWD), and hospital anxiety and depression scale (HADS) were obtained before surgery and one month after surgery. The subjects were divided into the following two groups: severe CRF group (CFS score of ≥19 points) and mild CRF group (CFS score of <19 points). Each parameter was compared between the severe and mild CRF groups. The factors associated with CRF were identified by logistic regression analysis involving factors with significant differences between the groups. RESULT The CFS score showed a significant interaction, and the CFS score, 6MWD, and HADS score showed significant differences both before and one month after surgery between the two groups. The CFS score was significantly higher in the severe CRF group than in the mild CRF group both before and one month after surgery. Additionally, the 6MWD was significantly lower in the severe CRF group than in the mild CRF group both before and one month after surgery. The factors identified on logistic regression analysis were the preoperative CFS score and preoperative 6MWD. CONCLUSION CRF occurring one month after surgery might be affected by preoperative fatigue and preoperative exercise tolerance.
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Affiliation(s)
| | - Tsuyoshi Hara
- Department of Physical Therapy, School of Health Science, International University of Health and Welfare
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Lee Y, Hung CF, Chien CY, Lin PY, Lin MC, Wang CC, Lu HI, Chen YC, Chong MY, Wang LJ. Comparison of prevalence and associated factors of depressive disorder between patients with head and neck cancer and those with lung cancer at a tertiary hospital in Taiwan: a cross-sectional study. BMJ Open 2020; 10:e037918. [PMID: 32601116 PMCID: PMC7328812 DOI: 10.1136/bmjopen-2020-037918] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Depression is a common comorbidity in cancer patients. This study aimed to compare the prevalence and associated factors of depressive disorder between patients with head and neck cancer (HNC) and those with lung cancer (LC). DESIGN This study used a cross-sectional design with consecutive sampling. SETTING A medical centre (Kaohsiung Chang Gung Memorial Hospital, Taiwan). PARTICIPANTS Patients for the study were recruited from the HNC and LC outpatient clinic and inpatient ward from March 2016 to February 2018. Patients with HNC and LC were enrolled and assessed using the Mini International Neuropsychiatric Interview (MINI). PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was psychiatric diagnoses assessed using the MINI. The secondary outcomes were psychological well-being assessed using the Beck Anxiety Inventory, Taiwanese Depression Questionnaire, Brief Fatigue Inventory, Numeric Pain Rating Scale and the List of Threatening Experiences Questionnaire. RESULTS In total, 113 HNC patients and 104 LC patients were recruited for the study. The most common psychiatric comorbidity of HNC patients was alcohol use disorder (49.6%), followed by adjustment disorder (20.4%) and depressive disorder (11.5%). The most common psychiatric comorbidity of LC patients was depressive disorder (25.0%), followed by adjustment disorder (17.3%), alcohol use disorder (3.8%) and insomnia disorder (3.8%). Among HNC patients, a self-harm history was positively associated with depression (OR=11.91; 95% CI, 1.47 to 96.83), and a higher educational level was negatively associated with depression (OR=0.77; 95% CI, 0.66 to 0.91). Among LC patients, severity of stressor (OR=2.78; 95% CI, 1.50 to 5.15) and severity of anxiety (OR=1.18; 95% CI, 1.04 to 1.34) were two significant factors associated with depression. CONCLUSION We reported the prevalence and associated factors of depression between patients with HNC and those with LC. Clinicians should be aware of this comorbidity and the associated risk factors, and conduct intervention programmes to prevent these cancer patients from developing depression.
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Affiliation(s)
- Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Meng-Chih Lin
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hung-I Lu
- Department of Cardiothoracic Vascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Che Chen
- Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Mian-Yoon Chong
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Ikeuchi K, Ishiguro H, Nakamura Y, Izawa T, Shinkura N, Nin K. The relation between mindfulness and the fatigue of women with breast cancer: path analysis. Biopsychosoc Med 2020; 14:1. [PMID: 32071613 PMCID: PMC7011601 DOI: 10.1186/s13030-020-0175-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background Although fatigue is a common and distressing symptom in cancer survivors, the mechanism of fatigue is not fully understood. Therefore, this study aims to investigate the relation between the fatigue and mindfulness of breast cancer survivors using anxiety, depression, pain, loneliness, and sleep disturbance as mediators. Methods Path analysis was performed to examine direct and indirect associations between mindfulness and fatigue. Participants were breast cancer survivors who visited a breast surgery department at a university hospital in Japan for hormonal therapy or regular check-ups after treatment. The questionnaire measured cancer-related-fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance. Demographic and clinical characteristics were collected from medical records. Results Two-hundred and seventy-nine breast cancer survivors were registered, of which 259 answered the questionnaire. Ten respondents with incomplete questionnaire data were excluded, resulting in 249 participants for the analyses. Our final model fit the data well (goodness of fit index = .993; adjusted goodness of fit index = .966; comparative fit index = .999; root mean square error of approximation = .016). Mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance were related to fatigue, and mindfulness had the most influence on fatigue (β = − .52). Mindfulness affected fatigue not only directly but also indirectly through anxiety, depression, pain, loneliness, and sleep disturbance. Conclusions The study model helps to explain the process by which mindfulness affects fatigue. Our results suggest that mindfulness has both direct and indirect effects on the fatigue of breast cancer survivors and that mindfulness can be used to more effectively reduce their fatigue. It also suggests that health care professionals should be aware of factors such as anxiety, depression, pain, loneliness, and sleep disturbance in their care for fatigue of breast cancer survivors. Trial registration This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN number. 000027720) on June 12, 2017.
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Affiliation(s)
- Kaori Ikeuchi
- 1Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawara-cho Shogo-in, Sakyo-ku, Kyoto, 606-8507 Japan.,2Department of Nursing, University of Shitennoji, 3-2-1 Gakuenmae, Habikino, Osaka, 583-8501 Japan
| | - Hiroshi Ishiguro
- 3Department of Medical Oncology, International University of Health and Welfare Hospital, 537-3 Iguchi, Nasushiobara, 329-2763 Japan
| | - Yasunori Nakamura
- 4Graduate School of Human Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192 Japan
| | - Tomoko Izawa
- 1Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawara-cho Shogo-in, Sakyo-ku, Kyoto, 606-8507 Japan
| | - Nobuhiko Shinkura
- Sawai Memorial Breast Clinic, 98 Matsumoto-cho Kamigamo, Kita-ku, Kyoto, 603-8052 Japan
| | - Kazuko Nin
- 1Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawara-cho Shogo-in, Sakyo-ku, Kyoto, 606-8507 Japan
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Daroszewski C, Stasiewicz M, Jaźwińska-Tarnawska E, Rachwalik A, Mura E, Luboch-Kowal J, Dryś A, Bogucki ZA, Brzecka A. Quality of Life in Patients with Advanced Non-Small-Cell Lung Cancer Receiving Palliative Chemotherapy. Adv Exp Med Biol 2019; 1160:11-18. [PMID: 30825114 DOI: 10.1007/5584_2019_346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
The goal of this study was to explore quality of life in patients with advanced non-small-cell lung cancer (NSCLC) in an attempt to single out features that could help predict the possibility of non-completion of chemotherapy. The survey tool was the Quality of Life Questionnaire Core-30 (QLQ-C30) with the module Lung Cancer 13 (LC-13) developed by the European Organization for Research and Treatment of Cancer. The assessment of quality of life (QoL) was performed in 58 patients with advanced NSCLC before palliative chemotherapy and it was repeated in 43 patients who completed at least three cycles of chemotherapy. We found that the patients who failed to complete the chemotherapy course distinctly showed, in contradistinction to those who completed it, poor physical functioning in (67.6 ± 16.3 vs. 78.3 ± 21.3 points, respectively, p < 0.05) and the lack of appetite (27.1 ± 38.0 vs. 48.9 ± 37.5 points, respectively p < 0.05). At the end of palliative chemotherapy alopecia, sore throat, and constipation significantly worsened QoL, but global health status remained unchanged. In conclusion, poor physical functioning and loss of appetite seem to harbinger a risk of non-completion of chemotherapy in advanced NSCLC.
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Affiliation(s)
- Cyryl Daroszewski
- Department of Pulmonology and Lung Cancer, Wrocław Medical University, Wrocław, Poland
| | | | | | - Anna Rachwalik
- Student's Scientific Association, Wrocław Medical University, Wrocław, Poland
| | - Ewa Mura
- Student's Scientific Association, Wrocław Medical University, Wrocław, Poland
| | - Joanna Luboch-Kowal
- Department of Physical Chemistry, Wrocław Medical University, Wrocław, Poland
| | - Andrzej Dryś
- Department of Physical Chemistry, Wrocław Medical University, Wrocław, Poland
| | - Zdzisław A Bogucki
- Department of Dental Prosthetics, Wrocław Medical University, Wrocław, Poland
| | - Anna Brzecka
- Department of Pulmonology and Lung Cancer, Wrocław Medical University, Wrocław, Poland
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Lee Y, Lin PY, Lin MC, Wang CC, Lu HI, Chen YC, Chong MY, Hung CF. Morbidity and associated factors of depressive disorder in patients with lung cancer. Cancer Manag Res 2019; 11:7587-7596. [PMID: 31496813 PMCID: PMC6691945 DOI: 10.2147/cmar.s188926] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 07/21/2019] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of this study was to assess morbidity and associated factors in patients with lung cancer (LC). Methods This study used a cross-sectional design with consecutive sampling. Study subjects were recruited from the LC outpatient clinic and inpatient ward in a medical center from March 2016 to February 2018. Patients with LC were enrolled and assessed using the Mini International Neuropsychiatric Interview, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Brief Fatigue Inventory, Numeric Pain Rating Scale, and the List of Threatening Experiences Questionnaire. Results One hundred and four patients were included in the study. The most prevalent psychiatric disorder was depressive disorder (25.0%), followed by adjustment disorder (17.3%), alcohol use disorder (3.8%), and insomnia disorder (3.8%). Fifty percent of patients had a psychiatric diagnosis. Using logistic regression analysis, it was found that severity of fatigue (OR=1.77; 95% CI, 1.03–3.03; p<0.05), severity of stressor (OR=14.14; 95% CI, 2.49–80.20; p<0.05), and severity of anxiety (OR=3.75; 95% CI, 1.87–7.54; p<0.001) were three significant associated factors. Patient health problems, death of a close family member or friend, and major financial crisis were the three most common stressors among our cancer patients. Conclusion Use of a standardized structured interview for early diagnosis and treatment of cancer patients with depressive disorder is crucial and might increase their quality of life.
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Affiliation(s)
- Yu Lee
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Meng-Chih Lin
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Chin-Chou Wang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Hung-I Lu
- Department of Cardiothoracic Vascular Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Yung-Che Chen
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
| | - Mian-Yoon Chong
- Chang Gung Memorial Hospital, Chiayi, and Chang Gung University School of Medicine, Kaohsiung, Taiwan
| | - Chi-Fa Hung
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine Kaohsiung, Kaohsiung, Taiwan
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Hashimoto H, Kanda K. Development and validation of the Total Dyspnea Scale for Cancer Patients. Eur J Oncol Nurs 2019; 41:120-125. [DOI: 10.1016/j.ejon.2019.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/23/2019] [Accepted: 05/30/2019] [Indexed: 11/12/2022]
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Guarda Korelo RI, Siega J, Cordeiro Woloschen AC, Paula do Amaral M, Barão Dos Santos Ivanski M, Schleder JC, Fernandes LC. Brazilian Version of Cancer Fatigue Scale: Validation of the Brazilian Version of Cancer Fatigue Scale in Patients With Breast Cancer. J Pain Symptom Manage 2019; 57:1130-1136. [PMID: 30904416 DOI: 10.1016/j.jpainsymman.2019.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022]
Abstract
CONTEXT Scales to assess the fatigue in patients with cancer may help the clinical decision-making process. OBJECTIVES The objective of this study was to cross-culturally adapt and determine the validity of the Brazilian version of Cancer Fatigue Scale. METHODS Translation and cross-cultural adaptation followed the recommendations of international guidelines. One hundred fifty-one women with breast cancer participated in the validity phase and they filled out the Brazilian version of another instruments (Piper Fatigue Scale Revised, Beck Depression Inventory, Verbal Numerical Rating Scale, and Karnofsky Performance Scale). The measurement properties of reliability, internal consistency, and validity were measured. RESULTS The few discrepancies identified in the back-translation were solved by consensus, and the Cancer Fatigue Scale was successfully translated and cross-culturally adapted. The Brazilian version of Cancer Fatigue Scale showed good stability (test-retest reliability intraclass correlation coefficient = 0.95, 95% CI = 0.94-0.97 and interexaminer reliability intraclass correlation coefficient = 0.98, 95% CI = 0.97-0.99) and good internal consistency (Cronbach's alpha >0.70 for the three subscales/domains). The high correlation was found with Piper Fatigue Scale (r = 0.643) and Beck Depression Inventory (r = 0.509) in terms of validity. However, a reasonable correlation was found with Verbal Numerical Rating Scale (r = 0.302) and Karnofsky Performance Scale (r = -0.324). CONCLUSION Here, we validated the Cancer Fatigue Scale in breast cancer Brazilian women meaning its use for the identification and evaluation of cancer-related fatigue in patients with breast cancer.
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Affiliation(s)
- Raciele Ivandra Guarda Korelo
- Universidade Federal do Paraná (UFPR)-Prevention and Rehabilitation in Physical Therapy Department Curitiba, Paraná, Brazil.
| | - Juliana Siega
- Universidade Federal do Paraná (UFPR)-Physiotherapist Post-Graduation Program in Physical Education Curitiba, Paraná, Brazil
| | | | - Maryelle Paula do Amaral
- Universidade Federal do Paraná (UFPR)-Graduate Program in Physical Therapy Curitiba, Paraná, Brazil
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Zou G, Li Y, Xu R, Li P. Resilience and positive affect contribute to lower cancer-related fatigue among Chinese patients with gastric cancer. J Clin Nurs 2018; 27:e1412-e1418. [PMID: 29266530 DOI: 10.1111/jocn.14245] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2017] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To investigate the prevalence of cancer-related fatigue and explore the relationship between resilience, positive affect, and fatigue among Chinese patients with gastric cancer. BACKGROUND Cancer-related fatigue is the most distressing symptom reported frequently by cancer patients during both treatment and survival phases. Resilience and positive affect as vital protective factors against cancer-related fatigue have been examined, but the underlying psychological mechanisms are not well understood. DESIGN A cross-sectional study. METHODS Two hundred and three gastric cancer patients were enrolled from three hospitals in China. The Cancer Fatigue Scale, the positive affect subscale of the Positive and Negative Affect Schedule and the Connor-Davidson Resilience Scale (CD-RISC10) were administered. Hierarchical linear regression modelling was conducted to examine the association between resilience and cancer-related fatigue, and the mediating effect of positive affect. RESULTS The incidence of clinically relevant fatigue among patients with gastric cancer was 91.6%. Regression analysis showed that resilience was negatively associated with cancer-related fatigue, explaining 15.4% of variance in cancer-related fatigue. Mediation analysis showed that high resilience was associated with increased positive affect, which was associated with decreased cancer-related fatigue. CONCLUSIONS Cancer-related fatigue is prevalent among patients with gastric cancer. Positive affect may mediate the relationship between resilience and cancer-related fatigue. RELEVANCE TO CLINICAL PRACTICE Interventions that attend to resilience training and promotion of positive affect may be the focus for future clinical and research endeavours.
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Affiliation(s)
- Guiyuan Zou
- School of Nursing, Shandong University, Jinan, Shandong Province, China.,Shandong Mental Health Center, Jinan, Shandong Province, China
| | - Ye Li
- Linyi People's Hospital, Linyi, Shandong Province, China
| | - Ruicai Xu
- Shandong Provincial Hospital, Jinan, Shandong Province, China
| | - Ping Li
- School of Nursing, Shandong University, Jinan, Shandong Province, China
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Kogure E, Hara T, Ishii T, Maeda M. Changes in fatigue and physical function with age for patients with gastrointestinal cancer in the perioperative period: a comparison between older and young patients. J Phys Ther Sci 2017; 29:2004-2008. [PMID: 29200645 PMCID: PMC5702835 DOI: 10.1589/jpts.29.2004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine changes in fatigue and physical
function with age for groups of patients with gastrointestinal cancer in the perioperative
period. [Subjects and Methods] The study involved 52 patients with gastrointestinal cancer
(28 males and 24 females, aged 62.4 ± 12.0 years). The subjects were divided into two
groups: those 65 or over (the so-called elderly group,) and those 64 or under (the
so-called young group). The six minute walk distance (6MWD), Cancer Fatigue Scale (CFS),
and serum albumin (ALB) were evaluated on three occasions: before surgery, after surgery
and after discharge. This study considered change in physical function and fatigue,
differences between the two groups and correlations between age and each evaluation on the
three occasions. [Results] The 6MWD was the main difference between the elderly and young
groups, with the former having significantly reduced 6MWD values as compared to the latter
after surgery. Age was positively correlated with 6MWD and ALB after surgery and after
discharge. Moreover, age was negatively correlated with CFS after surgery and after
discharge. [Conclusion] It is suggested that elderly patients are more likely to
experience a decline in exercise tolerance and an increase in fatigue.
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Affiliation(s)
- Eisuke Kogure
- Department of Rehabilitation, International University of Health and Welfare Graduate School: 1-3-3 Minami Aoyama, Minato-ku, Tokyo 107-0062, Japan.,Division of Rehabilitation, International University of Health and Welfare Mita Hospital, Japan
| | - Tsuyoshi Hara
- Department of Physical Therapy, Faculty of Health Science, International University of Health and Welfare, Japan
| | - Takaya Ishii
- Division of Rehabilitation, International University of Health and Welfare Mita Hospital, Japan
| | - Masaharu Maeda
- Department of Rehabilitation, International University of Health and Welfare Graduate School: 1-3-3 Minami Aoyama, Minato-ku, Tokyo 107-0062, Japan
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Jung JY, Lee JM, Kim MS, Shim YM, Zo JI, Yun YH. Comparison of fatigue, depression, and anxiety as factors affecting posttreatment health-related quality of life in lung cancer survivors. Psychooncology 2017; 27:465-470. [DOI: 10.1002/pon.4513] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/18/2017] [Accepted: 07/24/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Ju Youn Jung
- Department of Biomedical Science; Seoul National University College of Medicine and Hospital; Seoul South Korea
| | - Jong Mog Lee
- Center for Lung Cancer; National Cancer Center; Goyang South Korea
| | - Moon Soo Kim
- Center for Lung Cancer; National Cancer Center; Goyang South Korea
| | - Young Mog Shim
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center; Samsung Medical Center; Seoul South Korea
| | - Jae Ill Zo
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center; Samsung Medical Center; Seoul South Korea
| | - Young Ho Yun
- Department of Biomedical Science; Seoul National University College of Medicine and Hospital; Seoul South Korea
- Cancer Research Institute; Seoul National University College of Medicine; Seoul South Korea
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18
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Hamada T, Komatsu H, Rosenzweig MQ, Chohnabayashi N, Nishimura N, Oizumi S, Ren D. Impact of Symptom Clusters on Quality of Life Outcomes in Patients from Japan with Advanced Nonsmall Cell Lung Cancers. Asia Pac J Oncol Nurs 2016; 3:370-381. [PMID: 28083555 PMCID: PMC5214871 DOI: 10.4103/2347-5625.196489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/04/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Identify symptom clusters based on symptoms experienced by patients with advanced nonsmall cell lung cancers (NSCLCs), and examine the relationship between the symptom clusters and impairment in everyday life and quality of life (QOL). METHODS Using the M.D. Anderson Symptom Inventory, 9 symptom items and the QOL Questionnaire (QLQ-C-30) evaluation apparatus from the European Organization for Research and Treatment of Cancer, we evaluated symptom severity, interference in daily life, and QOL. Factor analysis and multiple regression analysis techniques were used. RESULTS Sixty patients with advanced NSCLCs seen in pulmonary medicine departments were included in the study. The average age of patients was 64.33 (standard deviation = 11.40). Thirty-six were male and 24 were female. Three symptom clusters were identified as fatigue/anorexia cluster (dry mouth, altered the sense of taste, drowsiness, fatigue/tiredness, and lack of appetite), pain cluster (anxiety, sadness, and pain), numbness cluster (numbness, leg weakness, and distress). The pain cluster had the strongest influence (adjusted R2 = 0.355) on daily life (emotions) while the numbness cluster most strongly affected walking. The fatigue/anorexia cluster explained 22.7% of role function variance. This symptom clustering may be unique among patients with advanced NSCLCs. CONCLUSIONS Each of these clusters affected QOL and everyday life with varying degrees of influence. In clinical screening assessments, focusing on symptom clusters could provide tailored management strategies for patients with advanced NSCLCs. These care strategies may improve outcomes specifically for advanced NSCLCs patients.
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Affiliation(s)
- Tamami Hamada
- Department of Nursing, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Margaret Quinn Rosenzweig
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pennsylvania, USA
| | - Naohiko Chohnabayashi
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Nishimura
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Satoshi Oizumi
- Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan
| | - Dianxu Ren
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pennsylvania, USA
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Charalambous A, Kouta C. Cancer Related Fatigue and Quality of Life in Patients with Advanced Prostate Cancer Undergoing Chemotherapy. Biomed Res Int 2016; 2016:3989286. [PMID: 26981530 DOI: 10.1155/2016/3989286] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 01/17/2016] [Indexed: 12/02/2022]
Abstract
Cancer related fatigue (CRF) is a common and debilitating symptom that can influence quality of life (QoL) in cancer patients. The increase in survival times stresses for a better understanding of how CRF affects patients' QoL. This was a cross-sectional descriptive study with 148 randomly recruited prostate cancer patients aiming to explore CRF and its impact on QoL. Assessments included the Cancer Fatigue Scale, EORTC QLQ-C30, and EORTC QLQ-PR25. Additionally, 15 in-depth structured interviews were performed. Quantitative data were analyzed with simple and multiple regression analysis and independent samples t-test. Qualitative data were analyzed with the use of thematic content analysis. The 66.9% of the patients experienced CRF with higher levels being recorded for the affective subscale. Statistically significant differences were found between the patients reporting CRF and lower levels of QoL (mean = 49.1) and those that did not report fatigue and had higher levels of QoL (mean = 72.1). The interviews emphasized CRF's profound impact on the patients' lives that was reflected on the following themes: “dependency on others,” “loss of power over decision making,” and “daily living disruption.” Cancer related fatigue is a significant problem for patients with advanced prostate cancer and one that affects their QoL in various ways.
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Komatsu H, Yagasaki K, Yamauchi H, Yamauchi T, Takebayashi T. A self-directed home yoga programme for women with breast cancer during chemotherapy: A feasibility study. Int J Nurs Pract 2015; 22:258-66. [PMID: 26643264 PMCID: PMC5064641 DOI: 10.1111/ijn.12419] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Revised: 09/29/2015] [Accepted: 11/08/2015] [Indexed: 12/01/2022]
Abstract
Recent studies suggest yoga as a promising approach for improving the cognitive function of cancer survivors. We studied whether a self‐directed home yoga programme was feasible for patients with breast cancer who were undergoing chemotherapy. Participants' preferences for the type of yoga course and the clinical effects of the programme were also assessed. In this study, 18 women (mean age, 43.9 years) were enrolled (44.7% recruitment rate). Of the participants, 63.6% had stage II cancer and 71.4% received adjuvant chemotherapy. Favourable retention (86%), adherence (94.4%) and acceptability (96.5%) rates were determined. Most (94.4%) of the women practiced the home programme more than twice a week on average. The participants preferred to gradually increase the intensity of the exercises. We only observed improvements in the cognitive aspects of fatigue. No serious adverse events were encountered during the programme. This self‐directed home yoga programme was safe and feasible for patients with breast cancer undergoing chemotherapy.
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Affiliation(s)
- Hiroko Komatsu
- Professor, Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Kaori Yagasaki
- Associate Professor, Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Hideko Yamauchi
- Head of the Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan
| | - Teruo Yamauchi
- Head of the Division of Medical Oncology, Department of Internal Medicine, St. Luke's International Hospital, Tokyo, Japan
| | - Toru Takebayashi
- Professor, Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
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Qiu C, Qu X, Shen H, Zheng C, Zhu L, Meng L, Du J. Evaluation of Prognostic Nutritional Index in Patients Undergoing Radical Surgery with Nonsmall Cell Lung Cancer. Nutr Cancer 2015; 67:741-7. [DOI: 10.1080/01635581.2015.1032430] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Abstract
The aim of this study was to evaluate the pain and fatigue levels of elderly cancer patients and to examine whether pain is an independent variable in fatigue development. A total of 250 elderly cancer patients undergoing treatment in the outpatient chemotherapy units and internal medicine clinic at 2 hospitals were enrolled. A "Patient Information Form," the "McGill Melzack Pain Questionnaire," and the "Brief Fatigue Inventory" were used as data instruments. It was determined that all patients had pain and that the mean present pain intensity score was 2.70 ± 0.99, the mean worst pain intensity score was 4.40 ± 0.86, and the mean least pain intensity score was 1.40 ± 0.66. Whereas the existing fatigue severity score of the patients with fatigue (43.6%) was 6.27 ± 2.06, the mean usual fatigue severity of the patients in the last 24 hours was 6.19 ± 1.63 and that the mean worst fatigue severity score in the last 24 hours was 7.29 ± 1.57. When the regression analysis carried out between the pain and fatigue intensities is examined, it was determined that pain is an independent variable in increasing fatigue and that there is a statistically significant relationship (P < .05). It is important that nurses develop strategies to prevent and determine activities to decrease the pain and fatigue of the patients while planning and implementing their holistic care in a relevant manner.
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Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Ogawa A, Fujisawa D, Sone T, Yoshiuchi K, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Personality traits and coping styles explain anxiety in lung cancer patients to a greater extent than other factors. Jpn J Clin Oncol 2015; 45:456-63. [DOI: 10.1093/jjco/hyv024] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 02/03/2015] [Indexed: 01/06/2023] Open
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Martinez-Alonso M, Dusso A, Ariza G, Nabal M. The effect on quality of life of vitamin D administration for advanced cancer treatment (VIDAFACT study): protocol of a randomised controlled trial. BMJ Open 2014; 4:e006128. [PMID: 25552610 PMCID: PMC4281528 DOI: 10.1136/bmjopen-2014-006128] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
INTRODUCTION Vitamin D is related to resistance to chronic diseases, physiological parameters and functional measures. All of these relationships underscore the potential benefits of cholecalciferol or D3 (nutritional vitamin D) in cancer. This is the first study designed to obtain conclusive evidence on the effect of cholecalciferol in advanced patients with cancer. The main goal is to assess its effects on the patient's perceived quality of life. Cholecalciferol's impact on fatigue and physical performance, as well as its cost utility, will also be assessed. METHODS AND ANALYSIS A randomised triple-blind phase II/III placebo-controlled multicentre trial has been designed. Patients satisfying the inclusion and exclusion criteria will be randomly assigned to receive cholecalciferol or placebo. Eligible patients will be adults with a locally advanced or metastatic or inoperable solid cancer in palliative care, who have given signed informed consent and have matched inclusion and exclusion criteria. The randomisation will be based on a computer-generated procedure and centralised by the pharmacy service of the coordinating centre. The assigned treatment will be administered by the hospital's pharmacy to conceal group allocation for patients and healthcare providers. Cholecalciferol (4000 IU/day) or placebo, starting at day 15 and continuing up to day 42, will be added to palliative care treatment. Outpatient visits will be scheduled every 14 days. ETHICS AND DISSEMINATION Ethical approval was received from the Medical Ethical Commitee of the HUAV (CEIC-1169). Participants and their families will receive the research findings which will also be disseminated on local and national media, presented at national and international meetings of the specialty, and published in peer-reviewed scientific journals. TRIAL REGISTRATION NUMBER EudraCT: 2013-003478-29.
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Affiliation(s)
- Montserrat Martinez-Alonso
- Ciències Mèdiques Bàsiques, Universitat de Lleida, Lleida, Spain
- Biostatistics and Methodological Support, IRBLLEIDA, Lleida, Spain
| | | | - Gemma Ariza
- Rehabilitation Unit, Hospital Universitari Arnau de Vilanova, Lleida, Spain
| | - Maria Nabal
- Palliative Care Supportive Team, Hospital Universitari Arnau de Vilanova, Lleida, Spain
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Miura K, Ando S, Imai T. The association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients. Breast Cancer 2014; 23:407-14. [PMID: 25548069 DOI: 10.1007/s12282-014-0578-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 12/18/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND The causes of cancer-related fatigue, which can influence patients' activities, are multidimensional; however, little is known about the cognitive dimension. We examined the association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients after primary treatment. METHODS This descriptive, cross-sectional study recruited 20-64-year-old breast cancer patients in an outpatient setting. The patients (N = 93; mean age = 53 years) were divided into low (L-CogF) and high-cognitive fatigue (H-CogF) groups according to their scores on the cognitive fatigue subscale of the Cancer Fatigue Scale. We compared the groups on their sociodemographic and medical characteristics and scores on the Functional Assessment of Cancer Therapy-Breast (FACT-B) [a measure of quality of life (QOL)], Simplified Menopausal Index (SMI), and Self-Rating Questionnaire for Depression (SRQ-D). RESULTS The L-CogF (n = 55) and H-CogF (n = 38) patients did not differ in age, years since diagnosis, marital status, educational background, or treatment history. Total and subscale FACT-B scores, except for physical well-being, were significantly lower in H-CogF participants than in L-CogF participants. SMI and SRQ-D scores were significantly higher in H-CogF participants. Employed H-CogF participants were concerned about keeping their jobs (p < 0.05). CONCLUSIONS Breast cancer patients with high-cognitive fatigue suffer from severe menopause and depressive symptoms, and deteriorating QOL. Cognitive fatigue should be considered when interpreting patients' cognitive complaints.
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Affiliation(s)
- Kiyoko Miura
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daikominami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan.
| | - Shoko Ando
- Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daikominami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan
| | - Tsuneo Imai
- Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan
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Peters MEWJ, Goedendorp MM, Verhagen CAHHVM, van der Graaf WTA, Bleijenberg G. Severe Fatigue During the Palliative Treatment Phase of Cancer: An Exploratory Study. Cancer Nurs 2014; 37:139-45. [DOI: 10.1097/ncc.0b013e318291bd2d] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Tonosaki A, Ishikawa M. Physical activity intensity and health status perception of breast cancer patients undergoing adjuvant chemotherapy. Eur J Oncol Nurs 2014; 18:132-9. [PMID: 24485013 DOI: 10.1016/j.ejon.2013.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 11/19/2013] [Accepted: 11/28/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim was to evaluate the physical activity intensity (PAI) of patients receiving adjuvant chemotherapy and investigate the relationship between health status perception and PAI in Japan. METHODS Consenting participants of this prospective, descriptive, repeated measures design were 28 women aged 20-64 with stage I-IIIA initial breast cancer whose regimen included anthracycline. Participants wore a triaxial accelerometer and their PAI was measured for a 14-day period at the beginning of chemotherapy. The SF-36 Survey and Cancer Fatigue Scale were administered. The accelerometer was used to calculate the number of steps, physical activity level (PAL) and total minutes of PAI levels of under 1.5 Mets, 1.5-2.9 Mets, and more than 3.0 Mets during the first half (FH; days 2-7) and second half (SH; days 8-14) of the study. Data were analyzed using Pearson's correlation coefficient and multiple regression analysis. RESULTS During FH, the mean number of steps was 3841.1 steps/day and mean PAL was 1.43; during SH, the mean number of steps was 4058.4 steps/day, mean PAL was 1.43; participants spent over 70% of the day working quietly in a sitting position. PAL during SH was significantly associated with mean time spent during activities of 1.5-2.9 Mets (β = 0.880, p < 0.0001) and 3.0 Mets (β = 0.268, p < 0.0001). CONCLUSION Patients receiving adjuvant chemotherapy had extremely low physical activity. They should be provided useful information of appropriate physical movement and be supported in resolving physical and psychological distress.
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Abstract
Patients with lung cancer have high mortality and high morbidity. Lung cancer-related symptoms and problems such as dyspnea, fatigue, pain, and cachexia that begin in the early phase later result in poor physical functioning, psychosocial, and quality of life status. In addition, advancing age is associated with significant comorbidity. These patients may benefit from multidisciplinary therapy to reduce the perceived severity of dyspnea and fatigue and increase physical functioning and quality of life. Based on management of symptoms and problems such as dyspnea, physical inactivity, cancer-related fatigue, respiratory secretions, pain, and anxiety–depression of these patients, it is thought that physiotherapy techniques can be used on advanced lung cancer patients following a comprehensive evaluation. However, well-designed, prospective, and randomized-controlled trials are needed to prove the efficacy of physiotherapy and pulmonary rehabilitation in general for patients with advanced lung cancer.
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Affiliation(s)
- Sevgi Ozalevli
- Dokuz Eylul University, School of Physical Therapy and Re-habilitation, Izmir, Turkey
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Komatsu H, Watanabe C, Yagasaki K, Sakakibara N, Nakamura S. Validation of the Japanese version of the Fatigue Barriers Scale (JFBS). Int J Palliat Nurs 2013; 19:503-9. [DOI: 10.12968/ijpn.2013.19.10.503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background: The Fatigue Barriers Scale (FBS) is an instrument to identify patient-derived barriers to fatigue management. Objective: To assess the reliability and validity of the Japanese version of the FBS (JFBS). Methods: Participants were 112 cancer patients. Reliability was determined through internal consistency using Cronbach's alpha coefficient and through test–retest reliability using Spearman's intra-class correlation coefficient (ICC). Construct, convergent, criterion-referenced, and concurrent validities were assessed. The Cancer Fatigue Scale (CFS), Patient Fatigue Knowledge Tool (PFKT), and Kessler 6-item distress scale (K6) were used for comparisons. Results: Cronbach's alpha coefficients were 0.74, 0.78, 0.72, and 0.54 for the JFBS total and for each subscale, respectively. All ICCs exceeded 0.65 (P<0.05). The JFBS had a weak negative correlation with the PFKT and a positive correlation with the CFS. The K6 scores showed weak positive correlations with the JFBS total and fatalism subscale scores. Conclusions: The JFBS can be used to measure fatigue barriers in Japanese people with cancer.
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Affiliation(s)
- Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Iyer S, Taylor-Stokes G, Roughley A. Symptom burden and quality of life in advanced non-small cell lung cancer patients in France and Germany. Lung Cancer 2013; 81:288-93. [DOI: 10.1016/j.lungcan.2013.03.008] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Revised: 03/06/2013] [Accepted: 03/07/2013] [Indexed: 01/17/2023]
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Oldenmenger WH, de Raaf PJ, de Klerk C, van der Rijt CCD. Cut points on 0-10 numeric rating scales for symptoms included in the Edmonton Symptom Assessment Scale in cancer patients: a systematic review. J Pain Symptom Manage 2013; 45:1083-93. [PMID: 23017617 DOI: 10.1016/j.jpainsymman.2012.06.007] [Citation(s) in RCA: 178] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/29/2012] [Accepted: 06/03/2012] [Indexed: 12/20/2022]
Abstract
CONTEXT To improve the management of cancer-related symptoms, systematic screening is necessary, often performed by using 0-10 numeric rating scales. Cut points are used to determine if scores represent clinically relevant burden. OBJECTIVES The aim of this systematic review was to explore the evidence on cut points for the symptoms of the Edmonton Symptom Assessment Scale. METHODS Relevant literature was searched in PubMed, CINAHL®, Embase, and PsycINFO®. We defined a cut point as the lower bound of the scores representing moderate or severe burden. RESULTS Eighteen articles were eligible for this review. Cut points were determined using the interference with daily life, another symptom-related method, or a verbal scale. For pain, cut point 5 and, to a lesser extent, cut point 7 were found as the optimal cut points for moderate pain and severe pain, respectively. For moderate tiredness, the best cut point seemed to be cut point 4. For severe tiredness, both cut points 7 and 8 were suggested frequently. A lack of evidence exists for nausea, depression, anxiety, drowsiness, appetite, well-being, and shortness of breath. Few studies suggested a cut point below 4. CONCLUSION For many symptoms, there is no clear evidence as to what the optimal cut points are. In daily clinical practice, a symptom score ≥4 is recommended as a trigger for a more comprehensive symptom assessment. Until there is more evidence on the optimal cut points, we should hold back using a certain cut point in quality indicators and be cautious about strongly recommending a certain cut point in guidelines.
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Affiliation(s)
- Wendy H Oldenmenger
- Department of Medical Oncology, Erasmus MC Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
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Lin S, Chen Y, Yang L, Zhou J. Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients. J Clin Nurs 2013; 22:1281-90. [DOI: 10.1111/jocn.12228] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Shuanglan Lin
- The Nursing College of Chongqing Medical University; Chongqing China
| | - Yanhan Chen
- The Nursing College of Chongqing Medical University; Chongqing China
| | - Liu Yang
- Nephrology Department of the First Affiliated Hospital of Chongqing Medical University; Chongqing
| | - Jianrong Zhou
- The Nursing College of Chongqing Medical University; Chongqing China
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Weiss T, Weinberger M, Schwerd AM, Holland J. A 30-year perspective on psychosocial issues in lung cancer: how lung cancer "Came out of the Closet". Thorac Surg Clin 2012; 22:449-56. [PMID: 23084609 DOI: 10.1016/j.thorsurg.2012.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Psychological responses to lung cancer have changed over the past 30 years as perceptions of the disease have changed. Previously seen as a fatal diagnosis, it is now regarded as a cancer whose treatment is increasingly effective as the science of the disease advances. The stigma of smoking is diminishing as more is learned about genetic factors and as more nonsmokers are diagnosed. Support groups are now widely available. The increasing social support and greater knowledge of lung cancer provide a more supportive environment in which patients cope with lung cancer today compared with 30 years ago.
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de Raaf PJ, de Klerk C, Timman R, Busschbach JJ, Oldenmenger WH, van der Rijt CC. Systematic Monitoring and Treatment of Physical Symptoms to Alleviate Fatigue in Patients With Advanced Cancer: A Randomized Controlled Trial. J Clin Oncol 2013; 31:716-23. [DOI: 10.1200/jco.2012.44.4216] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Several guidelines on the treatment of cancer-related fatigue recommend optimizing treatment of accompanying symptoms. However, evidence for this recommendation from randomized clinical trials is lacking. We investigated whether monitoring and protocolized treatment of physical symptoms alleviates fatigue. Patients and Methods In all, 152 fatigued patients with advanced cancer were randomly assigned to protocolized patient-tailored treatment (PPT) of symptoms or care as usual. The PPT group had four appointments with a nurse who assessed nine symptoms on a 0 to 10 numeric rating scale (NRS). Patients received a nonpharmacologic intervention for symptoms with a score ≥ 1 and a medical intervention for symptoms with a score ≥ 4. Fatigue dimensions, fatigue NRS score, interference of fatigue with daily life, symptom burden, quality of life, anxiety, and depression were measured at baseline and after 1, 2, and 3 months. Differences between the groups over time were assessed by using mixed modeling. Results Seventy-six patients were randomly assigned to each study arm. Mean age was 58 ± 10 years, 57% were female, and 65% were given palliative chemotherapy. We found significant improvements over time in favor of PPT for the primary outcome general fatigue (P = .01), with significant group differences at month 1 (effect size, 0.26; P = .007) and month 2 (effect size, 0.35; P = .005). Improvements in favor of PPT were also found for the following secondary outcomes: fatigue dimensions “reduced activity” and “reduced motivation,” fatigue NRS, symptom burden, interference of fatigue with daily life, and anxiety (all P ≤ .03). Conclusion In fatigued patients with advanced cancer, nurse-led monitoring and protocolized treatment of physical symptoms is effective in alleviating fatigue.
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Affiliation(s)
- Pleun J. de Raaf
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Cora de Klerk
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Reinier Timman
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Jan J.V. Busschbach
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Wendy H. Oldenmenger
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Carin C.D. van der Rijt
- Pleun J. de Raaf, Wendy H. Oldenmenger, and Carin C.D. van der Rijt, Daniel den Hoed Cancer Center; Pleun J. de Raaf, Cora de Klerk, Reinier Timman, and Jan J.V. Busschbach, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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Navigante A, Morgado PC, Casbarien O, Delgado NL, Giglio R, Perman M. Relationship between weakness and phase angle in advanced cancer patients with fatigue. Support Care Cancer 2013; 21:1685-90. [DOI: 10.1007/s00520-012-1714-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 12/28/2012] [Indexed: 12/21/2022]
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Spichiger E, Müller-fröhlich C, Denhaerynck K, Stoll H, Hantikainen V, Dodd M. Prevalence and contributors to fatigue in individuals hospitalized with advanced cancer: A prospective, observational study. Int J Nurs Stud 2012; 49:1146-54. [DOI: 10.1016/j.ijnurstu.2012.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/25/2012] [Accepted: 03/12/2012] [Indexed: 11/20/2022]
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Abstract
OBJECTIVES To present a clinical update regarding common distressing lung cancer symptoms and provide an update on management interventions. DATA SOURCES Journal articles, systematic reviews. CONCLUSION Goals of treatment of the patient with lung cancer must include management of the high symptom burden that often accompanies the disease. IMPLICATIONS FOR NURSING PRACTICE Early assessment and management of symptoms improves quality of life. Nurses play a key role in implementing and monitoring these interventions.
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Affiliation(s)
- Maureen Huhmann
- Department of Nutritional Sciences, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA.
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Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Yamada Y, Fujimori M, Ogawa A, Fujisawa D, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Clinical biopsychosocial risk factors for depression in lung cancer patients: a comprehensive analysis using data from the Lung Cancer Database Project. Ann Oncol 2012; 23:1973-1979. [PMID: 22473594 DOI: 10.1093/annonc/mds061] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Various risk factors for depression in lung cancer patients have been suggested but have been examined separately in studies with relatively small sample sizes. The present study examined the biopsychosocial risk factors of depression in lung cancer patients, focusing on psychological factors in the largest patient sample reported to date. PATIENTS AND METHODS A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, personal characteristics, health behaviors, physical symptoms, and psychological factors were obtained. The participants were divided into groups with or without depression using the Hospital Anxiety and Depression Scale. RESULTS Among the recruited patients, 165 (12.4%) manifested depression. The results of a binary logistic regression analysis were significant (overall R2, 36.5%), and a greater risk for depression was strongly associated with psychological factors, such as personality characteristics (neuroticism) and coping style (low fighting spirit, helplessness/hopelessness, and anxious preoccupation). Although the contributions of cancer-related variables, personal characteristics, health behaviors, and clinical state were relatively low, cancer stage, cancer type, sex, and age correlated significantly with depression. CONCLUSION Depression was most strongly linked with personality traits and coping style, and using screening instruments to identify these factors may be useful for preventive interventions.
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Affiliation(s)
- K Shimizu
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo.
| | - N Nakaya
- Department of Nutrition and Dietetics, Faculty of Family and Consumer Sciences, Kamakura Women's University, Kamakura; Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - K Saito-Nakaya
- Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - T Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - Y Yamada
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo
| | - M Fujimori
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo; Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa
| | - A Ogawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - D Fujisawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - K Goto
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa
| | - M Iwasaki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - S Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - Y Uchitomi
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Luciani A, Jacobsen P, Extermann M, Foa P, Marussi D, Ferrari D, Morabito A, Overcash J, Balducci L. The impact of fatigue and anemia on functional status in older cancer patients treated with chemotherapy. J Geriatr Oncol 2012; 3:182-8. [DOI: 10.1016/j.jgo.2012.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Tsai JS, Chen SC, Chiu TY, Leung KK, Hu WY, Hung SH, Wu CH, Chen CY. Correlates of fatigue phenomenon in palliative care patients with advance cancers in Taiwan. J Palliat Med 2012; 15:737-43. [PMID: 22612408 DOI: 10.1089/jpm.2011.0525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Fatigue is a multidimensional phenomenon that has different meanings according to different societal and cultural settings. This study aims to decipher fatigue in Taiwanese patients with cancer. METHODS We recruited 440 patients with advanced cancer admitted consecutively to the palliative care unit of a major medical center in Taiwan. The data were collected at admission, 1 and 2 weeks after admission, and 2 days before death. RESULTS The subject group consisted of 51.8% males and 48.2% females with a median age of 67 years (ranging from 27 to 93 years). The leading primary tumor sites among these patients were lung (20.2%), liver (18.0%), and colon-rectum (10.7%), and the median survival was 15 days, with a range of 1 to 418 days. All symptoms improved 1 week after admission, but most of them significantly worsened 2 days before death. In general, the physical signs manifested variation patterns similar to those of symptoms. The severity of psychosocial distress and death fear was lower after admission and retained the same level at 2 days before death, defying the consistent patterns found in other symptoms and signs. In the correlation analysis, most symptoms were correlated with fatigue during admission, with weakness being the most significant one. Although self-efficacy and emotion were correlated with fatigue both on admission and 1 week after admission, social support and death fear were not correlated with fatigue at all times. CONCLUSION The meaning of fatigue is mainly associated with physical factors among these patients. Education of complexities in fatigue in tandem with psychosocial and spiritual care may help alleviate this symptom, and promote quality of life.
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Affiliation(s)
- Jaw-Shiun Tsai
- Hospice and Palliative Care Unit, Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan
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Kwak SM, Choi YS, Yoon HM, Kim DG, Song SH, Lee YJ, Yeom CH, Koh SJ, Park J, Lee MA, Suh SY. The relationship between interleukin-6, tumor necrosis factor-α, and fatigue in terminally ill cancer patients. Palliat Med 2012; 26:275-82. [PMID: 21807751 DOI: 10.1177/0269216311406991] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although many cancer patients receiving palliative care experience distressing levels of fatigue, no well-designed studies have investigated contributing factors in Korean patients. We conducted a cross-sectional study using the Brief Fatigue Inventory-K (BFI-K) to measure fatigue while assessing a variety of possible correlates. Ninety patients with incurable cancer in the terminal stage (median survival: 27 days) participated in a structured interview and questionnaire related to their medical conditions and underwent blood sampling for laboratory data and cytokines, including interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Body mass index, dyspnea, the Eastern Cooperative Oncology Group performance status, and levels of albumin, blood urea nitrogen (BUN), total bilirubin, and C-reactive protein were significantly associated with fatigue. However, levels of the two proinflammatory cytokines, IL-6 and TNF-α, were not significantly correlated with the BFI-K score. In stepwise multiple linear regression, fatigue was related to elevated BUN (β = 0.376, p = 0.002), severe pain intensity (β = 0.349, p = 0.004), and impaired performance status (β = 0.268, p = 0.027), but not related to levels of inflammatory cytokines. In conclusion, the diagnostic work-up and therapeutic plan for patients with cancer-related fatigue should include an evaluation of laboratory parameters, pain severity, and physical performance.
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Affiliation(s)
- Sang Mi Kwak
- Department of Family Medicine, Korea University Guro Hospital, Seoul, Korea
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Tonosaki A. The long-term effects after hematopoietic stem cell transplant on leg muscle strength, physical inactivity and fatigue. Eur J Oncol Nurs 2012; 16:475-82. [PMID: 22265662 DOI: 10.1016/j.ejon.2011.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 11/10/2011] [Accepted: 11/26/2011] [Indexed: 10/14/2022]
Abstract
PURPOSE The purpose of this study was to analyze the effects of leg muscle strength and fatigue on step-count as a measure of physical activity for people staying at home after hematopoietic stem cell transplantation (HSCT). METHOD Nineteen persons receiving HSCT were assessed from hospitalization until about 2 months after discharge. Mean daily step-count was taken as a measure of physical activity. Leg muscle strength was measured in three ways (knee extension, ankle plantar flexion, and ankle dorsiflexion strength) at two points in time (time of hospital discharge and after 2 months). Fatigue and anxiety were assessed using the Japanese Cancer Fatigue Scale and State-Trait Anxiety Inventory. Correlations between the above and factors affecting physical activity were also investigated by multiple regression analysis. RESULTS Clinical follow-up measurements in subjects were made an average of 81.0 days after discharge. Subjects with higher mean step-count during hospitalization (β = 0.647, p = 0.000) and greater ankle plantar flexion strength/kg (β = 0.361, p = 0.021) reported higher mean step-count at home (adjusted R(2) = 0.701, p = 0.021). Subjects with body mass index <22.0 kg/m(2) also showed higher step-counts at home compared to other subjects. Mean fatigue score at home was 16.8 (SD = 8.75), a level not associated with clinical problems, and the proportion of physical fatigue was significantly lower than during hospitalization. CONCLUSION Mean step-count at home was most strongly affected by ankle plantar flexion strength/kg, and increasing ankle plantar flexion strength/kg was shown to promote recovery of normal physical activities.
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Kröz M, Schad F, Reif M, von Laue HB, Feder G, Zerm R, Willich SN, Girke M, Brinkhaus B. Validation of the State Version Questionnaire on Autonomic Regulation (State-aR) for cancer patients. Eur J Med Res 2011; 16:457-68. [PMID: 22024425 DOI: 10.1186/2047-783x-16-10-457] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives Current quality of life inventories used in oncology mainly measure the effects of chemo- or radiotherapy alongside functional and role scales. A new approach is to measure the autonomic state of regulation with the trait-inventory of autonomic regulation (Trait-aR). Loss of Trait-aR has been shown in different medical conditions such as breast cancer (BC) but not in colorectal cancer patients (CRC). In this paper we report the validation of a new state autonomic regulation scale (State-aR) of the last week. Methods Study 1 included 114 participants: (41 women/16 men with cancer and 57 age- and gender-matched healthy people) to conduct a reliability-, factor- and validity-analysis. Concurrent and convergent validity was evaluated with Trait-aR, Fatigue-Numeri-cal-Scale, Hospital Anxiety and Depression Scale (HADS-D) and the self-regulation scale, 65 participants were retested. Study 2 completed 42 participants: 17 with BC and 25 with CRC receiving chemotherapy. The State-aR was administered prior, during and after chemotherapy for measuring responsiveness. Results The factor analysis loaded to four subscales of State-aR (rest-activity, orthostatic-circulatory, thermosweating and digestive regulation) with a: Cronbach-α rα = 0.77-0.83 and a test-retest-reliability rrt = 0.60-0.80. The sum- and sub scales correlated with their concurrent subscales in the Trait-aR (0.48-0.74) and with the sum-scale moderately with all convergent criteria (r = 0.41 --0.44; p < 0.001). During chemotherapy the State-aR-sum and rest-activity-scale decreased significantly compared to the change in the Trait-aR (p < 0.05). Conclusions These findings support that the state autonomic regulation scale has satisfactory to good reliability, good validity and acceptable responsiveness in the context of chemotherapy treatment.
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Affiliation(s)
- Jordanka Kirkova
- Taussig Cancer Institute, Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio
- The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Aynur Aktas
- Taussig Cancer Institute, Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio
- The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Declan Walsh
- Taussig Cancer Institute, Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio
- The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
| | - Mellar P. Davis
- Taussig Cancer Institute, Department of Solid Tumor Oncology, Cleveland Clinic, Cleveland, Ohio
- The Harry R Horvitz Center for Palliative Medicine, Cleveland Clinic, Cleveland, Ohio
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Zeng L, Koo K, Zhang L, Jon F, Dennis K, Holden L, Nguyen J, Tsao M, Barnes E, Danjoux C, Sahgal A, Chow E. Fatigue in advanced cancer patients attending an outpatient palliative radiotherapy clinic as screened by the Edmonton Symptom Assessment System. Support Care Cancer 2012; 20:1037-42. [DOI: 10.1007/s00520-011-1179-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 04/25/2011] [Indexed: 11/25/2022]
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Tonosaki A. Impact of walking ability and physical condition on fatigue and anxiety in hematopoietic stem cell transplantation recipients immediately before hospital discharge. Eur J Oncol Nurs 2011; 16:26-33. [PMID: 21356606 DOI: 10.1016/j.ejon.2011.01.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 01/22/2011] [Accepted: 01/26/2011] [Indexed: 12/22/2022]
Abstract
PURPOSE This study analyzed the influence of walking ability and physical condition on fatigue and anxiety at hospital discharge in patients receiving hematopoietic stem cell transplantation (HSCT). METHOD A total of 25 subjects were assessed after receiving HSCT until discharge. The Japanese Cancer Fatigue Scale and the State-Trait Anxiety Inventory were used to assess fatigue and anxiety. Relationships of fatigue and anxiety status respective to walking ability variables: leg muscle strength (knee extension, ankle plantar flexion and ankle dorsiflexion strength) and average number of daily steps, and physical condition variables (food intake, febrile days, body mass index, and serum albumin) were examined with correlations and stepwise multiple regression analysis. RESULTS Subjects with later achievement of adequate food intake after HSCT (β = 0.62) and weaker knee extension strength per body mass at discharge (β = -0.42) reported higher fatigue (adjusted R(2) = 0.53, p = 0.00). Knee extension strength per body mass at discharge was correlated with an average step-count from 51 to 80 days after HSCT (r = 0.51, p = 0.01). In subjects whose Body Mass Index was above 23.5, weaker ankle dorsiflexion strength per body mass prior to transplantation reported higher fatigue at discharge (adjusted R(2) = 0.97, p = 0.00). Subjects with later achievement of food intake after HSCT (β = 0.59) and more days with fever reported higher anxiety (adjusted R(2) = 0.47, p = 0.00). CONCLUSION Post-HSCT fatigue was affected by a delay in adequate food intake and diminished muscle strength. The results of this study show the importance of encouraging walking for maintaining muscle endurance.
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Abstract
BACKGROUND Fatigue is one of the most common problems experienced by cancer patients. The factors most frequently reported to correlate with cancer-related fatigue are symptom distress (pain, nausea/vomiting, dyspnea, and lack of appetite) and psychological distress (depression and anxiety). AIMS This study was performed to examine the overall association of symptom and psychological distress with cancer-related fatigue using systematic literature review and meta-analysis. This study also aimed to determine which factors have a higher correlation with fatigue, and therefore should receive nursing priority. METHODS A meta-analysis of 30 primary studies identified by searching computer databases, which included MEDLINE, PubMed, and CINAHL. RESULTS Results showed that all symptoms (pain, dyspnea, nausea/vomiting, and lack of appetite) and psychological distress (depression and anxiety) included had a significant association with cancer-related fatigue with medium-to-large effect sizes, which were estimated using correlation coefficients. The overall correlations of psychological distress with cancer-related fatigue were found to be higher than those of symptom distress. The correlation of nausea/vomiting with cancer-related fatigue was higher than those of pain and dyspnea. CONCLUSIONS AND IMPLICATIONS Our findings highlight the importance of psychological distress in dealing with cancer-related fatigue in addition to the need to be attentive to a patient's symptom distress. Of the symptom distress, nausea/vomiting should be prioritized by nurses when managing cancer-related fatigue. This study provides sound empirical evidence that can be used to draft guidelines for the management of cancer-related fatigue.
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Affiliation(s)
- Hyun Soo Oh
- Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea
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Wu HS, Davis JE, Padiyar JP, Yarandi H. A comparison of disrupted sleep patterns in women with cancer-related fatigue and postmenopausal women without cancer. Eur J Oncol Nurs 2010; 15:318-24. [PMID: 21093372 DOI: 10.1016/j.ejon.2010.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Revised: 09/29/2010] [Accepted: 10/01/2010] [Indexed: 11/16/2022]
Abstract
PURPOSE Fatigue and disrupted sleep often coexist and both are prominent clinical problems in cancer affecting quality of life. Disrupted sleep patterns are likely related to cancer-related fatigue. The relationship needs further investigation. This study aimed to characterize and compare disrupted sleep patterns in fatigued breast cancer patients receiving chemotherapy with postmenopausal women without a history of cancer. Anxiety levels were also examined. METHODS Data for this secondary analysis came from two studies. Global sleep quality and state anxiety were self-reported by 30 fatigued female breast cancer chemotherapy outpatients and 32 non-cancer postmenopausal women using Pittsburgh Sleep Quality Index (PSQI) and State-Trait Anxiety Inventory, respectively. RESULTS Fatigued breast cancer patients showed significant sleep difficulties, characterized by prolonged sleep onset latency (M=54.3, SD=49.2 min) and frequent nighttime awakenings, despite 40% of the patients using sleep medications three or more times a week. Compared to the non-cancer comparison group, fatigued patients reported significantly longer sleep latency (p=0.041), more use of sleep medications (p=0.006), and higher total PSQI scores (p=0.005). State anxiety levels did not differ between the two groups (p=0.88). CONCLUSIONS Sleep is disrupted in fatigued breast cancer women undergoing chemotherapy. Nearly all fatigued patients (97%) had trouble sleeping (global PSQI scores>5), indicating significant difficulties in overall sleep quality among those patients. Knowledge of the nature of sleep disruption among cancer patients may contribute to CRF symptom management leading to tailored interventions designed to improve sleep quality in cancer patients thereby managing fatigue and improving quality of life.
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Abstract
Many different words are used to describe fatigue. It is unclear whether these word descriptors represent the same cancer symptom or dimension. The objective of this study was to identify clinical associations of three fatigue word descriptors (FWDs): 'easy fatigue', 'weakness', and 'lack of energy' (LOE). One thousand consecutive palliative medicine patients completed a 38-item symptom checklist. The prevalence of the three FWDs alone and in combination was calculated. Spearman correlations assessed associations between FWDs. Logistic regression analysis identified univariable and multivariable predictors for each FWD. Survival was estimated using the Kaplan-Meier method, individually and for 0-1 versus 2-3 FWDs, and compared using log-rank tests. The prevalence of easy fatigue was 69%, weakness 66%, and LOE 61%. Correlations between the FWDs were high (0.65-0.79). In multivariable models, clinical associations (particularly neuro-psychiatric symptoms and performance status) of the FWDs were variable. Weakness was associated with performance status, but not anxiety or depression. LOE was associated with anxiety and depression, but not performance status. Fatigue was associated with depression, but not anxiety or performance status. All FWDs were associated with dry mouth, early satiety, sleep problems, and weight loss. The worst survival was associated with two or three reported FWDs compared with none or one (P < 0.001). Weakness and LOE had distinct clinical associations that differed from fatigue. Evaluation of fatigue should use multiple descriptors (particularly weakness), as they are not synonymous. Further research is necessary to identify biological associations for discrete FWDs.
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Affiliation(s)
- Katherine Hauser
- The Harry R. Horvitz Center for Palliative Medicine, Section of Palliative Medicine and Supportive Oncology, Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, USA
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