Cancer-related fatigue stratification system based on patient-reported outcomes and objective outcomes: A cancer-related fatigue ambulatory index

• Published in: PloS one 2019-04, Vol.14 (4), p.e0215662-e0215662
• Main Authors: Cuesta-Vargas, Antonio, Buchan, Jena, Pajares, Bella, Alba, Emilio, Roldan-Jiménez, Cristina
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biomedical research; Bivariate analysis; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - therapy; Cancer; Cancer patients; Cancer research; Cancer survivors; Cancer therapies; Cancer treatment; Care and treatment; Chemotherapy; Classification; Clinical outcomes; Factor analysis; Fatigue; Fatigue - complications; Fatigue - diagnosis; Fatigue tests; Female; Health aspects; Health sciences; Humans; Medical diagnosis; Medical research; Middle Aged; Morbidity; Mortality; Multivariate Analysis; Oncology; Patient outcomes; Patient Reported Outcome Measures; Patients; Physiology; Psychological aspects; Quality of life; Quartiles; Questionnaires; Reproducibility of Results; Risk factors; Signs and symptoms; Surveys and Questionnaires; Survivors - statistics & numerical data; Systematic review; Tumors; Women; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0215662

Although breast cancer mortality is decreasing, morbidity following treatment remains a significant issue, as patients face symptoms such as cancer-related fatigue (CRF). The aim of the present study is to develop a classification system that monitors fatigue via integration of an objective clinical assessment with patient self-report. Forty-three women participated in this research. Participants were post-treatment breast cancer survivors who had been surgically treated for their primary tumour with no evidence of neoplastic disease at the time of recruitment. Self-perceived fatigue was assessed with the Spanish version of the Piper Fatigue Scale-Revised (R-PFS). Objective fatigue was assessed by the 30 second Sit-to-Stand (30-STS) test. Confirmatory factor analysis was done with Maximum Likelihood Extraction (MLE). Internal consistency was obtained by Cronbach's α coefficients. Bivariate correlation showed that 30-STS performance was negatively-inversely associated with R-PFS. The MANOVA model explained 54.3% of 30-STS performance variance. Using normalized scores from the MLE, a classification system was developed based on the quartiles. This study integrated objective and subjective measures of fatigue to better allow classification of patient CRF experience. Results allowed development of a classification index to classify CRF severity in breast cancer survivors using the relationship between 30-STS and R-PFS scores. Future research must consider the patient-perceived and clinically measurable components of CRF to better understand this multidimensional issue.