Fatigue and its associated psychosocial factors in cancer patients on active palliative treatment measured over time

• Published in: Supportive care in cancer 2016-03, Vol.24 (3), p.1349-1355
• Main Authors: Peters, Marlies E. W. J., Goedendorp, Martine M., Verhagen, Constans A. H. H. V. M., Bleijenberg, Gijs, van der Graaf, Winette T. A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Analysis; Cancer; Cancer patients; Care and treatment; Cross-Sectional Studies; Fatigue; Fatigue - etiology; Fatigue - psychology; Female; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasms - psychology; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Palliative care; Palliative Care - methods; Prospective Studies; Psychological aspects; Quality of Life; Rehabilitation Medicine; Sleep disorders; Social aspects; Studies; Surveys and Questionnaires
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-015-2909-0

Purpose Fatigue is a frequently reported symptom by patients with advanced cancer, but hardly any prospective information is available about fatigue while on treatment in the palliative setting. In a previous cross-sectional study, we found several factors contributing to fatigue in these patients. In this study, we investigated the course of fatigue over time and if psychosocial factors were associated with fatigue over time. Methods Patients on cancer treatment for incurable solid tumors were observed over 6 months. Patients filled in the Checklist Individual Strength monthly to measure the course of fatigue. Baseline questionnaires were used to measure disease acceptance, anxiety, depressive mood, fatigue catastrophizing, sleeping problems, discrepancies in social support, and self-reported physical activity for their relation with fatigue over time. Results At baseline 137 patients and after 6 months 89 patients participated. The mean duration of participation was 4.9 months. At most time points, fatigue scores were significantly higher in the group dropouts in comparison with the group participating 6 months (completers). Overall fatigue levels remained stable over time for the majority of participants. In the completers, 42 % never experienced severe fatigue, 29 % persisted being severely fatigued, and others had either an increasing or decreasing level. Of the investigated factors, low reported physical activity and non-acceptance of cancer were associated significantly to fatigue. Conclusion A substantial number of participants never experienced severe fatigue and fatigue levels remained stable over time. For those who do experience severe fatigue, non-acceptance of having incurable cancer and low self-reported physical activity may be fatigue-perpetuating factors.