title: Fatigue and its correlates in cancer patients who had returned to work--a cohort study.
abstract: OBJECTIVE
  Fatigue and other symptoms in cancer patients often interfere with social and occupational activities. Only a few studies, however, have examined relationship between fatigue and work-related outcomes. The aim of this study was to investigate which disease-related factors (treatment, diagnosis, cognitive dysfunction, depression, pain, and sleep disturbance) and work-related factors (work-load, work pressure, relationship to supervisor and colleagues, size of the company, and workplace accommodations) were related to fatigue in employed cancer survivors.
  
  
  METHODS
  Data was collected by questionnaire at 6 months (baseline) and 18 months (end of the follow-up) after cancer diagnosis from 135 people with different types of cancer who had returned to work at follow-up. Fatigue was measured with a four-item sub-scale of MFI. Scores ranged from 4 to 20, with higher scores indicating more fatigue.
  
  
  RESULTS
  The mean rate of general fatigue was 11.9 at baseline decreasing to 10.4 at the end of the follow-up (p<0.0001). At 6 months, higher work pressure (p = 0.02), physical workload (p<0.05) and less workplace accommodations (p = 0.03) were related to higher levels of fatigue. From disease-related factors, depression was associated with fatigue (p<0.0001) at baseline. Lack of workplace accommodations was the only factor affecting higher levels of fatigue at 18 months (p<0.001) and was also related to higher levels of depression at 6 months (p = 0.02) and at 18 months (p<0.001).
  
  
  CONCLUSIONS
  Lack of workplace accommodations was significantly related to fatigue at the end of the follow-up, which suggests that accommodations for illness can help to reduce fatigue and depression.
authors.affiliation: Coronel Institute of Occupational Health, Academic Medical Center, Amsterdam, The Netherlands. T.K.Taskila@bham.ac.uk
authors.forename: T
authors.initials: T
authors.lastname: Taskila
authors.forename: A G E M
authors.initials: AG
authors.lastname: de Boer
authors.forename: F J H
authors.initials: FJ
authors.lastname: van Dijk
authors.forename: J H A M
authors.initials: JH
authors.lastname: Verbeek
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D015331:Cohort Studies; D003863:Depression / Q000209:etiology / Q000523:psychology; D004651:Employment / Q000523:psychology*; D005221:Fatigue / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult