title: Systematic review and meta-analysis of the correlates of cancer-related fatigue.
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).
  
  
  OBJECTIVE
  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
  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.
authors.affiliation: Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea.
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Oh
authors.forename: Wha Sook
authors.initials: WS
authors.lastname: Seo
mesh_terms: D005221:Fatigue / Q000209:etiology* / Q000451:nursing* / Q000523:psychology; D006801:Humans; D009369:Neoplasms / Q000150:complications* / Q000451:nursing* / Q000523:psychology; D009859:Oncology Nursing / Q000379:methods*; D013315:Stress, Psychological / Q000209:etiology / Q000451:nursing / Q000523:psychology