title: Quality of life and barriers to symptom management in colon cancer.
abstract: OBJECTIVE
  Pain and fatigue are recognized as critical symptoms that impact QOL for patients with colon cancer. Barriers to optimum pain and fatigue relief include patient-related beliefs and attitudes about the treatment of cancer-related symptoms. The overall objective of this paper was to describe quality of life (QOL) and barriers to pain and fatigue management in patients with colon cancer.
  
  
  METHODS
  This longitudinal, descriptive study included was conducted in the ambulatory clinic of one NCI-designated comprehensive cancer center. A cohort of 56 patients with colon cancer and a pain and/or fatigue of ≥4 (moderate to severe) was recruited. Subjects completed questionnaires to assess subjective ratings of overall QOL, fatigue, barriers to pain and fatigue, and pain and fatigue knowledge.
  
  
  RESULTS
  The majority of subjects (58%) reported having moderate to severe (4-6) fatigue at the time of accrual. Overall QOL score was moderate (M = 5.20, SD = 1.43), and the social well-being subscale had the lowest score (M = 4.57, SD = 1.82). Patient barriers to pain and fatigue existed in attitudes and beliefs regarding addiction, tolerance, and that fatigue is an inevitable part of cancer and its treatments. Patient knowledge of pain and fatigue was high (77%-88% correct), but lack of knowledge persisted in areas such as addiction to pain medications and utilizing physical activity to manage fatigue.
  
  
  CONCLUSIONS
  Several patient-related attitudes and beliefs may hinder optimum relief of symptoms such as pain and fatigue. Social well-being may be a major determinant of overall QOL for patients with colon cancer.
authors.affiliation: City of Hope - Nursing Research and Education, 1500 East Duarte Road, Duarte, CA 91010, USA. vsun@coh.org
authors.forename: Virginia
authors.initials: V
authors.lastname: Sun
authors.forename: Tami
authors.initials: T
authors.lastname: Borneman
authors.forename: Marianna
authors.initials: M
authors.lastname: Koczywas
authors.forename: Mihaela
authors.initials: M
authors.lastname: Cristea
authors.forename: Barbara F
authors.initials: BF
authors.lastname: Piper
authors.forename: Gwen
authors.initials: G
authors.lastname: Uman
authors.forename: Betty
authors.initials: B
authors.lastname: Ferrell
mesh_terms: D003110:Colonic Neoplasms / Q000451:nursing / Q000523:psychology*; D005221:Fatigue / Q000451:nursing / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000451:nursing / Q000523:psychology*; D059408:Pain Management; D010147:Pain Measurement; D011788:Quality of Life; D011795:Surveys and Questionnaires