title: Correlates of fatigue phenomenon in palliative care patients with advance cancers in Taiwan.
abstract: BACKGROUND
  Fatigue is a multidimensional phenomenon that has different meanings according to different societal and cultural settings. This study aims to decipher fatigue in Taiwanese patients with cancer.
  
  
  METHODS
  We recruited 440 patients with advanced cancer admitted consecutively to the palliative care unit of a major medical center in Taiwan. The data were collected at admission, 1 and 2 weeks after admission, and 2 days before death.
  
  
  RESULTS
  The subject group consisted of 51.8% males and 48.2% females with a median age of 67 years (ranging from 27 to 93 years). The leading primary tumor sites among these patients were lung (20.2%), liver (18.0%), and colon-rectum (10.7%), and the median survival was 15 days, with a range of 1 to 418 days. All symptoms improved 1 week after admission, but most of them significantly worsened 2 days before death. In general, the physical signs manifested variation patterns similar to those of symptoms. The severity of psychosocial distress and death fear was lower after admission and retained the same level at 2 days before death, defying the consistent patterns found in other symptoms and signs. In the correlation analysis, most symptoms were correlated with fatigue during admission, with weakness being the most significant one. Although self-efficacy and emotion were correlated with fatigue both on admission and 1 week after admission, social support and death fear were not correlated with fatigue at all times.
  
  
  CONCLUSIONS
  The meaning of fatigue is mainly associated with physical factors among these patients. Education of complexities in fatigue in tandem with psychosocial and spiritual care may help alleviate this symptom, and promote quality of life.
authors.affiliation: Hospice and Palliative Care Unit, Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan.
authors.forename: Jaw-Shiun
authors.initials: JS
authors.lastname: Tsai
authors.forename: Su-Chiu
authors.initials: SC
authors.lastname: Chen
authors.forename: Tai-Yuan
authors.initials: TY
authors.lastname: Chiu
authors.forename: Kai-Kuen
authors.initials: KK
authors.lastname: Leung
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Hu
authors.forename: Shou-Hung
authors.initials: SH
authors.lastname: Hung
authors.forename: Chih-Hsun
authors.initials: CH
authors.lastname: Wu
authors.forename: Ching-Yu
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005221:Fatigue / Q000208:ethnology / Q000503:physiopathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000523:psychology*; D010166:Palliative Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D013624:Taiwan