Exploring the contribution of psychosocial factors to fatigue in patients with advanced incurable cancer.
OBJECTIVE
Fatigue is the most frequently occurring and distressing symptom in patients with advanced cancer, caused by multiple factors. Neither a specific histological diagnosis of malignancy nor the type of anticancer treatment seem to be strongly related to fatigue, which support the idea that other factors may play a role. This study investigated to what extent the model of fatigue-perpetuating factors that is known for cancer survivors was applicable for patients with advanced cancer.


METHODS
Patients on active treatment for various incurable cancers were asked to complete the Checklist Individual Strength, subscale fatigue severity and physical activity, the Acceptance scale of the Illness Cognition Questionnaire, the Hospital Anxiety and Depression Scale, the Fatigue Catastrophizing Scale, the Symptom Checklist subscale sleep, and the van Sonderen Social Support List-Discrepancies.


RESULTS
The questionnaires were filled in by 137 patients. Inappropriate coping, fear of progression, fatigue catastrophizing, discrepancies in social support, depressive mood, self reported physical activity, and sleeping problems were all related to fatigue severity in univariate analyses, of which the latter two were significant in a multivariate linear regression analysis.


CONCLUSIONS
This study tested fatigue-perpetuating factors known to be of relevance in cancer survivors, for their relation with fatigue severity in palliative patients. We demonstrated that these factors were also relevant for patients on palliative treatment. On the basis of our results, we suggest clinicians confronted with palliative patients with serious fatigue to address sleeping problems and promote physical activity. In case of persistent fatigue, personalized cognitive behavioral therapy can be considered.
Department of Medical Oncology, Radboud University, Medical Center, Nijmegen, The Netherlands.
Marlies E W J
ME
Peters
Martine M
MM
Goedendorp
Stans A H H V M
SA
Verhagen
Winette T A
WT
van der Graaf
Gijs
G
Bleijenberg
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000523:psychology; D005221:Fatigue / Q000175:diagnosis / Q000209:etiology* / Q000523:psychology; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology / Q000628:therapy*; D010166:Palliative Care; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires
Advanced Cancer; Fatigue; Oncology; Perpetuating Factors; Psychosocial Factors