title: What are the best terms in Portuguese to explain the concepts of "fatigue" and "depression" in cancer patients?
abstract: OBJECTIVE
  Although "fatigue" and "depression" are well-accepted clinical terms in the English language, they are ill defined in many other languages, including Portuguese. We aimed to investigate the most appropriate words to describe cancer-related fatigue (CRF) and depression in Brazilian cancer patients.
  
  
  METHODS
  The interviewers read to patients two clinical vignettes describing fatigued patients and two others describing depressed patients. Participants were asked to choose from among "fatigue," "tiredness," "weakness," "depression," and "sadness" the best and worst terms to explain the vignettes. In addition, they were administered an instrument containing numeric rating scales (NRSs), addressing common symptoms, including the aforementioned terms. Pearson correlation analysis and accuracy diagnostic tests were conducted using the Hospital Anxiety and Depression Scale (HADS) and the Functional Assessment of Cancer Treatment-Fatigue (FACIT-F) as references.
  
  
  RESULTS
  Among the 80 participants, 40% reported that the best term to explain the concept of CRF was "tiredness," and 59% chose "sadness" as the best descriptor of depression. Regarding diagnostic accuracy, the areas under the curve (AUCs) for "fatigue," "weakness," and "tiredness" were 0.71, 0.81, and 0.76, respectively; the AUCs for "depression" and "sadness" ranged from 0.81 to 0.91 and 0.73 to 0.83, respectively. Negative correlations were found among FACIT-F fatigue subscale scores and NRS scores for "fatigue" (r = -0.58), "tiredness" (r = -0.67), and "weakness" (r = -0.62). Regarding depression, there were positive correlations between HADS-D scores and both NRS for "depression" (r = 0.61) and "sadness" (r = 0.54).
  
  
  CONCLUSIONS
  "Tiredness" was considered the best descriptor of CRF. Taking into consideration the clinical correlation with depression scores, the term "depression" was accepted as the best term to explain the concept of depression.
authors.affiliation: Department of Clinical Oncology,Barretos Cancer Hospital,Barretos,São Paulo,Brazil.
authors.forename: Carlos Eduardo
authors.initials: CE
authors.lastname: Paiva
authors.affiliation: Cancer Hospital Children and Youth President Luiz Inacio Lula da Silva,Barretos Cancer Hospital,Barretos,São Paulo,Brazil.
authors.forename: Luciana Lopes
authors.initials: LL
authors.lastname: Manfredini
authors.affiliation: Palliative Care and Quality of Life Research Group,Post Graduation Program,Barretos Cancer Hospital,Barretos,São Paulo,Brazil.
authors.forename: Bianca Sakamoto Ribeiro
authors.initials: BS
authors.lastname: Paiva
authors.affiliation: Palliative Care and Quality of Life Research Group,Post Graduation Program,Barretos Cancer Hospital,Barretos,São Paulo,Brazil.
authors.forename: Estela Cristina
authors.initials: EC
authors.lastname: Carneseca
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,The University of Texas MD Anderson Cancer Center,Houston,Texas.
authors.forename: David
authors.initials: D
authors.lastname: Hui
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil; D003144:Communication Barriers; D003863:Depression / Q000175:diagnosis*; D005221:Fatigue / Q000175:diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms
keywords: Cancer; Depression; Diagnostic accuracy; Fatigue; Meaning