Aim:
The aim of this study is to investigate the prevalence of fatigue among cancer patients under radiation therapy and its associated factors.
Methods:
Cancer patients aged twenty years or older were consecutively sampled when they started radiation therapy at two university hospitals. The patients were asked to complete self-administered questionnaires assessing fatigue (Cancer Fatigue Scale: CFS, composed of three subscale: physical, affective and cognitive), psychological distress (Hospital Anxiety and Depression Scale: HADS), subjective symptoms (M.D. Anderson Symptom Inventory: MDASI) and sociodemographic & clinical factors.
Results:
Two hundred and fifty-nine patients returned their questionnaire. (Response rate: 67%) The mean (+-SD) and median age of the study population was 63.6(+-12) and 66 years, respectively. 37% of the participants had clinical fatigue (CFS total score >18). Univariate analysis indicated that 1.Period from diagnosis, ECOG-PS, pain, nausea, sleep disturbance, shortness of breath, lack of appetite, dry mouth, sad, vomiting, numbness, psychological distress and history of anti cancer therapy (chemotherapy & molecular target therapy) were associated with physical fatigue, 2. Education, nausea, sleep disturbance, shortness of breath, lack of appetite, dry mouth, sad, vomiting, psychological distress were associated with affective fatigue, 3. Age, period from diagnosis, pain, sleep disturbance, shortness of breath, lack of appetite, dry mouth, sad, vomiting, numbness, psychological distress, employment were associated with cognitive fatigue. A multiple regression analysis revealed that 1. Nausea, lack of appetite, dry mouth, numbness and psychological distress were associated with physical fatigue, 2. Psychological distress was associated with affective fatigue, 3. Period from diagnosis, dry month and psychological distress were associated with cognitive fatigue.
Conclusions:
Multi-dimensional factors were associated with fatigue among cancer patients under radiation therapy. Especially, psychological distress was associated with all subscale of fatigue. Intervention to psychological distress may relieve cancer patients’ fatigue under radiation therapy.