Okuyama T, Akechi T, Kugaya A, Okamura H, Imoto S, Nakano T, Mikami I, Hosaka T, Uchitomi Y
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan.
Support Care Cancer. 2000 May;8(3):215-22. doi: 10.1007/s005200050288.
Fatigue is one of the most frequent symptoms in cancer patients. However, the precise causes of this fatigue are still unknown, and this situation makes it difficult to combat the problem. The present study was conducted to investigate factors correlated with fatigue in disease-free breast cancer patients. A group of 134 randomly selected ambulatory breast cancer patients who had undergone successful surgical treatment participated. They completed the Cancer Fatigue Scale, the Hospital Anxiety and Depression Scale, the Mental Adjustment to Cancer Scale, and an ad hoc questionnaire detailing physical symptoms, social support, and demographic variables at home and returned them by mail the following day. Multiple regression analysis revealed that fatigue was significantly correlated with dyspnea, insufficient sleep, and depression, and that these three variables accounted for a total of 46% of variance in fatigue. Factors concerned with the cancer and treatment, such as disease stage, lymph node metastasis, number of days since operation, past intravenous chemotherapy, radiotherapy, current use of fluoropyrimidine compounds, and current use of tamoxifen citrate were not correlated with fatigue. The results suggest that fatigue in this population is determined by current physical and psychological distress rather than by the cancer itself and prior cancer treatments, and that the management of dyspnea, insomnia, and depression might be important in reducing fatigue in this population.
疲劳是癌症患者最常见的症状之一。然而，这种疲劳的确切原因仍然不明，这种情况使得对抗这一问题变得困难。本研究旨在调查无病乳腺癌患者中与疲劳相关的因素。一组134名随机挑选的、已接受成功手术治疗的门诊乳腺癌患者参与了研究。他们完成了癌症疲劳量表、医院焦虑抑郁量表、癌症心理调适量表，以及一份详细列出身体症状、社会支持和家庭人口统计学变量的特设问卷，并于次日通过邮件返还。多元回归分析显示，疲劳与呼吸困难、睡眠不足和抑郁显著相关，这三个变量共解释了疲劳变异的46%。与癌症及治疗相关的因素，如疾病分期、淋巴结转移、术后天数、既往静脉化疗、放疗、当前使用氟嘧啶类化合物以及当前使用枸橼酸他莫昔芬，均与疲劳无关。结果表明，该人群的疲劳是由当前的身体和心理困扰决定的，而非由癌症本身及既往癌症治疗决定，并且对呼吸困难、失眠和抑郁的管理可能对减轻该人群的疲劳很重要。
