Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Support Care Cancer. 2013 Jan;21(1):229-33. doi: 10.1007/s00520-012-1515-7. Epub 2012 Aug 23.
Fatigue among patients with cancer is prevalent, disabling, and treatable. While fatigue management guidelines have been in place for a decade, their use remains unclear.
We surveyed 160 patients with stage IV lung (40), breast (40), colon (40), and prostate (40) cancer who reported moderate to severe fatigue (i.e., >5 of 10 on an 11-point numerical rating scale). Participants were queried about receipt of treatments in fatigue management domains emphasized in the National Comprehensive Cancer Network guidelines: general management strategies, activity enhancement, psychosocial strategies, and pharmaceuticals.
The cohort was half male, had a mean age of 67, and reported an average fatigue rating of 6.4. Participants reported treatment or receipt of specific guidance in the fatigue management domains as follows: general management strategies 16.8 %, activity enhancement 11.9 %, psychosocial strategies 9.9 %, and pharmaceuticals 37.3 %. Fatigue >7 of 10 increased the likelihood of instruction in activity enhancement but no other domain.
The low rates of guideline-congruent treatment reported here are concerning, particularly as better validated behavioral treatments were the least prescribed.
癌症患者的疲劳普遍存在、具有致残性且可治疗。尽管针对疲劳管理的指南已存在十余年，但它们的使用情况仍不明确。
我们调查了 160 例报告中至重度疲劳（即 11 点数字评定量表中 >5 分）的 IV 期肺癌（40 例）、乳腺癌（40 例）、结肠癌（40 例）和前列腺癌（40 例）患者，询问他们在国家综合癌症网络指南强调的疲劳管理领域中接受治疗的情况：一般管理策略、活动增强、心理社会策略和药物治疗。
该队列患者中一半为男性，平均年龄为 67 岁，平均疲劳评分为 6.4。参与者报告在疲劳管理领域接受了以下治疗或特定指导：一般管理策略 16.8%、活动增强 11.9%、心理社会策略 9.9%和药物治疗 37.3%。疲劳评分 >7 分增加了接受活动增强指导的可能性，但其他领域则不然。
此处报告的与指南一致的治疗率较低令人担忧，尤其是更有效的验证性行为治疗的处方率最低。
