Research Institute Havelhöhe (FIH), Berlin, Germany,
J Cancer Surviv. 2014 Jun;8(2):319-28. doi: 10.1007/s11764-013-0314-6. Epub 2013 Nov 20.
Cancer-related fatigue (CRF) has a major impact on the quality of life in breast cancer patients (BC). So far, only a few prospective studies have investigated the effect of adaptive salutogenic mechanisms on CRF. The aim of our study was to evaluate the possible prospective influence of autonomic Regulation (aR) and self-regulation (SR) on CRF and distress in long-term survivors.
95 BC and 80 healthy female controls (C) had been included in the observational study between 2000 and 2001 and completed the questionnaires on aR, SR and Hospital Anxiety and Depression Scale (HADS). Of these, 62 BC, and 58 C participated in the re-evaluation 6.6 years later: 16 participants were deceased (14 BC and 2 C). During follow-up, participants were requested to answer questions involving (Cancer Fatigue Scales) CFS-D, aR, SR and HADS. Multiple regression analysis was used to evaluate the influence of aR, SR, age, Charlson co-morbidity-index and diagnosis on CFS-D and HADS, and to select further potentially relevant factors.
High aR values showed significant effects, namely inverse relationships with CFS-D, cognitive fatigue, anxiety and depression. SR showed a reduced influence on anxiety and depression (all p < 0.05).
Autonomic regulation might have an independent, reductive influence on global fatigue, cognitive fatigue and--together with self-regulation--it seems to have a protective influence on anxiety and depression. The connection between these parameters is still unclear and awaits further evaluation.
AR seems to be a prognostic factor in breast cancer survivors, capable of reducing cancer-related fatigue and self-regulation distress as well. Further research is necessary in order to show how aR can be improved by therapeutic interventions.
癌症相关疲劳（CRF）对乳腺癌患者（BC）的生活质量有重大影响。到目前为止，只有少数前瞻性研究调查了适应性健康促进机制对 CRF 的影响。我们的研究目的是评估自主调节（aR）和自我调节（SR）对长期幸存者 CRF 和困扰的可能前瞻性影响。
本观察性研究于 2000 年至 2001 年期间纳入了 95 名 BC 和 80 名健康女性对照（C），并完成了 aR、SR 和医院焦虑抑郁量表（HADS）的问卷。其中，62 名 BC 和 58 名 C 参加了 6.6 年后的重新评估：16 名参与者死亡（14 名 BC 和 2 名 C）。在随访期间，要求参与者回答涉及（癌症疲劳量表）CFS-D、aR、SR 和 HADS 的问题。多元回归分析用于评估 aR、SR、年龄、Charlson 合并症指数和诊断对 CFS-D 和 HADS 的影响，并选择进一步潜在相关因素。
高 aR 值显示出显著的效果，即与 CFS-D、认知疲劳、焦虑和抑郁呈负相关。SR 对焦虑和抑郁的影响降低（均 p<0.05）。
自主调节可能对整体疲劳、认知疲劳有独立的、减轻的影响，并且与自我调节一起，对焦虑和抑郁似乎有保护作用。这些参数之间的联系尚不清楚，有待进一步评估。
AR 似乎是乳腺癌幸存者的预后因素，能够减轻癌症相关疲劳和自我调节困扰。需要进一步研究以表明如何通过治疗干预来改善 aR。
