Lewis Shirley, Salins Naveen, Rao M Raghavendra, Kadam Amrit
Department of Palliative Medicine, Tata Memorial Centre, Mumbai, India.
J Cancer Res Ther. 2014 Jul-Sep;10(3):676-80. doi: 10.4103/0973-1482.138125.
Spiritual well-being and fatigue are key parameters in assessing health related quality of life that determine treatment tolerance, treatment outcomes and reflect patient's coping ability in the illness-wellness disease trajectory.
A total of 200 patients on active cancer treatment were enrolled to the study. Functional assessment of chronic illness therapy-spirituality (FACIT-Sp) and FACIT-Fatigue scales were used to assess spiritual well-being and fatigue scores during their cancer treatment. Data were analyzed using one-way analysis of variance and bivariate relationships determined using the Spearman Correlation analysis. Linear regression analysis was performed to determine predictors of fatigue score during treatment.
Mean spiritual well-being score was 20.96 out of 48 and scores were significantly higher in females compared with males (P = 0.03), lower with higher stage (P = 0.008) and lower in head and neck and gastrointestinal malignancies (P = 0.03) when compared with gynecological and breast malignancies. Fatigue was present in all the 200 patients studied and the mean fatigue score was 13.09. Higher fatigue scores were observed in patients with advanced stages of cancer (Stage IV) (F [3,199] = 5.67, P = 0.001). There was a significant inverse relationship between fatigue scores with spiritual well-being (P < 0.001). Spiritual well-being score emerged as a significant primary negative predictor (β = -0.23, P = 0.001) for fatigue scores followed by stage of disease (β =0.23, P = 0.001) and gender (β = -0.18, P = 0.01) as significant secondary predictors.
Fatigue during cancer directed treatment is influenced by spiritual wellbeing, disease stage and gender. Further studies should examine the mediating variables that influence fatigue.
精神健康和疲劳是评估健康相关生活质量的关键参数，这些参数决定治疗耐受性、治疗结果，并反映患者在疾病-健康疾病轨迹中的应对能力。
共有200名正在接受积极癌症治疗的患者被纳入该研究。使用慢性病治疗-精神健康功能评估量表（FACIT-Sp）和FACIT-疲劳量表来评估他们在癌症治疗期间的精神健康和疲劳得分。数据采用单因素方差分析进行分析，并使用Spearman相关分析确定双变量关系。进行线性回归分析以确定治疗期间疲劳得分的预测因素。
精神健康平均得分在48分制中为20.96分，女性得分显著高于男性（P = 0.03），随着疾病分期升高得分降低（P = 0.008），与妇科和乳腺恶性肿瘤相比，头颈部和胃肠道恶性肿瘤患者得分较低（P = 0.03）。在所有200名研究患者中均存在疲劳，平均疲劳得分为13.09。癌症晚期（IV期）患者的疲劳得分更高（F [3,199] = 5.67，P = 0.001）。疲劳得分与精神健康之间存在显著的负相关关系（P < 0.001）。精神健康得分成为疲劳得分的显著主要负向预测因素（β = -0.23，P = 0.001），其次疾病分期（β = 0.23，P = 0.001）和性别（β = -0.18，P = 0.01）为显著的次要预测因素。
癌症针对性治疗期间的疲劳受精神健康、疾病分期和性别的影响。进一步的研究应检查影响疲劳的中介变量。
