Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Untere Zahlbacher Str. 8, 55131, Mainz, Germany.
Department of Psychosomatic Medicine and Psychotherapy, Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Support Care Cancer. 2019 Aug;27(8):2809-2818. doi: 10.1007/s00520-018-4587-1. Epub 2018 Dec 11.
Fatigue has found increasing attention as a debilitating and lasting condition of cancer patients. However, it has remained unclear to what degree long-term survivors of malignant melanoma suffer from fatigue. Therefore, this study aimed to determine fatigue and its link with quality of life, aftercare behavior, and mental and physical symptoms among melanoma survivors.
A register-based sample of 684 long-term survivors an average of 8.4 (SD = 1.72; range 5.67-12.17) years after diagnosis was compared to 2049 participants from a representative survey by the Multidimensional Fatigue Inventory. In a hierarchical linear regression, statistical predictors for fatigue were ascertained.
Overall fatigue was not increased in melanoma survivors except for younger melanoma survivors under 40 years. As in the general population, fatigue increased with age, and it was higher in women compared to men. Fatigue was associated with decreased quality of life, reduced functioning, and increased physical and mental symptoms. Substantial predictors (30% explained variance) were higher age, additional chronic illness, self-blame, detrimental interactions and lack of social support, and also fear of recurrence. There was neither an effect of medical parameters (clinical stage, time since diagnosis) nor of participation in follow-up care.
Fatigue needs to be taken seriously in the aftercare of melanoma survivors as it is associated with multiple functional and quality of life impairments and heightened distress. Reduction of fatigue in melanoma patients should address younger survivors (under 40 years) and older survivors (over 60 years) with additional chronic illness and focus on illness coping and social support.
疲劳作为癌症患者衰弱且持久的一种状态，越来越受到关注。然而，恶性黑素瘤的长期幸存者究竟会在多大程度上受到疲劳的影响仍不清楚。因此，本研究旨在确定黑素瘤幸存者的疲劳程度及其与生活质量、康复后行为以及心理和身体症状的关系。
本研究基于登记处的样本，包括 684 名平均诊断后 8.4 年（SD=1.72；范围 5.67-12.17 年）的长期幸存者，与来自多维度疲劳量表的代表性调查的 2049 名参与者进行了比较。在分层线性回归中，确定了疲劳的统计学预测因素。
除了 40 岁以下的年轻黑素瘤幸存者外，黑素瘤幸存者的整体疲劳并未增加。与一般人群一样，疲劳随年龄增长而增加，女性比男性更高。疲劳与生活质量下降、功能降低以及身体和心理症状增加有关。重要的预测因素（解释方差的 30%）包括年龄较大、额外的慢性疾病、自责、有害的相互作用和缺乏社会支持，以及对复发的恐惧。医疗参数（临床分期、诊断后时间）和随访护理的参与均无影响。
在黑素瘤幸存者的康复后护理中，需要认真对待疲劳问题，因为它与多种功能和生活质量受损以及焦虑增加有关。减少黑素瘤患者的疲劳应针对年龄较小（40 岁以下）和年龄较大（60 岁以上）的幸存者，他们还患有额外的慢性疾病，并应侧重于疾病应对和社会支持。
