Kumar Naveen, Sinha Aditi Prashant, Garg Rakesh, Deo S V S, Kumar Sunil
1College of Nursing, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
2Department of Surgical Oncology, BRA - Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, 110029 India.
Indian J Surg Oncol. 2019 Sep;10(3):441-445. doi: 10.1007/s13193-019-00918-5. Epub 2019 Apr 13.
Fatigue is an underassessed and underreported aspect of cancer patients undergoing treatment. In patients being treated with surgery, its extent and manifestations may be varied but it affects their functional quality of life. This study was designed to evaluate the level of fatigue in pre- and post-surgery period and its relation with the functional disability in patients undergoing upfront surgery for solid malignancies. A prospective observational study was conducted between 2016 and 2017. A total of 71 patients with malignant solid tumors (up to stage III) undergoing upfront surgery were included. The fatigue and functional disability were assessed in pre- and post-surgery period using Multidimensional Fatigue Inventory-20 (MFI-20) and Functional Assessment of Chronic Illness Therapy (FACIT-F) questionnaires respectively. The mean age was 42.4 years. The post-operative fatigue levels were significantly higher compared with the pre-operative levels ( = 0.001). The maximum levels of fatigue and loss of functional ability were seen at the time of discharge that recovered up to some extent after 30 days of surgery. Operative duration > 8 h, hospital stay > 9 days, and blood loss of > 200 ml were associated with increased fatigue level. Mental fatigue and limitation of physical activity were the most significant domains in pre- and post-surgery period respectively. This study concludes that cancer-related fatigue is present in both pre- and post-surgery period and it correlates with functional disability. Assessment of different dimensions of fatigue is important and patients need to be made aware about them for planning any specific intervention including life style modification to help them cope up with these practical issues.
疲劳是癌症患者治疗过程中一个评估不足且报告较少的方面。在接受手术治疗的患者中,其程度和表现可能各不相同,但会影响他们的生活功能质量。本研究旨在评估接受实体恶性肿瘤初次手术患者手术前后的疲劳水平及其与功能残疾的关系。2016年至2017年进行了一项前瞻性观察研究。共纳入71例接受初次手术的恶性实体肿瘤患者(分期达III期)。分别使用多维疲劳量表-20(MFI-20)和慢性病治疗功能评估量表(FACIT-F)问卷在手术前后评估疲劳和功能残疾情况。平均年龄为42.4岁。术后疲劳水平显著高于术前水平(P = 0.001)。出院时疲劳和功能能力丧失程度最高,术后30天有所恢复。手术时间> 8小时、住院时间> 9天以及失血量> 200毫升与疲劳水平增加相关。精神疲劳和身体活动受限分别是手术前后最显著的方面。本研究得出结论,癌症相关疲劳在手术前后均存在,且与功能残疾相关。评估疲劳的不同维度很重要,需要让患者了解这些情况,以便规划任何具体干预措施,包括改变生活方式,帮助他们应对这些实际问题。