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膀胱癌治疗中的疲劳及相关变量——纵向试点研究

Fatigue and related variables in bladder cancer treatment - Longitudinal pilot study.

作者信息

Zdun-Ryżewska Agata, Gawlik-Jakubczak Teresa, Trawicka Agnieszka, Trawicki Paweł

机构信息

Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences, Medical University of Gdansk, Poland.

Department of Urology, Faculty of Medicine, Medical University of Gdansk, Poland.

出版信息

Heliyon. 2024 Aug 8;10(16):e35995. doi: 10.1016/j.heliyon.2024.e35995. eCollection 2024 Aug 30.

Abstract

Fatigue is a significant problem in patients with bladder cancer treated by radical cystectomy. This pilot study evaluated fatigue and related variables during a treatment period. Four measurements were made, the first 1 month after the cystectomy, and the next three at an interval of about 3 months each (at 4 months, 7 months, and 10 months after the surgery). In addition to the author's questionnaire (sociodemographic variables and a question about the impact of the disease on the patient's life), the FACIT-F Fatigue (to measure fatigue), NCCN/FACT FBISI-18, version 2 (symptoms, general condition of the patient), HADS (depression, anxiety, and irritability) measures were used. In this study, 21 patients participated in all four measurement periods. The fatigue intensity increased significantly between the first and second measurements and gradually decreased between the third and fourth measurements. As the severity of fatigue increases, can be observed an increase in the sense of the impact of the disease on the patient's life in all except the first measurement. The study revealed statistically significant correlations between fatigue and experiencing symptoms of cancer and treatment at each stage of the study, with the strongest correlations in the second and fourth measurements regarding symptoms of cancer and a stronger correlation in the second compared to the first measurement regarding side effects. At each stage of measurement, the experience of dizziness, lack of appetite, feeling of being sick, and feeling of annoyance from treatment side effects were statistically significantly correlated with fatigue. The intensity of fatigue correlated with the feeling of experiencing difficulties in meeting the needs of the family due to the physical condition in the first measurement (Rho = 0.76), a sense of weakness (Rho = 0.92) and sleepiness (Rho = 0.72) in the second measurement, pain in the third (Rho = 0.77). The greatest number of correlates of fatigue were described in the fourth measurement (all symptoms of cancer and side effects except losing weight). Stress, anxiety, depression and irritability were correlated with fatigue at each of the stages of research except the first one (without differences between the correlation coefficients in the second, third and fourth measurements). Significantly lower levels of fatigue characterised patients who survived over 6 months after the end of the study compared to the first three measurements.

摘要

疲劳是接受根治性膀胱切除术的膀胱癌患者的一个重要问题。这项初步研究评估了治疗期间的疲劳及相关变量。进行了四次测量,第一次在膀胱切除术后1个月,接下来三次测量的间隔约为3个月(分别在术后4个月、7个月和10个月)。除了作者的问卷(社会人口统计学变量以及一个关于疾病对患者生活影响的问题)外,还使用了FACIT - F疲劳量表(用于测量疲劳)、NCCN/FACT FBISI - 18第2版(症状、患者总体状况)、HADS量表(抑郁、焦虑和易怒)。在本研究中,21名患者参与了所有四个测量阶段。疲劳强度在第一次和第二次测量之间显著增加,在第三次和第四次测量之间逐渐降低。随着疲劳严重程度的增加,除第一次测量外,在所有测量中都可观察到疾病对患者生活影响的感知增加。该研究揭示了在研究的每个阶段,疲劳与癌症症状及治疗体验之间存在统计学上的显著相关性,在第二次和第四次测量中,与癌症症状的相关性最强,与第一次测量相比,在第二次测量中与副作用的相关性更强。在每个测量阶段,头晕、食欲不振、恶心和治疗副作用引起的烦恼感与疲劳在统计学上显著相关。疲劳强度在第一次测量中与因身体状况而难以满足家庭需求的感觉相关(Rho = 0.76),在第二次测量中与虚弱感(Rho = 0.92)和困倦感(Rho = 0.72)相关,在第三次测量中与疼痛相关(Rho = 0.77)。在第四次测量中描述的与疲劳相关的因素数量最多(除体重减轻外的所有癌症症状和副作用)。除第一个研究阶段外,压力、焦虑、抑郁和易怒在研究的每个阶段都与疲劳相关(第二次、第三次和第四次测量的相关系数之间无差异)。与前三次测量相比,研究结束后存活超过6个月的患者的疲劳水平显著较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e7b/11366915/65e37f927fa8/gr1.jpg

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