Zdun-Ryżewska Agata, Szablewska Anna, Kamińska Justyna, Błażek Magdalena
Division of Quality of Life Research, Department of Psychology, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdańsk, Poland.
Division of Obstetric and Gynaecological Nursing, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdańsk, Poland.
Support Care Cancer. 2025 Apr 2;33(4):341. doi: 10.1007/s00520-025-09390-0.
Healthcare providers and oncology patients may assess fatigue differently without direct communication. This study was performed to compare patient barriers to discussing cancer-related fatigue with healthcare providers in 2002 and 2023/24 using the Polish adaptation of the Fatigue Management Barriers Questionnaire (FMBQ). The FMBQ measures the intensity of barriers in communicating with medical staff about fatigue.
This cross-sectional study with a historical comparison utilized the FMBQ, the Chalder Fatigue Questionnaire (CFQ-PL), the Multidimensional Scale of Perceived Social Support (MSPSS), and a custom-designed questionnaire. The study was conducted at the turn of 2023 and 2024, with participants recruited during hospitalization in the preoperative period as part of their treatment process.
The study included 54 women with histopathologically confirmed reproductive organ malignancies (68% ovarian cancer, 28% endometrial and cervical cancer). The Polish adaptation of the FMBQ demonstrated good psychometric properties, which have been preliminarily confirmed. No significant correlations were found between barriers to communication and fatigue intensity, illness duration, or length of treatment. Two decades after the first study on barriers to discussing fatigue, these barriers persist and have intensified. This is particularly evident in concerns regarding the futility of addressing fatigue, the fear of jeopardizing cancer treatment, and the avoidance of the topic due to concerns that fatigue may signal disease progression. Additionally, patients report an increased need to maintain the image of a "good patient" by avoiding complaints, along with growing concerns about excessive medication use. The percentage of patients not asked about fatigue by medical staff has remained consistent over time (25%-33%). Present-day key barriers to discussing fatigue include the desire to limit medication intake (53%), the effort to maintain a "good patient" image (49%), the belief that fatigue is a less important issue (42%), and fears that it is either a side effect of treatment (38%) or an indicator of disease progression (36%).
Barriers to discussing fatigue remain a significant issue in cancer care. Addressing these barriers through education and structured communication strategies could enhance supportive care for oncology patients.
医疗服务提供者和肿瘤患者在没有直接沟通的情况下，对疲劳的评估可能会有所不同。本研究旨在使用波兰语版的疲劳管理障碍问卷（FMBQ），比较2002年和2023/2024年患者在与医疗服务提供者讨论癌症相关疲劳方面存在的障碍。FMBQ用于衡量与医务人员沟通疲劳相关问题时障碍的强度。
本横断面研究采用历史对照，使用了FMBQ、查尔德疲劳问卷（CFQ-PL）、多维感知社会支持量表（MSPSS）以及一份定制问卷。该研究于2023年末至2024年初进行，参与者为术前住院治疗期间招募的患者，作为其治疗过程的一部分。
该研究纳入了54名经组织病理学确诊为生殖器官恶性肿瘤的女性患者（68%为卵巢癌，28%为子宫内膜癌和宫颈癌）。波兰语版的FMBQ显示出良好的心理测量特性，已得到初步证实。沟通障碍与疲劳强度、病程或治疗时长之间未发现显著相关性。在首次研究讨论疲劳障碍的二十年之后，这些障碍依然存在且有所加剧。这在对解决疲劳问题徒劳无功的担忧、对危及癌症治疗的恐惧以及因担心疲劳可能预示疾病进展而回避该话题等方面表现得尤为明显。此外，患者报告称，为了维持“好患者”形象而避免抱怨的需求增加，同时对过度用药的担忧也在增加。医务人员未询问患者疲劳情况的比例长期保持稳定（25%-33%）。当前讨论疲劳的主要障碍包括限制药物摄入的愿望（53%）、努力维持“好患者”形象（49%）、认为疲劳是不太重要的问题（42%）以及担心它是治疗副作用（38%）或疾病进展指标（36%）。
讨论疲劳的障碍在癌症护理中仍然是一个重要问题。通过教育和结构化沟通策略来解决这些障碍，可以加强对肿瘤患者的支持性护理。
