Irvine D, Vincent L, Graydon J E, Bubela N, Thompson L
Department of Health Administration, Faculty of Medicine, University of Toronto, Ontario, Canada.
Cancer Nurs. 1994 Oct;17(5):367-78.
Fatigue can be a prevalent and serious problem for the individual with cancer and can negatively impact on the individual's quality of life. Little is known about the prevalence of clinical fatigue among patients with cancer and how the fatigue cancer patient's experience compares with the fatigue people experience as a function of their normal daily activities. This study, which utilized a control group, investigated the prevalence of fatigue among patients receiving treatment with radiotherapy (n = 54) and chemotherapy (n =47) over two measurement points. The level of fatigue experienced by cancer patients was compared with the level of fatigue experienced by apparently healthy auxiliary staff (n = 53) working at three cancer treatment facilities. There were no differences in the mean level of fatigue experienced by cancer patients and the mean level experienced by healthy controls before the start of cancer treatment. However, cancer patients experienced a significant increase in fatigue over a 5- or 6-week course of radiotherapy and 14 days after treatment with chemotherapy, and these increases were significantly greater than the fatigue reported by healthy control subjects. The midpoint of the Pearson Byars Fatigue Feeling Checklist was accepted as a crude measure of clinical fatigue and was found to be significantly different from the mean level of fatigue reported by healthy controls. The prevalence of fatigue among patients after undergoing cancer treatment was determined to be 61%. Fatigue in cancer patients was found to covary with weight, symptom distress, mood disturbance, and alterations in usual functional activities. The best predictors of fatigue in the patient sample were their symptom distress and mood disturbance. Symptom distress and fatigue were significant predictors of impairment in functional activities related to illness. Implications for practice and future research are discussed.
疲劳对于癌症患者来说可能是一个普遍且严重的问题，会对患者的生活质量产生负面影响。目前对于癌症患者临床疲劳的患病率以及癌症患者所经历的疲劳与人们在日常正常活动中所经历的疲劳相比情况知之甚少。本研究采用了一个对照组，在两个测量点调查了接受放疗（n = 54）和化疗（n = 47）的患者中的疲劳患病率。将癌症患者所经历的疲劳程度与在三个癌症治疗机构工作的看似健康的辅助人员（n = 53）所经历的疲劳程度进行了比较。在癌症治疗开始前，癌症患者所经历的平均疲劳水平与健康对照组所经历的平均疲劳水平没有差异。然而，癌症患者在为期5或6周的放疗过程中以及化疗治疗后14天疲劳显著增加，且这些增加幅度明显大于健康对照受试者报告的疲劳程度。皮尔逊·拜尔斯疲劳感觉清单的中点被用作临床疲劳的粗略衡量指标，发现其与健康对照组报告的平均疲劳水平有显著差异。确定接受癌症治疗后的患者中疲劳患病率为61%。发现癌症患者的疲劳与体重、症状困扰、情绪紊乱以及日常功能活动的改变相关。患者样本中疲劳的最佳预测因素是他们的症状困扰和情绪紊乱。症状困扰和疲劳是与疾病相关的功能活动受损的显著预测因素。讨论了对实践和未来研究的启示。
