Smets E M, Garssen B, Schuster-Uitterhoeve A L, de Haes J C
Department of Medical Psychology, Academic Medical Centre, Amsterdam, The Netherlands.
Br J Cancer. 1993 Aug;68(2):220-4. doi: 10.1038/bjc.1993.319.
In this paper an overview is presented on what is currently known of fatigue in cancer. Fatigue is considered to be a multi-dimensional concept, that should be measured as such. However, fatigue has been assessed mostly by single items in general symptom checklists. The few specific instruments that have been used in cancer patient populations are discussed. The majority of cancer patients, about 70%, report feelings of fatigue during radio- or chemotherapy. Follow-up results show that, at least for some diagnoses, patients remain fatigued long after treatment has ended. Somatic and psychological mechanisms that have been proposed to explain fatigue are discussed. It is argued that the significance of the results obtained on fatigue as a symptom in cancer depends on comparison with other patient and non-patient populations. Also the occurrence of a response-shift has to be considered, leading to under reporting of fatigue. Finally, possible interventions to decrease feelings of fatigue are presented.
本文对目前已知的癌症疲劳情况进行了概述。疲劳被认为是一个多维度的概念，应该以此方式进行测量。然而，疲劳大多是通过一般症状清单中的单项条目来评估的。文中讨论了在癌症患者群体中使用过的少数几种特定工具。大约70%的癌症患者报告在放疗或化疗期间有疲劳感。随访结果表明，至少对于某些诊断而言，患者在治疗结束后很长时间仍会感到疲劳。文中讨论了为解释疲劳而提出的躯体和心理机制。有人认为，将疲劳作为癌症症状所获得的结果的意义取决于与其他患者群体和非患者群体的比较。还必须考虑到反应转移的发生，这会导致对疲劳的报告不足。最后，介绍了减轻疲劳感的可能干预措施。
