Cancer-related Fatigue And Its Related Factors In Lung Cancer Patients Based On The Theory Of Unpleasant Symptoms

Objectives:The study aimed to describe the current situation of cancer-related fatigue(CRF)in lung cancer patients,explore the influencing factors of CRF in lung cancer patients from the physiological,psychological and environmental aspects based on the theory of unpleasant symptoms,and explore the mediating role of positive effect in lung cancer patients between resilience and CRF,so as to provide theoretical basis for medical staff to formulate targeted intervention measures to improve CRF.Methods:By convenience sampling,225 inpatients with lung cancer in the Department of respiratory medicine and chemotherapy of a hospital in Shandong Province from December 2019 to September 2020 were recruited.The general situation questionnaire,Revised Piper Fatigue Scale(PFS-R),Insomnia Severity Index(ISI),The 10-item Connor-Davidson Resilience Scale(CD-RISC-10),Positive and Negative Affect Schedule(PANAS),and Social Support Rating Scale(SSRS)were used to collect data,SPSS24.0 software was used for data processing.The specific statistical methods included descriptive statistics,t test,ANOVA,Spearman correlation,multiple stepwise regression,etc.Results:1.General information in lung cancer patientsThe age of lung cancer patients ranged from 29 to 82 years,with an average age of(57.7±9.3)years.56.7%of patients were men;97.8%were married;41.6%were within the normal range of BMI;68.4%were junior high school students or below;39.5%of families had a per capita monthly income of less than 1000 yuan;60.9%were adenocarcinoma.85.4%were in stage Ⅲ to Ⅳ;73.1%were treated by chemotherapy;The chemotherapy cycle of 65.1%was 1-6;46.2%had pain;38.6%had complications.2.The status of CRF in lung cancer patientsThe total score of CRF in lung cancer patients ranged from 22 to 185,with an average score of(94.94±35.46).The scores of behavioral fatigue,affective fatigue,physical fatigue and cognitive fatigue were 29.16± 10.91,24.00(15.00,32.00),21.00(15.00,27.50),19.00(11.00,27.00).Univariate analysis results showed that there were statistical differences in CRF and its dimensions in age,gender,educational level,pathological classification,clinical stage,chemotherapy cycle,pain and complications(P<0.05).3.Spearman correlation analysis of factors related to CRF in lung cancer patientsThe results showed that CRF and its dimensions were significantly correlated with insomnia(r=0.318～0.432),resilience(r=-0.224～-0.391),positive affect(r=-0.407～-0.523),and social support(r=-0.219～-0.313)(P<0.01).4.Multiple stepwise regression analysis of factors related to CRF in lung cancer patientsThe study selected CRF and its dimensions as dependent variables,demographic and clinical factors with statistical differences in univariate analysis as independent variables.Multiple stepwise regression analysis was conducted according to the standard of α-in=0.05 and α-out=0.10.The results showed that age,insomnia,resilience,positive affect,social support and subjective support were the main factors affecting CRF and its dimensions of lung cancer patients(P<0.05).5.Test of the mediating effect of positive affect between resilience and CRF in lung cancer patientsThe study selected CRF as the dependent variable,resilience and positive affect were included in the regression equation after controlling for demographic and clinical factors with statistical differences.The results showed that resilience negatively predicted CRF(β=-3.064,P<0.001),but when the resilience and positive affect entered the regression equation at the same time,positive affect negatively predicted CRF(β=-3.222,P<0.001),resilience can not negatively predict CRF(β=-0.998,P>0.05),indicating that positive affect could complete mediate the relationship between resilience and CRF.The indirect effect value of Bootstrap test was-2.301,and 95%confidence interval was[-2.983,-1.674],excluding 0,which further verified the complete mediating effect of positive affectConclusions:1.Lung cancer patients have a high incidence of CRF,mostly in the moderate degree of fatigue.2.CRF of lung cancer patients were positively correlated with insomnia,and negatively correlated with resilience,positive affect,and social support.3.The main factors affecting CRF of lung cancer patients were age,insomnia,resilience,positive affect and social support.4.Positive affect in lung cancer patients played a completely mediating role in the relationship between resilience and CRF.