The Prevalence And Moderators Of Cancer-related Fatigue In Cancer Patients

Cancer Related Fatigue (CRF) is a new hot spot of tumor patient quality of liferesearch. CRF, the most common symptom of cancer patients, is associated with cancerand anticancer treatments. CRF is a very distressing condition, which has serious impacton the quality of life and is strongly associated with depression. During the last decade,related researches have developed some study tools, such as the multi-dimensionalFatigue Symptom Inventory (MFSI), Brief Fatigue Inventory (BFI), Piper's Fatigue Scale.Some CRF related pathogenic factors and influencing factors having been identified byusing these tools and other approach. At present, the domestic oncology academe juststarted to the CRF research, the CRF epidemiology characteristic of the Chinese cancerpatients crowd was still inexplicit. CRF's pathogenesis, influencing factors and thesuitable appraisal standard wait for realizing.In view of the different between under treatment patient and the convalescencepatient, we selected the partial cancer patients in community and some others in hospitalas the object of our study, to understand the incidence of CRF, the mediator of CRF andCRF's impact to the patient quality of life in the two crowds. We validated the Chineseversion of BFI and FACIT-F in the sample of Chinese cancer patients and chose thesuitable fatigue analysis variable. Based on the social psychology - biomedicine pattern,we identify independent predictors of clinically significant fatigue based upon amultidimensional model. In the community, the fatigue incidence of cancer patients was: (28.0%). UnivariateAnalysis showed that there had significant relation between fatigue and anorexia,insomnia, constipation, pain, age. In a multiple logistic regression model, age andanorexia symptom predicted fatigue independently with good calibration (HosmerLemeshow Chi Square = 2.58, P = 0.461). A multiple linear regress model showed thatseverity of anorexia and pain could respectively explained the 28.9%, 20.3% change offatigue severity. The development of clinically significant CRF could be predicted by lowage and anorexia symptom. The main factors which impact on the severity of CRF wereseverities of anorexia and pain. These findings support that CRF is a severe problem toChinese cancer patients in community. The low age survivor suffered this symptommore than the older. The mechanism of age's effect to fatigue in cancer survivorsneeds more study. Anorexia is the most important symptom which affects thedevelopment and progress of fatigue. Uncontrolled pain is another symptom affected theprogress of fatigue. The main strategy for management and treatment of fatigue could bethe control of related symptoms.We validated the Chinese version of the FACIT-F and BFI in a sample of 106Chinese inpatients with multiple cancer diagnoses. Internal consistency was indicated byCronbach alphas of 0.930 for FACIT-F and 0.963 for BFI. Factor analysis revealed afour-factor structure for the subscale FACT-G, a three-factor structure for the subscaleFACT-F. Convergent validity was examined by correlating the FACT-F scores andBFI-F scores. The present fatigue scores and FACT-F scores had the highest relativity.Known-group validity was established by comparing BFI-T and FACIT-F scores between patients with low functional status and high functional status. The Chineseversion of FACIT-F and BFI is reliable, valid, and sensitive for measuring cancer-relatedfatigue severity and interference among Chinese cancer patients.The BFI present fatigue severity > 3/10 was defined as clinically significant fatigue.Fatigue was present in 81.4% cancer inpatients, and 60.0% had present fatigue>3. In amultiple logistic regression model, count of monocyte, level of serum albumin andmouth dry predicted fatigue independently with good calibration (Hosmer LemeshowChi Square = 7.19, P = 0.41) and discrimination (area under the receiver operatingcharacteristic curve = 0.85). A multiple linear regress model showed that workingfunction, shortness of breath and sleep disturbance could respectively explained the35.2%, 29.75%, 24.3% change of fatigue severity. The development of clinicallysignificant CRF could be predicted by high count of monocyte, low level of serumalbumin and the present of mouth dry symptoms. The main factors which impact on theseverity of CRF were working function, shortness of breath and sleep disturbance. Thesefindings support that the development of CRF is multi-origin, including inflammatoryresponse, low nutritional status and related symptoms, and CRF severity is mediated byphysical function and symptoms like shortness of breath and sleep disturbance. CRF isthe most prevalent symptom of Chinese cancer inpatient.Through this study, we found some characteristic of CRF in Chinese cancerpatients, and appraised the value of the Chinese version of BFI and FACIT-F. It wouldbe a good foundation for further exploration the patterns and interventions of CRF.