| Background:Cancer-related fatigue is a persistent, subjective sense of discomfort with the cancer or cancer treatment, which have caused patients feel fatigue in physical, emotional and (or) on fatigue or cognitive dimensions, and impact normal function of patients, but out of proportion with the recent activity. Compared to the ordinary fatigue with rest or sleep can ease, CRF is a duration of longer, more serious symptoms.Colorectal cancer in our country the incidence and mortality of all malignant tumors accounted for the first four .Colorectal cancer treatment by surgery, supplemented by chemotherapy and radiotherapy. Currently, because of the means of diagnosis and treatment improve, colorectal cancer after 5-year overall survival rate at 60% (including the survival of patients with tumors), radical resection of colon cancer after 5-year survival rate is generally 60% to 80%, colorectal cancer is about 50～70%; DukesA period of sick after radical resection of the 5-year survival rate can be over 90%.Under the influence of the new medical paradigm shift, the medical profession not only pay attention to tumor treatment, improve the quality of life of cancer patients has now become the focus of medical attention. CRF is a life events which has negatively relation with the quality of life, reducing CRF can improve quality of life of patients.The improvement of survival in patients, remission of colorectal cancer in patients with CRF to enhance their quality of life has an important significance.Currently on cancer related fatigue identification and intervention research is still at the initial stage, yet to be seen on the postoperative patients with colorectal cancer related fatigue and the impact of factors research reported.In this study, subjects try to select the top three at two hospitals in Guangzhou in colorectal cancer patients after operation, select the status of epidemiological investigation methods, use of Brief Fatigue Inventory-Chinese Version (BFI-C), Quality of Life Instruments for cancer patients (QLICP-CR),Social Support Rating Scale(SSRS), Hospital Anxiety and Depression Scale (HAD), Numeric Rating Scale(NRS)and self socio-demographic information and clinical data questionnaire on postoperative colorectal cancer patients, analysis of postoperative patients with colorectal cancer the incidence of CRF, the quality of life, social support, anxiety, depression, pain, as well as related factors. To further the application of basic research, as well as to ease the CRF care institutions to improve the quality of life in patients with colorectal cancer, which provided a reference basis.Objectives:On postoperative colorectal cancer patients with CRF, the quality of life, social support, psychological problems and pain conduct investigations, to explore the factors of CRF in colorectal cancer patients after operation.Subjects and MethodsUsing cross-sectional methods, the researchers investigated colorectal cancer patients after operation for the CRF at two top three hospitals in Guangzhou. Using convenience sampling method collected 187 colorectal cancer patients. Inclusion criteria: diagnosed by pathological examination in patients with colorectal cancer; The hospital has accepted or received any surgical treatment; age≥18 years of age; primary or higher; expected survival time is greater than six months. Exclusion criteria: patients with the disease have not inform; with other primary cancers, serious persons; has history of mental illness, mental retardation patients; do not want to cooperate with the investigation of patients. From 187 cases who meet the standard, male 99 cases, 88 cases of female, age 18～84 years (55.94±12.93); married 166 cases, five cases of unmarried, widowed 11 cases, 5 cases of divorce; 63 cases of retirement, in-service 49 cases, the other 75 cases; 68 cases of primary and secondary schools, 51 cases of middle school, high school or secondary school 41 cases, 15 cases of university, college-level and above 12 cases; 29 cases of living in large cities, medium-sized cities in 48 cases, 49 cases of small towns, rural 61 cases ; ways to pay medical fees at their own expense70 cases fully, in part at their own expense 104 cases, 13 cases of public funds; home monthly income <1000RMB52 cases , 1000-3000RMB 74 cases ,3000-5000RMB,24 cases,> 5,000RMB 37 cases. One of 83 cases of colon cancer, at the junction of colon and rectal 8 cases of cancer, 96 cases of rectal cancer;in the hospital 73 cases of surgery, postoperative chemotherapy is less than 6 times 90 cases, after 6 times greater than 13 cases of chemotherapy, adjuvant therapy or review 11 cases; DukesA period of 18 cases, B period of 65 cases, C period of 53 cases, D period of 51 cases; histology type: 161 cases of adenocarcinoma, 14 cases of mucinous adenocarcinoma, 12 cases of the other; 103 cases have c omplications, No complications were 84 cases; 11 cases of the use of sedative drugs, 176 cases of non-use.The questionnaires were used including:self-socio-demographic data and clinical data of the questionnaire, Brief Fatigue Inventory -Chinese Version (BFI-C), Quality of Life instruments for Cancer Patients -Colorecatal cancer(QLICP-CR), as well as Society Support Rating Scale (SSRS), Hospital Anxiety and Depression Scale (HAD) as well as the Numeric Rating scale (NSR). SPSS13.0 software was used to set up a database for data input, statistics and analysis,statistical Methods including Descriptive analysis, chi-square test, two independent samples t-test, one-way ANOVA Pearson correlation analysis, two categories of non-condition logistic regression analysis, testing the standard = 0.05.RESULTS:1. Colorectal cancer patients have the high incidence of CRFIn 187 patients, 162 people have varying degrees of fatigue, the overall incidence of fatigue are 86.30%. 37 people with mild fatigue, accounting for the overall trial of patients were 17.79%, moderate to severe fatigue were 125 people, accounting for 66.84 percent of the overall subjects. Theaverang score and SD is of fatigueis 4.01±2.49.2. Socio-demographic factors on the study of the impact of CRFDifferent ages of CRF in patients is different, P=0.013, 61-70-year-old patients with the most serious fatigue; different family income on fatigue in patients with significant differences exist, P=0.046, the family monthly income of 1000-3000 in patients have the extent of fatigue with the most seriousdegeree.3. Clinical factors on the study of the impact of CRFDifferent treatment in patients of fatigue with significant difference between the level of degree, P<0.05, the patient received surgical treatment exist the most serious fatigue, followed by patients treated by chemotherapy more than six times, less than six times, then the patient rechecked; the length of stay in hospital among patients with different degree of fatigue is different,P=0.000,length of stay of 7-30 days in patients with the most serious degree;the length of diagnosed time among patients with different degree of fatigue is different,P=0.022, diagnosed time of patients less than one month with the most serious degree of fatigue;the length of the time from operation with different degree CRF,P=0000, the time from operation less than one month of patients with more serious fatigue than others;the number of leukocytes in patients with different degree of fatigue is different; P=0.039, the increase in the number of leukocytes in patients with fatigue more serious than others.4. Postoperative colorectal cancer patients' quality of life and the incidence of CRFThe score of postoperative colorectal cancer patients of QLICP-CR is 54.75±10.85, there is fatigue of the patients in all areas of quality of life lower than patients without fatigue, P<0.05.5. Postoperative colorectal cancer patients' social support and the incidence of CRFSocial support score in exist in postoperative colorectal cancer patients who have fatigue is higer than the patients who do not have fatige, but there is no statistical significance,P>0.05. 6. Postoperative colorectal cancer patients' anxiety, depression and the incidence of CRFPostoperative colorectal cancer patients with anxiety, depression rates were 21.39%, 16.04%, respectively; different anxiety, depression status in patients exist different degreeof CRF;the CRF degree of patients who is anxiety or depression than the critical and normal state.7. Postoperative Colorectal cancer patients' pain and the incidence of CRFThe pain score of the postoperative colorectal cancer patients is 3.59±2.80. The patients with pain exist more serious CRF than who has no pain, t=-6.313, P<0.05.8. Postoperative Colorectal cancer patients' quality of sleep and the incidence of CRFDifferent quality of sleep have difference in CRF, x~2 = 15.479, P = 0.004, sleep quality is not good in patients with the most severe fatigue, followed by a little better, some good, quite good, very good,quite good sleep quality in patients with the least fatigue.9. Postoperative Colorectal cancer patients' anus praetematuralis with or not and the incidence of CRFDifferent ages of CRF in patients is different, P=0.013, 61-70-year-old patients with the most serious fatigue; different family income on fatigue in patients with significant differences exist, P=0.046, the family monthly income of 1000-3000 in patients have the extent of fatigue with the most seriousdegeree.10. The main factors of CRF of postoperative colorectal cancerThe Socio-demographic factors,clinical factors socialsupport, anxiety,depression, pain,the quality of sleep,scio-The treatment type, quality of sleep, depression, pain, anus praetematuralis were dependent variable,total score of CRF is independent,the result of the main factors which effect the CRF in patients with colorectal cancer after operation were the type of treatment,quality of sleep,depression,pain,the equation of logistic is: total score of CRF=2.603-0.627type of treatment-0.474quality of sleep+0.174depression+0.426pain.Conclusions: 1. CRF is one of the most common symptoms in patients with colorectal cancer after operation,which should pay more attention.2. Socio-demographic factors on the study of postoperative patients with colorectal cancer after operation have certain impact on the incidence of CRF, different age group, family monthly income on the impact of fatigue significantly. Surgery, the length of time in hospital ,the time from diagnose less than one month, the time from operation less than one month,there is inflammation in patients with more severe fatigue. Anxiety, depression in cancer patients exist obviously, should be given to patients with psychological treatment timely. Patients with pain should be given to timely and effective mitigation measures.The patients with wrost quality of sleep, with stoma have more serious degree fatigue than others.3. The relation between CRP and QOL is negative of patients with colorectal cancer after operation.4. The treatment type, quality of sleep, depression, pain in CRP are the main factors which effect the CRF in patients with colorectal cancer after operation.We should pay more attention to the patients who treated by surgery this time in hospital, know the factor of influence the quality of sleep, depression, pain, and to release the psychological problem and pain, in order to relieve the fatigue of patients and improve the quality of life.
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