Analysis Of The Influencing Factors Of Cancer-related Fatigue In Patients With Thyroid Cancer Treated By ¹³¹I

Objectives In order to carry out the intervention of ¹³¹I in the treatment of cancer-related fatigue in patients with thyroid cancer by analysing influence factors of cancer-related fatigue in DTC patients treated with¹³¹I.Methods 1 161 cases of DTC patients with cancer-related fatigue treated with one-month¹³¹I from November 2014 to November 2015 were concluded into the observation group,while the control group consist of 173 cases of DTC patients without cancer-related fatigue treated with same method for one month.Investigation of cancer-related fatigue and other data of DTC patients treated with ¹³¹I by questionnaire.2 The patients in the two groups were investigated as follows:?1?Cancer-related fatigue data:CFS was used for evaluation.?2?Thyroid cancer patients with general information: the main survey of patients are gender,age,degree of education,occupation and whether there was a health insurance.?3?Investigation of clinical data:operation mode,pathological type,diameter of primary tumor,cervical lymph node metastasis,family medical history and number of ¹³¹I treatment are included.?4?Family factors: family income and family function.The family function of the patients was evaluated by FAD.?5?Social support was assessed by SSRS.?6?The investigation of psychological status,including self efficacy of chronic disease,medical coping modes and the status of anxiety.The self efficacy of chronic disease were evaluated though Self-Efficacy for Managing Chronic Disease,and the evaluation of medical coping modes was conducted by Medical Coping Modes Questionnaire,while SAS was used for evaluation of the status of anxiety.3 All the data were collected into data bank by Excel 2003 software,and SPSS17.0 was used to obtain a result of the influence factors of cancer related fatigue in patients with thyroid cancer treated with ¹³¹I by single factor analysis and Binary Logistic analysis.Results 1 The single factor analysis results showed that:?1?The general information:compared with the control group,cancer-related fatigue occurrence of high school degree or above,more than 45 years old,uninsured mental-work women in the observation group is higher than which in the male manual workers with medical insurance,whose age below45 years with high school education or below,the difference was statistically significant.?x2=5.333,7.489,79.729,21.445,4.728,P<0.05?,OR value?95%CI?= 0.125?0.023⁰.224?,0.148?0.037⁰.242?,0.127?0.079⁰.204?,2.826?1.811⁴.409?,0.410?0.180⁰.935?.?2?Clinical data: compared with the control group,the pathological type of follicular carcinoma,primary tumor diameter>4cm,cervical lymph node metastasis,treatment >once in the observation group have statistically significant?x2 =13.743,6.363,4.919,17.15,P<0.05?,OR values=0.099,0.432,1.964,0.25,95%CI=0.023⁰.436,0.222⁰.840,1.074³.59,0.125⁰.499.Comparative observation of surgical method A and B in the observation group has no significant difference?x2=0.267,P>0.05?,OR was 1.120,95%CI was 0.729¹.721.And,patients with or without family medical history in the observation group also has no significant difference?x2=0.655,P>0.05?,OR was 0.72,95%CI was 0.323¹.601.?3?Family factor: compared with the control group,in the observation group,cancer-related fatigue occurrence is higher in the family which per capita monthly income was below 2000 yuan with poor family function,than the per capita monthly income more than 2000 yuan with good family function,the difference was statistically significant?x2=13.24,63.16,P<0.05?,OR=0.434,0.137,95%CI=0.276⁰.683,0.082⁰.23.?4?Social support: compared with the control group,higher incidence of cancer-related fatigue is occurred in whom had lower social support than those with high social support in the observation group,the difference was statistically significant?x2=5.562,P<0.05?,OR=0.468,95%CI=0.247⁰.888.?5?Mental state: compared with the control group,those who had lower chronic disease self efficacy level,negative coping style,and with anxiety had a higher incidence than who had higher chronic disease self efficacy level,positive coping style,and without anxiety,the difference was statistically significant?x2=4.928,8.429 4.555,P<0.05?,OR?95% CI?were 0.608?0.392⁰.945?,0.395?0.208⁰.750?,1.603?1.038².474?.2 Multivariate analysis showed that thyroid carcinoma underwent ¹³¹I treatment of cancer-related fatigue occurs mainly with primary lesion diameter?OR=10.094,95%CI=4.294¹7.499?,social support?OR=7.284,95% CI=4.342¹3.552?,educational level?OR=6.696,95%CI=4.148¹0.552?,the level of chronic disease self-efficacy?OR=6.628,95%CI=3.630¹2.218?,the family function?OR=4.003,95%CI=2.004¹2.103?,lymph node metastasis?OR=2.314,95%CI=1.190⁴.931?,anxiety?OR=2.136,95%CI=1.126⁴.803?,medical coping modes?OR=1.644,95%CI=1.059⁴.054?,the number of treatment?OR=0.509,95% CI=0.279³.092?,with or wothout medical insurance?OR=0.378,95%CI=0.163¹.372?,occupation?OR= 0.354,95% CI=0.227⁰.881?,gender?OR=0.137,95%CI=0,085².324?,age?OR=0.048,95%CI=0.027¹0.810?and other factors.Conclusions Primary tumor diameter,social support,education level,chronic disease self-efficacy,family function,lymph node metastasis,anxiety,coping style,times of treatment,with or without medical insurance,occupation,gender,age and other factors are the main influence factors of cancer-related fatigue factors in thyroid cancer patients treated with ¹³¹I.