Trajectories Of Cancer-related Fatigue And Its Predictive Value On Health-related Quality Of Life:a Longitudinal Study

Objectives:To investigate the different development trajectories of cancer-related fatigue in Chinese cancer patients from the initial diagnosis to the completion of all medical treatments;to explore the predictive effects of demographic variables,medical variables and self-compassion on different trajectories of cancer-related fatigue;and to reveal the predictive effects of different trajectories of cancer-related fatigue on their health-related quality of life.Methods:The longitudinal study design was adopted in this study.For 150 cancer patients with initial onset and initial treatment,the longitudinal follow-up of cancer-related fatigue was conducted at 3 time points:within one week after the initial diagnosis of cancer(T1),within one week after the start of medical treatment(T2),and within one week after the completion of all treatment(T3).The self-Chen questionnaire was used as a survey tool,including demographic variables and medical variables,Checklist Individual Strength(CIS),self-compassion scale(SCS)and quality of life questionnaire(EORTC-QLQ-C30).Latent class growth analysis(LCGA)was used to investigate the different development and change trajectories of cancer-related fatigue from T1 to T3.SPSS22.0 software was used to perform one-way ANOVA and Chi-square independence test to investigate the predictive effects of demographic variables,medical variables and self-sympathy on the development and change trajectories of cancer-related fatigue and the predictive effects of the development and change trajectories of cancer-related fatigue on health-related quality of life.Results:LCGA analysis results show that cancer patients have five different development and change tracks of cancer-related fatigue,namely "high level-falling group"(n=15),"medium level-stable group"(n=99),"medium level-falling group"(n=18),"low level-rising group"(n=12)and "low level-stable group"(n=6).The results of one-way ANOVA and Chi-square test show that demographic variables and medical variables cannot predict the development and change track of cancer-related fatigue.Self-sympathy is a good predictor of cancer-related fatigue.The total score of self-sympathy(F(4,134)=9.24,p<0.001),positive self-sympathy(F(4,139)=4.01,p<0.01)and negative self-sympathy(F(4,138)=2.51,p<0.05)can significantly predict the development and change track of cancer-related fatigue(p<0.05).At the same time,it was found that besides constipation and economy,the development track of cancer-related fatigue can significantly predict the health-related quality of life of cancer patients(p<0.05).Conclusions:(1)Cancer-related fatigue of cancer patients has different development and change trajectories,and only a few of them have improved from diagnosis to the end of treatment,and most patients have moderate or above cancer-related fatigue.(2)Self-sympathy has predictive value for the development and change track of cancer-related fatigue.(3)The different development and change tracks of cancer-related fatigue have long-term prediction and guidance significance for improving patients' health-related quality of life.The results of this study show that,in clinical practice,medical staff should pay special attention to patients with high cancer-related fatigue and whose development and change track are worsening.At the same time,medical staff should carry out health education and psychological support for patients with low level of self-sympathy,formulate corresponding treatment and intervention programs for patients with different cancer-related fatigue development and change trajectories,and finally predictably improve the health-related quality of life of patients.