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Factors predicting fatigue in breast cancer patients

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Abstract

A prospective study was designed to investigate the factors predicting fatigue in breast cancer patients using the Cancer Fatigue Scale (CFS) in addition to the Hospital Anxiety and Depression Scale (HADS) and a questionnaire containing items on demographic and clinical data, and measures of patients' physical symptoms. The CFS measures total fatigue score ranging from 0 (lowest level) to 60 (highest level) and contains three subscales namely: physical, affective and cognitive fatigue. The questionnaires were administered to a consecutive sample of breast cancer patients attending the Iranian Center for Breast Cancer either for their treatment or follow-up examination. In all, 112 patients were studied. The mean age of the respondents was 45.7 years (SD11.0). Most had stage II breast cancer (67%) and had completed their initial treatment (45%). The mean total fatigue score of the patients was 18.7 (SD 13.5) and overall 49% reported experiencing fatigue to some degree (from quite a bit to very much). Severe anxiety and depression was reported by 16% and 32%, respectively. The regression analysis revealed that fatigue was predicted by depression (P=0.003), pain (P=0.005), current tamoxifen use (P=0.001), undergoing mastectomy (P=0.03) and anxiety (P=0.04). The other variables studied did not emerge as significant predictors of fatigue in the regression analysis. The study findings suggest that in comparison to treatment factors, physical and psychological symptoms have a more important role in cancer-related fatigue and that fatigue should be recognized and managed even before commencing breast cancer treatment.

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References

  1. Andrykowski MA, Curran SL, Lightner R (1998) Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med 21:1–18

    Article  CAS  PubMed  Google Scholar 

  2. Atkinson A, Barsevick A, Cella D, et al (2000) NCCN practice guidelines for cancer-related fatigue. Oncol New York 14 [Suppl 10]:151–161

    Google Scholar 

  3. Berger AM, Farr L (1999) The influence of daytime inactivity and nighttime restlessness on cancer related fatigue. Oncol Nurs Forum 26:1663–1671

    CAS  PubMed  Google Scholar 

  4. Bower JE, Ganz PA, Desmond KA. Rowland JH, Meyerowitz BE, Belin TR (2000) Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 18:743–753

    CAS  PubMed  Google Scholar 

  5. Broeckel JA, Jacobson PB, Horton J, Balducci L, Lymman GH (1998) Characteristics and correlates of fatigue after adjuvant chemotherapy for breast cancer. J Clin Oncol 16:1689–1696

    CAS  PubMed  Google Scholar 

  6. Cella D (1997) Manual of the functional assessment of chronic illness therapy (FACIT) scales, vol 4. Evanston Northwestern Healthcare, Chicago

  7. Chan CWH, Molassiotis A (2000) The impact of fatigue on Chinese cancer patients in Hong Kong. Support Care Cancer 9:18–24

    Article  Google Scholar 

  8. Curt GA (2001) Fatigue in cancer. BMJ 322:1560

    Article  CAS  PubMed  Google Scholar 

  9. Curt GA, Breitbart W, Cella D, et al (2000) Impact of cancer-related fatigue on the lives of patients: new findings from the Fatigue Coalition. Oncologist 5:353–360

    CAS  PubMed  Google Scholar 

  10. de Jong N, Courtens AM, Abu-Saad HH, Schouten HC (2002) Fatigue in patients with breast cancer receiving adjuvant chemotherapy: a review of the literature. Cancer Nurs 25:283–297

    PubMed  Google Scholar 

  11. Fürst CJ, Ahsberg E (2001) Dimensions of fatigue during radiotherapy. An application of Multidimensional Fatigue Inventory. Support Care Cancer 9:355–360

    CAS  PubMed  Google Scholar 

  12. Glaus A (1993) Assessment of fatigue in cancer and non-cancer patients and in healthy individuals. Support Care Cancer 1:305–315

    CAS  PubMed  Google Scholar 

  13. Glaus A (2001) Fatigue in patients with cancer—from orphan topic to global concern. Support Care Cancer 9:1–3

    Article  CAS  PubMed  Google Scholar 

  14. Hann DM, Denniston MM, Baker F (2000) Measurement of fatigue in cancer patients: further validation of the Fatigue Symptom Inventory. Qual Life Res 9:847–854

    Article  CAS  PubMed  Google Scholar 

  15. Hayes JR (1991) Depression and chronic fatigue in cancer patients. Prim Care 18:327–339

    CAS  PubMed  Google Scholar 

  16. Herrmann C (1997) International experience with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. J Psychosom Res 42:17–41

    Article  CAS  PubMed  Google Scholar 

  17. Irvine DM, Vincent L, Graydon JE, Bubela N (1998) Fatigue in women with breast cancer receiving radiation therapy. Cancer Nurs 21:127–135

    CAS  PubMed  Google Scholar 

  18. Jacobson PB, Hann DM, Azzarello LM, Horton J, Balducci L, Lyman GHC (1999) Fatigue in women receiving adjuvant chemotherapy for breast cancer: characteristics, course, and correlates. J Pain Symptom Manage 18:233–242

    Article  PubMed  Google Scholar 

  19. Lavidor M, Weller A, Babkoff H (2003) How sleep is related to fatigue. Br J Health Psychol 8:95–105

    Article  PubMed  Google Scholar 

  20. Magnusson K, Moller A, Ekman T, Wallgren A (1999) A qualitative study to explore the experience of fatigue in cancer patients. Eur J Cancer Care 8:224–232

    Article  CAS  Google Scholar 

  21. Mast ME (1998) Correlates of fatigue in survivors of breast cancer. Cancer Nurs 21:136–142

    CAS  PubMed  Google Scholar 

  22. Mendoza TR, Wang XS, Cleeland CS, et al (1999) The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer 85:1186–1196

    CAS  PubMed  Google Scholar 

  23. Molassiotis A, Chan CWH (2001) Fatigue patterns in Chinese patients receiving chemotherapy. Eur J Oncol Nurs 5:60–70

    Article  Google Scholar 

  24. Montazeri A, Harirchi I, Vahdani M, et al (2000) Anxiety and depression in Iranian breast cancer patients before and after diagnosis. Eur J Cancer Care 9:151–157

    Article  CAS  Google Scholar 

  25. Norusis MJ (1999) SPSS regression models 10.0. SPSS, Chicago, IL

  26. Okuyama T, Akechi T, Kugaya A, et al (2000) Development and validation of the cancer fatigue scale: a brief three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage 19:5–14

    Article  CAS  PubMed  Google Scholar 

  27. Okuyama T, Akechi T, Kugaya A, et al (2000) Factors correlated with fatigue in disease-free breast cancer patients: application of the Cancer Fatigue Scale. Support Care Cancer 8:215–222

    Article  CAS  PubMed  Google Scholar 

  28. Payne DK, Hoffman RG, Theodoulou M, et al (1999) Screening for anxiety and depression in women with breast cancer. Psychiatry and medical oncology gear up for managed care. Psychosomatics 40:64–69

    CAS  PubMed  Google Scholar 

  29. Piper BF, Dibble SL, Dodd MJ (1998) The revised Piper Fatigue Scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 25:677–684

    CAS  PubMed  Google Scholar 

  30. Portenoy RK, Itri LM (1999) Cancer-related fatigue: guidelines for evaluation and management. Oncologist 4:1–10

    CAS  PubMed  Google Scholar 

  31. Schwartz AL (1998) The Schwartz Cancer Fatigue Scale: testing reliability and validity. Oncol Nurs Forum 25:711–717

    CAS  PubMed  Google Scholar 

  32. Servaes P, van der Werf S, Prins J, Verhagen S, Bleijenberg G (2001) Fatigue in disease-free cancer patients compared with fatigue in patients with chronic fatigue syndrome. Support Care Cancer 9:11–17

    Article  CAS  PubMed  Google Scholar 

  33. Servaes P, Verhagen C, Bleijenberg G (2002) Fatigue in cancer patients during and after treatment: prevalence, correlates and interventions. Eur J Cancer 38:27–43

    CAS  PubMed  Google Scholar 

  34. Sharpe M, Wilks D (2002) ABC of psychological medicine: fatigue. BMJ 325:480–483

    Article  PubMed  Google Scholar 

  35. Stone P, Richards M, A'Hern R, Hardy J (2000) A study to investigate the prevalence, severity and correlates of fatigue among patients with a control group of volunteers without cancer. Ann Oncol 11:561–567

    PubMed  Google Scholar 

  36. Visser RM, Smets MA (1998) Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer 6:101–108

    Google Scholar 

  37. Winningham ML, Nail LM, Burke MB, et al (1994) Fatigue and the cancer experience: the state of the knowledge. Oncol Nurs Forum 12:23–36

    Google Scholar 

  38. Woo B, Dibble SL, Piper BF, Keating SB, Weiss MC (1998) Differences in fatigue by treatment methods in women with breast cancer. Oncol Nurs Forum 25:915–920

    CAS  PubMed  Google Scholar 

  39. Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression scale. Acta Psychiatr Scand 67:361–370

    CAS  PubMed  Google Scholar 

  40. Zorn M, Rowland JH, Varricchio CG (2002) Symptom management in cancer: pain, depression, and fatigue. Current bibliographies in medicine, no. 2002-4. National Library of Medicine, Bethesda (http://www.nlm.nih.gov/pubs/cbm/cancersymptoms.pdf)

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Authors and Affiliations

  1. Iranian Center for Breast Cancer, P.O. Box 13185-1488, Tehran, Iran

    Shahpar Haghighat, Mohammad Esmail Akbari & Ali Montazeri

  2. School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Kourosh Holakouei & Abbas Rahimi

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  1. Shahpar Haghighat
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  2. Mohammad Esmail Akbari
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  3. Kourosh Holakouei
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  4. Abbas Rahimi
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  5. Ali Montazeri
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Correspondence to Ali Montazeri.

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Haghighat, S., Akbari, M.E., Holakouei, K. et al. Factors predicting fatigue in breast cancer patients. Support Care Cancer 11, 533–538 (2003). https://doi.org/10.1007/s00520-003-0473-5

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  • DOI: https://doi.org/10.1007/s00520-003-0473-5

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