Assessment of fatigue in cancer and non-cancer patients and in healthy individuals
Tóm tắt
Fatigue is a very complex phenomenon. It has been described as a major distressing symptom in cancer patients. It is a multidimensional experience that focuses not only on biochemical or pathophysiological causes, but also involves psychological and behavioural aspects. Until today, measurement of fatigue has been a neglected topic in medicine and nursing and a nihilistic attitude still prevails. The lack of valid, reliable tools of measurement is one of the problems inhibiting further research. Only recently has quality- of-life research begun to acknowledge this phenomenon and include fatigue in assessment. In this study, fatigue was measured and explored in cancer patients non-cancer patients and in healthy individuals. A clear distinction evolved between “healthy” fatigue in healthy individuals and “unhealthy” fatigue in cancer patients, where the impact of fatigue was far more negative. Characteristic fatigue profiles underlined these findings. The new visual-analogue fatigue scale, to measure fatigue four times daily, proved to be very useful. Further research is needed to develop therapeutic strategies and to support the patients who have to cope with this distressing symptom.
Tài liệu tham khảo
Astairs J (1987) Fatigue in the cancer patient: a conceptual approach to a clinical problem. Oncol Nurs Forum 14:25–30
Bickel P, Doksum K (1977) Mathematical statistics: basic ideas and selected topics. Holden Day, San Francisco
Blesch K, Paice J (1991) Correlates of fatigue in people with breast or lung cancer. Oncol Nurs Forum 18:81–87
Bruera E (1988) Asthenia in patients with advanced cancer. J Pain Symptom Manage 3:9–13
Butow P, Coates A (1991) On the receiving end. IV. Validation of quality of life indicators. Ann Oncol 2:297–603
Cella D, Perry S (1986) Reliability and validity of three visual analogue mood scales. Psychiatry Rep 59:827–833
Cronbach L (1951) Coefficient alpha and the internal structure of tests. Psychometrica 16:227–234
Gaut D (1983) Development of a theoretically adequate description of caring. West J Nurs Res 5:313–324
Gelber R (1992) How to compare quality of life of breast cancer patients in clinical trials. Oral presentation at the 4th International Conference on Adjuvant Therapy of Primary Breast Cancer, 29 February 1992, St Gallen
Glaus A (1990) Survey of patient problems within a medical oncology department. Unpublished course work for Master's degree studies (Nursing), University of Guildford, Guildford
Gordon M (1986) Differential diagnosis of weakness: a common geriatric symptom. Geriatrics 41:75–79
Grandjean E (1968) Fatigue: its physiological and psychological significance. Ergonomics 11:427–436
Grandjean E (1970) Fatigue. Am Ind Hyg Assoc J 31:401–411
Hart L, Freel M (1982) Fatigue. In: Norris C (ed) Concept clarification in nursing. Aspen, Rockville, pp 251–261
Haylock P, Hart L (1979) Fatigue in patients receiving localized radiation. Cancer Nurs 6:461–467
Holmes S (1991) Preliminary investigation of symptom distress in two cancer patient populations: evaluation of a measurement instrument. J Adv Nurs 16:439–446
Holmes S, Dickerson J (1987) The quality of life: design and evaluation of a self-assessment instrument for use with cancer patients. Int J Nurs Stud 24:15–24
Irvine D, Vincent L (1991) A critical appraisal of the research literature investigating fatigue in the individual with cancer. Cancer Nurs 14:188–199
Jamar S (1982) Fatigue in women receiving chemotherapy for ovarian cancer. In: Funk S, Tornquist E (eds) Key aspects of comfort. Springer, New York Berlin Heidelberg, p 224–228
Kashiwagi S (1971) Psychological ratings of human fatigue. Ergonomics 14:17–21
Killander E (1991) Assessment of pain. In: Managing pain in cancer and palliative care. Teaching package. European College of Cancer Care, London
Klein E, Hart A (1987) Assessment of quality of life: scoring performance status in cancer patients. In: Aaronson N (ed) The quality of life in cancer patients. Raven Press, New York, pp 93–99
Kremer E, Atkinson J (1981) Measurement of pain: patient preference does not confound pain measurement. Pain 10:241–248
McCaffrey M (1979) Nursing management of the patient in pain, 2nd edn. Lippincott, Philadelphia
McCorkle R, Quint-Benoliel J (1983) Symptom distress, current concerns and mood disturbance after diagnosis of lifethreatening. Soc Sci Med 17:431–438
Mc Corkle R., Young K (1978) Development of a symptom distress scale. Cancer Nurs 5:373–375
Mc Guire WP, Hoskins WJ (1987) Protocol G.O.G. no. 97. Gynecologic Oncology Group, Philadelphia
Mc Nair D, Lorr M (1971) EITS manual for the profile of mood states. Educational and Industrial Testing Service, San Diego, Calif
Morant R (1991) Asthenia in cancer patients—a doubleedged inflammatory response against the tumor? J Palliat Care 7:22–24
Nerenz DR, Leventhal H (1982) Factors contributing to emotional distress during cancer chemotherapy. Cancer 50:1020–1027
Pearson P, Byars G (1956) The development and validation of a checklist measuring subjective fatigue. (Report no 56-115) School of Aviation, USAF, Randolf AFB Texas
Pickard S (1991) Fatigue in cancer patients. Cancer Nurs 14:13–19
Piper B, Lindsey A (1987) Fatigue mechanisms in cancer patients: developing nursing theory. Oncol Nurs Forum 14:17–23
Piper B, Lindsey A (1989) Development of an instrument to measure the subjective dimension of fatigue. In: Funk S, Tornquist E (eds) Key aspects of comfort. Springer, New York Berlin Heidelberg, pp 199–208
Piper B, Rieger L (1989) Recent advances in the management of biotherapy-related side effects: fatigue. Oncol Nurs Forum 16 [Suppl]:27–32
Polit D, Hungler P (1983) Nursing research, principles and methods. Lippincott, Philadelphia
Poteliakhoff A (1981) Adrenocortical activity and some clinical findings in acute and chronic fatigue. J Psychosom Res 25:91–95
Potempa K (1989) Chronic fatigue: direction for research and practice. In: Funk S, Tornquist E (eds) Key aspects of comfort. Springer, New York Berlin Heidelberg, pp 229–233
Rhodes V, Watson P (1988) Patients' descriptions of the influence of tiredness and weakness on self-care abilities. Cancer Nurs 11:186–194
Rhoten D (1979) Concept clarification of pathophysiological fatigue in the surgical client. Master's thesis, University of Arizona, Tucson
Rhoten D (1982) Fatigue and the post-surgical patient. In: Norris C (ed) Concept clarification in nursing. Aspen, Rockville, Md
Sontag S (1981) Krankheit als Metapher. Fischer, Frankfurt
St Pierre B, Kasper C (1992) Fatigue mechanisms in patients with cancer: effects of tumor necrosis factor and exercise on skeletal muscle. Oncol Nurs Forum 19:419–425
Theologides A (1986) Anorexins, asthenins and cachectins in cancer. Am J Med 81:296–298
Varicchio C (1985) Selecting a tool for measuring fatigue. Oncol Nurs Forum 12:122–127
World Health Organization (1979) Handbook for reporting results of cancer treatment. World Health Organization, Geneva
World Health Organization (1990) Cancer pain relief and palliative care. WHO Techn Rep Ser 804
Yasko J (1983) Guidelines for cancer: symptom management. Preston, Preston, Va
Yoshitake H (1971) Relations between the symptoms and feelings of fatigue. Ergonomics 14:175–186