Changes in children's fatigue during the course of treatment for paediatric cancer

Background: Fatigue is described as one of the most distressing symptoms of cancer therapy; yet it has received limited clinical attention. Children are suffering from a symptom that is under‐diagnosed during their treatment. Aim: The aim of this study is: (a) to assess the change in fatigue scores during cancer treatment according to children's perspectives, and (b) to describe the possible causes of fatigue from children's points of view. Sample and methods: The present study is part of an ongoing prospective study. The research group consisted of 40 (n = 40) children aged 7–12 years with cancer who are being followed up in the oncology clinic of a Greek children's hospital. After parental consent was obtained, data were collected using the Child Fatigue Scale and a sociodemographic data form. Results: The children with cancer reported a statistically significant increase in fatigue scores during their treatment (F = 6.846, P = 0.003). Gender was the only demographic factor associated with a significant increase in the fatigue scores (F = 4.857, P = 0.034). Conclusions: Cancer treatment was found significantly to increase children's fatigue levels. Medical procedures and the hospital environment seemed to be major causative factors of the fatigue experienced by children with cancer during their treatment.     

Heavy to carry: a survey of parents' and healthcare professionals' perceptions of cancer-related fatigue in children and young people

Cancer-related fatigue is a prevalent, but often under-recognized, symptom with the potential to impact the lives of both the child and the family. There is little known about the biological and the behavioral dimensions of fatigue, and not about the patterns of this symptom. The aim of this study was to investigate cancer-related fatigue from the perspective of parents of children and young people with cancer and from the perspective of healthcare professionals (HCPs) and to examine its impact on quality of life. A cross-sectional, questionnaire-based survey was undertaken with parents of patients attending 4 of the 22 United Kingdom Childhood Cancer Study Group centers; HCPs from 20 of these centers were also surveyed. Response rates were 42% for parents and caregivers (95/224) and 35% for HCPs (235/679). Results showed that fatigue was prevalent. Fifty-six percent of HCPs thought "most" or "all" patients experienced moderate fatigue; 57% of parents said that the patient experienced fatigue at least once a week. Data demonstrate that fatigue was perceived to be a significant problem by parents and HCPs. Healthcare professionals indicated that the mean percentage of patients who experience fatigue, to whom they recommended a treatment, was 29%. Rest and relaxation were recommended by the majority (59%; 138). The overall impression is that both HCPs and parents acknowledge that children and young people are likely to experience fatigue. Recognition of the significance of this symptom is a crucial first step in improving future management and offering strategies that can help both child and family.     

癌症病人癌因性疲乏影响因素的研究进展

综述国内外癌症病人癌因性疲乏影响因素的研究现状,病人性别、肿瘤位置、治疗方式、疼痛、睡眠、情绪、社会支持等因素已被证实会对癌因性疲乏产生不同程度的影响,血液学中血清细胞因子以及血红蛋白浓度会对癌因性疲乏产生影响,但目前尚无明确的病理生理学机制,且众多因素互相影响,还需进一步的探讨。     

Psychometric assessment of four fatigue scales with a sample of rural cancer patients

There are differences between rural and urban persons experiencing cancer that may make the experience of fatigue more difficult for rural cancer patients. There were no scale to measure fatigue that had been validated with rural cancer patients. The purpose of the present research was to study the psychometric properties of four fatigue scales for use with rural cancer patients. The four scales were the Multidimensional Assessment of Fatigue Scale, the Fatigue Severity Scale, the Visual Analogue Scale for Fatigue, and the Rhoten Fatigue Scale. The four scales were mailed to 270 rural cancer patients, with 131 usable scales returned (48% return rate). Interitem correlations, Cronbach's alpha reliability, and factor analyses were performed on the four scales. Based on these analyses, the Multidimensional Assessment of Fatigue Scale, the Fatigue Severity Scale, and the Visual Analogue Scale for Fatigue were judged to be adequate for use with rural cancer patients.     

Psychometric properties of the brief fatigue inventory in Greek patients with advanced cancer

To validate the Greek version of the Brief Fatigue Inventory (BFI-Gr) in a sample of cancer patients, the scale was translated with the "forward-backward" procedure to Greek. It was administered twice, at a three-day interval, to 102 eligible patients with cancer. Together with the BFI-Gr scale, the patients also completed the European Organization for Research and Treatment of Cancer QLQ-C30 (version 3.0) subscales of fatigue and emotional functioning, and the M. D. Anderson Symptom Inventory. The BFI-Gr had an overall Cronbach alpha for the nine items of 0.954. The assessment of the relationships between the BFI-Gr and the other measurements showed statistically significant correlations between all the assessed measurements (r values between 0.47 and 0.76, P<0.0005), except with the emotional subscale of the European Organization for Research and Treatment of Cancer scale. Factor analysis yielded a one-factor solution, explaining 73.6% of the variance. Interitem correlations were high and ranged from 0.567 to 0.882 (P<0.0005). The test-retest reliability of scale showed that the coefficient agreement was 0.901 (P<0.0005). Univariate analysis revealed significant correlations between hemoglobin and fatigue (r=-0.21, P=0.037), and between performance status (P<0.0005) and opioids (P=0.009). These results support that the BFI-Gr is an instrument with satisfactory psychometric properties, and is a valid research tool for cancer-related fatigue in Greek cancer patients.     

肺癌术后化疗病人癌因性疲乏相关因素调查分析

[目的]探讨肺癌术后化疗病人癌因性疲乏的影响因素。[方法]采用Piper疲乏修订量表对100例肺癌术后化疗病人进行调查。[结果]癌因性疲乏在肺癌术后化疗病人中普遍存在,其中86％是中重度疲乏;化疗副反应、化疗方案、疼痛、经济状况等是癌因性疲乏的主要影响因素。[结论]肺癌术后化疗病人癌因性疲乏的发生率较高,应采取相应的干预措施,降低病人癌因性疲乏的程度。     

乳腺癌放疗病人癌因性疲乏与社会支持及心理弹性的相关性研究

目的:探讨乳腺癌放疗病人癌因性疲乏与社会支持及心理弹性的关系。方法:采用方便抽样法选取2018年10月—2019年10月92例乳腺癌放疗病人,在病人放疗期间应用癌因性疲乏量表、社会支持量表、心理弹性量表对其进行调查,乳腺癌放疗病人癌因性疲乏与心理弹性、社会支持三者的关系应用Pearson相关分析,应用多元回归分析影响乳腺癌放疗病人癌因性疲乏的独立因素。结果:乳腺癌放疗病人癌因性疲乏总分为(26.25±4.78)分、社会支持总分为(45.23±3.98)分、心理弹性总分为(60.12±5.11)分。Pearson相关分析显示,乳腺癌放疗病人癌因性疲乏总分、情感疲乏及认知疲乏评分与社会支持总分、社会支持利用度评分和心理弹性总分及其各维度评分呈负相关(P<0.05)。多元回归分析显示,病人文化程度、临床分期、放疗效果、社会支持及心理弹性是乳腺癌放疗病人癌因性疲乏发生的独立影响因素(P<0.05)。结论:影响乳腺癌放疗病人癌因性疲乏的因素较多,护理人员可通过加强病人放疗期间心理疏导,强化病人外部社会支持,从而减轻病人放疗期间癌因性疲乏,促进病人身心健康。     

甘肃地区肺癌患者癌因性疲乏影响因素调查

目的 探索癌因性疲乏（cancer related fatigue,CRF）发生的影响因素。方法 采用问卷调查的方法,依照国际疾病分类标准第10版癌因性疲乏的定义,对符合纳入/排除标准的肺癌患者进行分组,分析社会人口学特征、临床指标及心理因素对CRF的影响。分析癌因性疲乏的独立影响因素。结果 最终纳入肺癌患者242例,疲乏组162人,非疲乏组80人。单因素分析显示,性别、年龄、血红蛋白水平、白细胞计数、家庭月收入、焦虑情绪、抑郁情绪均与癌因性疲乏有关。经多元Logistic回归分析后,年龄、性别、家庭月收入、白细胞计数、血红蛋白水平、焦虑情绪为癌因性疲乏的独立影响因素。结论 年龄、性别、焦虑情绪是癌因性疲乏的危险因素,家庭月收入、血红蛋白水平、白细胞计数是其保护性因素。     

简易式经皮穴位电刺激缓解肿瘤患者癌因性疲乏的效果

目的探讨经皮穴位电刺激缓解化疗患者癌因性疲乏的效果,提高肿瘤患者的生活质量。方法将60例消化道肿瘤化疗患者,随机分为观察组（n=30）和对照组（n=30）。对照组选用常规治疗和护理,观察组在此基础上采用经皮穴位电刺激治疗。比较两组患者治疗前后Piper疲乏量表评分变化。结果两组患者干预前Piper疲乏量表各维度及总分比较差异均无统计学意义（P〉0．05）;观察组躯体疲乏维度干预前得分为（6．85±0．21）分,干预后为（6．76±0．13）分,差异有统计学意义（t=2．171,P〈0．05）;行为疲乏维度得分及Piper疲乏量表总评分观察组干预后为（5．53±0．18）,（6．10±0．09）分,对照组为（5．65±0．22）,（6．17±0．11）分,两组比较差异均有统计学意义（t=2．275,2．615;P〈0．05）;两组在行为、认知、情感疲乏维度方面差异无统计学意义（P〉0．05）。结论经皮穴位电刺激对化疗患者癌因性疲乏有一定的缓解作用。     

系统护理对乳腺癌患者围手术期癌因性疲乏及生活质量的影响

目的探讨系统护理对乳腺癌患者围手术期癌因性疲乏及生活质量的影响。方法选取2010年11月至2011年12月197例乳腺癌患者为研究对象,随机分为实验组99例和对照组98例。实验组给予系统护理方法;对照组给予传统护理方法。对比2种护理方法对乳腺癌患者围手术期癌因性疲乏及生活质量的影响。结果实验组护理后的QOL生活质量评分结果为（92．1±1．6）分,明显高于自身护理前及同期对照组水平。对比2组患者癌因性疲乏程度,护理后实验组的癌因性疲乏程度均较自身护理前及同期对照组有显著的改善。结论应用系统的护理方法能够显著降低癌症患者围手术期癌因性疲乏的程度,同时能够显著提高乳腺癌患者的生活质量,可以在临床上推广。     

Sexual dysfunction related to the treatment of young women with breast cancer

Women have a 13.4% chance of developing breast cancer over their lifetime, and an estimated 60,000 women aged 20-50 will develop breast cancer in 2005. Surgical, radiologic, and chemotherapeutic treatments used to treat breast cancer can alter women's body image and menopausal status, ultimately affecting sexual health. A diagnosis of breast cancer is more traumatic for young women because of psychosocial concerns, side effects of treatment, and a potentially shortened life expectancy. Alterations in sexual health interfere with intimate relationships. Nurses can play a pivotal role in improving the sexual health of young women with breast cancer. This article explores the potential side effects of treatment that can affect sexual health, the unique needs of young women, and nursing interventions that systematically address sexual health concerns.     

Evaluating depression in a sample of children and adolescents with cancer in Greece

Background:  Several studies have found that serious illness increases the risk of depression. One of the most common psychiatric disorders related to the diagnosis and treatment of cancer is depression.
Aim:  The aim of the present study was to investigate the rate of depression in children with cancer compared with that in healthy children.
Patients and methods:  The present study is an ongoing prospective study. The research group consisted of 80 children with cancer followed up by an oncology inpatient clinic of a Greek Children's hospital. The control group consisted of 84 healthy children. After parental consent was obtained, data were collected using the Children's Depression Inventory (CDI) and a socio-demographic data form.
Results:  At the time that this study was carried out, neither the research group nor the control group suffered from depression. In particular, there was no statistically significant difference between the two groups with respect to symptoms of depression (  = 5.88 for children with cancer vs.  = 7.23 for healthy children, U  = 3013, P  = 0.25).
Conclusions:  Our findings suggest that the children in this study with malignancies did not have higher depression scores than their healthy peers, although many previous surveys confirm that children with cancer are at high risk for depression.     

姑息性护理在肺癌病人癌因性疲乏的应用进展

介绍姑息性护理和癌因性疲乏的概念,阐述肺癌病人癌因性疲乏的状况,分析癌因性疲乏对肺癌病人的影响,以及姑息性护理在肺癌病人癌因性疲乏中的应用,为国内学者更好地认识和评价姑息性护理及肺癌病人的癌因性疲乏,为不断提高肺癌病人的生活质量作为参考。     

An exercise trial to reduce cancer related fatigue in African American breast cancer patients undergoing radiation therapy: Design,rationale, and methods

BackgroundCancer related fatigue (CRF) is a common and debilitating side-effect of radiotherapy in breast cancer patients. Physical activity interventions can attenuate CRF but evidence in African–American women with breast cancer is lacking.Methods/designThe “Pedlar” Study is a prospective, 8-week structured moderate-intensity exercise intervention, delivered concurrently with radiotherapy, to reduce CRF and improve health-related quality of life among African American breast cancer patients. Forty African American women with breast cancer scheduled to receive radiation therapy at MedStar Washington Hospital Center will be randomized to one of the two trial arms: 1) a facility-based aerobic exercise utilizing a portable stationary pedal exerciser; and 2) a control group. Intervention arm participants will exercise at the hospital either before or after their radiation treatment. Assessments will be conducted at baseline, 4, and 8 weeks. The outcome variables are CRF, biomarkers of inflammation, and health-related quality of life.DiscussionThe Pedlar Study will provide preliminary evidence on whether a short-term moderate-intensity exercise intervention might be effective in reducing CRF in African American women undergoing radiotherapy for breast cancer, and whether this effect is mediated by inflammation.     

Three instruments to assess fatigue in children with cancer: the child,parent and staff perspectives

The purpose of this study was to develop and test three instruments to measure fatigue in children with cancer from the perspectives of the child, parents and staff. The study consisted of three phases: instrument development, content validation, and estimations of psychometric properties of the three fatigue instruments. One hundred forty-nine children between the ages of 7-12 years presently receiving chemotherapy for cancer, 147 parents and 124 staff participated in this study. The instruments demonstrated strong initial validity and reliability estimates. This study is the first to provide valid and reliable instruments to measure fatigue in children with cancer.     

Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients

We herein describe the development and validation of the Cancer Fatigue Scale (CFS) for assessment of fatigue in cancer patients. We designed this scale specifically to reflect the nature of fatigue experienced by cancer patients, by using factor analysis; the CFS is a 15-item scale composed of 3 subscales (physical, affective, and cognitive subscales). Three hundred seven cancer patients participated in the validation phase. Construct validity, confirmed by repeating factor analysis, was good. Convergent validity, confirmed by a correlation between CFS and a visual analogue scale for fatigue, was also shown to be good (r = 0.67, P < 0.001). The CFS had good stability (average test-retest reliability r = 0.69, P < 0.001) and good internal consistency (Cronbach's alpha coefficient for all 15 items = 0.88). The present study indicates that the CFS is a brief, valid, and feasible measure of fatigue for use with cancer patients.