Cancer-related fatigue, depressive symptoms, and functional status
Cancer-related fatigue, depressive symptoms, and functional status
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DOI：
10.1097/00006199-200609000-00009
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发表时间：
2006-09-01
期刊：
影响因子：
2.5
通讯作者：
Beck, Susan L.
中科院分区：
文献类型：
--
作者：
Barsevick, Andrea M.;Dudley, William N.;Beck, Susan L.
背景癌症患者在努力维持正常角色和日常活动的同时，还要应对一系列令人困惑的疾病和治疗相关症状。研究需要整理和识别的症状集群作为一个合理的方法，以症状management.Objective的基础上：本研究的目的是测试，通过二次分析，中介假说之间的直接和间接关系疲劳和抑郁症状通过一个途径，涉及功能状态。对第二次化疗后或放疗最后一周收集的疲劳管理随机临床干预试验的实验组和对照组数据进行分析。调解途径疲劳抑郁症状通过功能状态分别进行了测试组接受节能干预或控制干预，等同于时间和attention.Results：对于对照组，结果表明支持部分调解。疲劳和抑郁症状之间的关系以前显着减少后，功能状态得到控制，占总介导效应的43%。调解假设不支持节能组，表明干预可能改变了功能状态的作用，在调解疲劳对抑郁症状的影响。讨论：在对照组，当日常活动变得更加困难，因为疲劳，个人有更多的抑郁症状。结果表明，功能状态是疲劳症状管理中需要考虑的重要因素。适当的疲劳干预有两个目标：疲劳和策略，以减少可能导致抑郁症状加重的功能受损的可能性。
Background. Patients with cancer grapple with a confusing array of disease- and treatment-related symptoms while trying to maintain functioning in usual roles and daily activities. Research is needed to sort out and identify symptom clusters as a basis for a rational approach to symptom management.Objective: The aim of this study was to test, through secondary analysis, a mediation hypothesis about the direct and indirect relationships between fatigue and depressive symptoms through a pathway involving functional status.Methods: Data from the experimental and control groups of a randomized clinical intervention trial for fatigue management, collected after the second chemotherapy treatment or during the last week of radiotherapy, were analyzed. The mediation pathway from fatigue to depressive symptoms through functional status was tested separately for groups receiving either an energy conservation intervention or a control intervention, equating for time and attention.Results: For the control group, the results indicate support for partial mediation. The previously significant relationship between fatigue and depressive symptoms was reduced after functional status was controlled, accounting for 43% of the total mediated effect. The mediation hypothesis was not supported in the energy conservation group, indicating that the intervention may have changed the role of functional status in mediating the effect of fatigue on depressive symptoms.Discussion: In the control group, when routine activities became more difficult because of fatigue, individuals had more depressive symptoms. The results suggest that functional status is an important factor to consider in symptom management for fatigue. An appropriate intervention for fatigue would have two targets: the fatigue and strategies to reduce the likelihood of impaired functioning that could result in elevated depressive symptoms.