Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition.
Patient, caregiver, and oncologist perceptions of cancer-related fatigue: results of a tripart assessment survey. The Fatigue Coalition.
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发表时间：
1997-07
影响因子：
3.6
通讯作者：
N. Vogelzang;W. Breitbart;D. Cella;G. Curt;J. Groopman;S. Horning;L. Itri;D. H. Johnson;S. L. Scherr;R. Portenoy
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文献类型：
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作者：
N. Vogelzang;W. Breitbart;D. Cella;G. Curt;J. Groopman;S. Horning;L. Itri;D. H. Johnson;S. L. Scherr;R. Portenoy
尽管疲劳是癌症患者最常见的症状，并且对生活质量产生严重的不利影响，但人们对它仍然知之甚少。一项调查旨在从患者、主要护理人员和肿瘤学家的角度描述癌症相关疲劳的流行病学特征。一项电话调查包括从全国随机抽取的 10 万个家庭中招募的 419 名癌症患者。患者可以接触到 200 名主要护理人员（通常是家庭成员），他们也接受了电话采访。在另一项邮件调查中，600 名随机抽样的肿瘤科医生（与患者无关）中有 197 名回答了一份调查问卷，该调查问卷评估了接受化疗或放疗的癌症患者及其护理人员对疲劳的看法和态度。患者中位年龄为 65 岁，主要癌症诊断为乳腺癌（女性）和泌尿生殖系统癌症（男性）。 59% 的患者接受过化疗，63% 的患者接受过放射治疗，24% 的患者同时接受过两种治疗； 20% 的患者在 6 周内接受了最后一次治疗，31% 在 7 周至 1 年内接受了最后一次治疗，49% 的患者在 1 年前接受了最后一次治疗。超过四分之三的患者 (78%) 在疾病和治疗过程中经历过疲劳（定义为普遍的虚弱疲倦或精力丧失的感觉）。 32% 的人每天都会感到疲劳，32% 的人表示疲劳严重影响了他们的日常生活。护理人员报告观察到 86% 的指数患者出现疲劳，肿瘤科医生认为 76% 的患者出现疲劳。尽管肿瘤学家认为疼痛对患者的不利影响比疲劳更大（61% 对 37%），但患者认为疲劳对他们日常生活的不利影响比疼痛更大（61% 对 19%）。大多数肿瘤学家 (80%) 认为疲劳被忽视或治疗不足，大多数患者 (74%) 认为疲劳是一种必须忍受的症状。 50% 的患者没有与肿瘤科医生讨论治疗方案，只有 27% 的患者报告说，他们的肿瘤科医生建议采取任何治疗疲劳的方法。使用时，患者和护理人员普遍认为疲劳治疗是成功的。这些数据证实了癌症相关疲劳的高患病率和不利影响，尽管很少讨论和治疗。对于患者和肿瘤科医生来说，提高癌症患者的生活质量需要提高对疲劳的认识，更好地了解其影响，并改善沟通和熟悉可以减少疲劳影响的干预措施。
Although fatigue is the most common symptom reported by cancer patients and has serious adverse effects on quality of life, it remains poorly understood. A survey was designed to characterize the epidemiology of cancer-related fatigue from the perspectives of the patient, primary caregiver, and oncologist. A telephone survey included 419 cancer patients recruited from 100,000 randomly selected households nationwide. Patients provided access to 200 primary caregivers (usually family members) who were also interviewed by telephone. In a separate mail survey, 197 of 600 randomly sampled oncologists (unrelated to the patients) responded to a questionnaire that assessed perceptions and attitudes concerning fatigue in cancer patients who had received chemotherapy or radiotherapy and their caregivers. The median patient age was 65 years, and the principal cancer diagnoses were breast (females) and genitourinary (males). Fifty-nine percent of the patients had received chemotherapy, 63% radiation therapy, and 24% both; 20% of patients received their last treatment within 6 weeks, 31% within 7 weeks to 1 year, and 49% more than 1 year ago. More than three quarters of patients (78%) experienced fatigue (defined as a general feeling of debilitating tiredness or loss of energy) during the course of their disease and treatment. Thirty-two percent experienced fatigue daily, and 32% reported fatigue significantly affected their daily routines. Caregivers reported observing fatigue in 86% of the index patients, and oncologists perceived that 76% of their patients experienced fatigue. Although oncologists believed that pain adversely affected their patients to a greater degree than fatigue (61% v 37%), patients felt that fatigue adversely affected their daily lives more than pain (61% v 19%). Most oncologists (80%) believed fatigue is overlooked or undertreated, and most patients (74%) considered fatigue a symptom to be endured. Fifty percent of patients did not discuss treatment options with their oncologists, and only 27% reported that their oncologists recommended any treatment for fatigue. When used, treatments for fatigue were generally perceived by patients and caregivers to be successful. These data confirm the high prevalence and adverse impact of cancer-related fatigue, although it is seldom discussed and infrequently treated. For patients and oncologists, improving the quality of life of cancer patients requires a heightened awareness of fatigue, a better understanding of its impact, and improve communication and familiarity with interventions that can reduce its debilitating effects.