Prevalence and associated factors of cancer-related fatigue among cancer patients in University Malaya Medical Centre / Tan, Hooi Ling

Tan, Hooi Ling (2021) Prevalence and associated factors of cancer-related fatigue among cancer patients in University Malaya Medical Centre / Tan, Hooi Ling. Masters thesis, Universiti Malaya.

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Abstract

Cancer-related fatigue is a distressing symptom commonly experienced by our patients diagnosed with cancer. However, there is no data on cancer-related fatigue among our local population. The objective of this study was to evaluate the prevalence of cancer-related fatigue and its association with sociodemographic factors, clinical characteristics of patients, depression, anxiety and demoralisation. Correlation between cancer-related fatigue, depression, anxiety and demoralization were also studied. Method: A cross-sectional study was conducted using convenience sampling among one hundred and fifty patients from Oncology Clinic, University Malaya Medical Centre, Kuala Lumpur from July 2020 until December 2020. Data were collected from self- administered questionnaire consisted of sociodemographic data, clinical characteristic of patients, Fatigue Symptom Inventory (FSI), Hospital Anxiety and Depression Scale (HADS) and Demoralisation Scale. The study participants were also interviewed to assess fatigue using Proposed ICD-10 criteria for Cancer-related Fatigue (interview was conducted based on Diagnostic Interview Guide for Cancer-related Fatigue). Chi-square test, Spearman’s correlation and logistic regression were used to study the relationship between cancer-related fatigue and its associated factors. Result: The mean age of the study participants was 63.3 ± 10.29 years old. Majority of the subjects were female (n=102, 68.0%), of Chinese ethnicity (n=74, 49.3%) and married (n=135, 90.0%). Most of our patients were diagnosed with solid tumours (n=149, 99.3%), with breast cancer being the commonest (n=50, 33.3%). Most of the subjects were at Stage IV (n=68, 45.3%), having had the diagnosis of malignancy between one to five years (n=105, 70.0%). Out of 150 study participants, 58.7% of them were diagnosed to have cancer-related fatigue. Among patients with cancer-related fatigue, 97.7% of them were reported to have clinically meaningful fatigue (p<0.001), 17.0% reported anxiety symptoms (p=0.009), 34.1% had depressive symptoms (p<0.001) and 28.4% had high demoralisation level (p=0.001). All assessment scales were significantly correlated to each other (p<0.001). ICD-10 scoring was positively correlated with Total Disruption Index of FSI (r=0.761, p<0.001) and FSI composite (r= 0.751, p<0.001). Cancer-related fatigue also correlated positively with anxiety (r= 0.454, p<0.001), depression (r= 0.544, p<0.001) and demoralisation (r= 0.461, p<0.001). Stages of cancer was the significant contributing factor to cancer-related fatigue (p=0.021). No significant association was found between fatigue and sociodemographic data, other clinical characteristics of patients. In addition, stages of cancer, anxiety, depression and demoralization independently predict the presence of cancer-related fatigue in our study population. Conclusion: 58.7% of our cancer patients have reported cancer-related fatigue. Stages of cancer was identified to be a significant contributing factor. Cancer-related fatigue was positively associated with depression, anxiety and demoralisation. Routine assessment should be done to screen for fatigue and related psychological factors in our clinical practice.

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