The prevalence and moderators of fatigue in people who have been successfully treated for cancer
Received 10 May 2004; accepted 29 March 2005.
Abstract
Objective
The aims of this study were to estimate the prevalence of severe fatigue in disease-free breast cancer patients according to draft International Classification of Disease, Tenth Edition (ICD-10) criteria for cancer-related fatigue (CRF) and to obtain further information on the validity of these criteria. Furthermore, hypotheses derived from psychosocial theories of fatigue regarding the association of fatigue with activity level, psychological distress, and cognitive constructs were also tested.
Methods
Sixty-nine disease-free breast cancer patients were assessed at least 6 months posttreatment, using self-report questionnaires and a structured interview.
Results
Nineteen percent of the sample met criteria for CRF. This subgroup differed significantly from the rest of the sample on multiple measures of fatigue and interference. Self-reported activity level bore no relationship to fatigue. Fear of recurrence (FOR) contributed to fatigue indirectly, whilst psychological distress and beliefs about activity appeared to predict fatigue directly.
Conclusion
The validity of the draft ICD-10 criteria for CRF was supported. Further research is required into the relationship between fatigue, emotional distress, and cognitive–behavioural factors.
aSection of Psychological Medicine, University of Glasgow, Glasgow Royal Infirmary, United Kingdom
bClinical Psychology Department, Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, United Kingdom
cMacmillan Consultant in Psychosocial Oncology, Consulting and Clinical Psychology Services, NHS Ayrshire and Arran, Ayrshire Central Hospital, United Kingdom