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Abstract：
BACKGROUND: Symptoms of cancer-related fatigue (CRF) can have a significant impact on patients\' quality of life and treatment adherence. We aimed to investigate the relationship between CRF and multiple psychosocial and somatic indicators within a large mixed cancer sample.
METHODS: In this cross-sectional study, N = 1787 outpatients with cancer were assessed for CRF, pain, anxiety, and depression using validated screening instruments. We further obtained clinical parameters (Hb, CRP, creatinine, leukocytes, ASAT, and ALAT), sociodemographic data (age, gender, income, education level, marital status, parenthood, and living area), and lifestyle factors. Multivariate linear regression models were applied to estimate the impact of each indicator on CRF.
RESULTS: Overall, 90.6% of patients experienced some CRF, with 14.8% experiencing severe CRF. No gender difference was found in the prevalence of CRF. Patients with higher levels of pain, depressive symptoms, and lower Hb levels had significantly higher levels of CRF (ps <0.001). Lower levels of CRF were observed in patients who had children (p = 0.03), had less education (p < 0.001), and were physically active for more than 2 h per week before their oncological diagnosis (p = 0.014). The latter was only a significant indicator in the male subsample.
CONCLUSIONS: The present results demonstrate a high prevalence of CRF and highlight that not only somatic and psychosocial factors, but also lifestyle factors prior to diagnosis appear to be associated with the etiology and persistence of CRF. To effectively treat CRF, a biopsychosocial, personalized approach is recommended.
METHODS: In this cross-sectional study, N = 1787 outpatients with cancer were assessed for CRF, pain, anxiety, and depression using validated screening instruments. We further obtained clinical parameters (Hb, CRP, creatinine, leukocytes, ASAT, and ALAT), sociodemographic data (age, gender, income, education level, marital status, parenthood, and living area), and lifestyle factors. Multivariate linear regression models were applied to estimate the impact of each indicator on CRF.
RESULTS: Overall, 90.6% of patients experienced some CRF, with 14.8% experiencing severe CRF. No gender difference was found in the prevalence of CRF. Patients with higher levels of pain, depressive symptoms, and lower Hb levels had significantly higher levels of CRF (ps <0.001). Lower levels of CRF were observed in patients who had children (p = 0.03), had less education (p < 0.001), and were physically active for more than 2 h per week before their oncological diagnosis (p = 0.014). The latter was only a significant indicator in the male subsample.
CONCLUSIONS: The present results demonstrate a high prevalence of CRF and highlight that not only somatic and psychosocial factors, but also lifestyle factors prior to diagnosis appear to be associated with the etiology and persistence of CRF. To effectively treat CRF, a biopsychosocial, personalized approach is recommended.
摘要：
背景：癌症相关性疲劳（CRF）的症状会对患者的生活质量和治疗依从性产生重大影响。我们的目的是调查一个大型混合癌症样本中CRF与多个心理社会和躯体指标之间的关系。
方法：在这项横断面研究中，N=1787例癌症门诊患者进行CRF评估，疼痛,焦虑,和抑郁症使用经过验证的筛查工具。我们进一步获得了临床参数(Hb，CRP,肌酐,白细胞,ASAT,和ALAT），社会人口统计数据(年龄，性别,收入,教育水平,婚姻状况,为人父母,和居住面积)，和生活方式因素。采用多元线性回归模型估计各指标对CRF的影响。
结果：总体而言，90.6%的患者经历了一些CRF，14.8%经历严重CRF。CRF的患病率无性别差异。疼痛程度较高的患者，抑郁症状,和较低的Hb水平具有显著较高的CRF水平(ps<0.001)。在有孩子的患者中观察到CRF水平较低（p=0.03），受教育程度较低(p<0.001)，并且在他们的肿瘤诊断之前每周运动超过2小时（p=0.014）。后者仅是男性子样本中的重要指标。
结论：目前的结果表明CRF的患病率很高，并强调不仅躯体和社会心理因素，而且诊断前的生活方式因素似乎也与CRF的病因和持续性相关。为了有效治疗CRF，生物心理社会，建议采用个性化方法。
方法：在这项横断面研究中，N=1787例癌症门诊患者进行CRF评估，疼痛,焦虑,和抑郁症使用经过验证的筛查工具。我们进一步获得了临床参数(Hb，CRP,肌酐,白细胞,ASAT,和ALAT），社会人口统计数据(年龄，性别,收入,教育水平,婚姻状况,为人父母,和居住面积)，和生活方式因素。采用多元线性回归模型估计各指标对CRF的影响。
结果：总体而言，90.6%的患者经历了一些CRF，14.8%经历严重CRF。CRF的患病率无性别差异。疼痛程度较高的患者，抑郁症状,和较低的Hb水平具有显著较高的CRF水平(ps<0.001)。在有孩子的患者中观察到CRF水平较低（p=0.03），受教育程度较低(p<0.001)，并且在他们的肿瘤诊断之前每周运动超过2小时（p=0.014）。后者仅是男性子样本中的重要指标。
结论：目前的结果表明CRF的患病率很高，并强调不仅躯体和社会心理因素，而且诊断前的生活方式因素似乎也与CRF的病因和持续性相关。为了有效治疗CRF，生物心理社会，建议采用个性化方法。
