| Objective Understanding the reasons and influence factors of cancer-related fatiguesymptom and exploring the intervention of self-management on cancer-related fatiguein perioperative digestive system cancer patients.Methods Firstly, a qualitative research method was used to interview the15digestivesystem cancer patients about cancer-related fatigue and then refined the themes.Secondly, a cross-sectional survey was carried,170digestive system cancer patientswere recruited continuously by convenient method in the fifth surgery departments ofthe First Affiliated Hospital of Anhui Medical University and the Second AffiliatedHospital of Anhui Medical University. Demographic variables collect questionnaire,CFS, MSAS, FACT-G and numberic rating scale were recorded the day of admission.The survey was to exploe the main influenced factors about cancer-related fatigue andits telationship with quality of life and disease related symptoms. Thirdly,62digestivesystem cancer patients who met the inclusion criteria were recruited to the experimentalstudy,and were completely random divided into two group.The control group was31cases, and the intervention group was31cases.The control group received the routineclinical care, and the intervention group received self-management based on the routineclinical care. The two groups were both investigated by CFS and MSAS in the seventhday after surgery,and by the CFS,MSAS and FACT-G the day before the discharged toassess the cancer-related fatigue level, the quality of life and the symptoms level before and after intervention in the two groups.The qualitative research datas were analyzed byColaizzi and Triangulation method and then refined the themes. The quantitative dataswere analysed with descriptive statistics, normal distribution variables correlationanalysis were used pearson correlation, non-normal distribution variables correlationanalysis were used sperman correlation.Stepwise regression analysis were used toanalyse the influenced factors about cancer-related fatigue.The repeated measurement ofvariance analysis was used to compare the cancer-related fatigue level and diseaserelated symptoms level before and after intervention. The compare of the quality of lifebetween the two group after intervention was used two independent t test,and beforeand after intervention was used paired design t test.Results Four themes were found, including the cancer-related fatigue symptom wascommon; patients often had other symptoms when they had cancer-related fatiguesymptom; cancer-related fatigue symptom had a great influence on patients′dailyactivities and work;patients hoped to pay attention to fatigue management during thecourse of treatment.The incidence of fatigue was high in the cross-sectional survey,withthe incidence of cancer-related fatigue was77percents.The lever of fatigue was light tomedium, accounting for64%of all patients,and the average score of CFS was15.16±7.05.The critical value of the cancer fatigue scale was18.0. The number of thesymptoms and the incidence in the digestive system cancer patients were both high,andthe average number of symptoms was7.5. The score of the quality of life was66.84±14.286, with a medium lever. The total and dimensions of CFS and FACT-G hadnegative correlation, and had positive correlation with MSAS. The total and dimensionsof FACT-G had negative correlation with MSAS. Logistic regression analysis showedthat age, anemia, combined diseases, worry, energy lack, difficulty concentration andweight lose were influenced factors of cancer-related fatigue. In the experimental study,there was no significant difference (P>0.05) between the two groups on general population, disease characteristics, the level of cancer-related fatigue and disease relatedsymptoms, and quality of life before the intervention. Before and after the intervention,cancer-related fatigue and disease related symptoms showed downward trend in boththe intervention group and the control group. The time effect, group effect andinteraction effect all had statistical significance in cancer-related fatigue and diseaserelated symptoms,with the scores in the intervention group were significantly lowerthan those in the control group(P<0.01). After the intervention, the total and alldimensions of the quality of life in the intervention group were all higher than those inthe control group, the difference were statistically significant (P>0.05).Before and afterintervention, the scores of the quality of life in the control group patients had nostatistically significant except the body dimension, but the intervention group had allstatistically significant in the total and all the dimensions (P<0.01).Conclusion Cancer-related fatigue was a subjective, multi-dimensional symptom, andit often accompanied with other symptoms. The incidences of cancer-related fatigue anddisease related symptoms were all high in digestive system cancer patients.The total anddimensions of CFS and FACT-G had negative crrelation, and had positive crrelationwith MSAS. The total and dimensions of FACT-G had negative crrelation withMSAS.Age, anemia, combined diseases,worry, enengy lack,difficulty concentration andweight lose were influenced factors of cancer-related fatigue.The self-managementmode had alleviated the cancer-related fatigue and disease related symptoms in theperioperative digestive system cancer patients, and improved patients’ quality of life bythe management. |
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