Fatigue of oncological patients – incompatible perspectives of patients and medical staff
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Medical University of Gdansk, Gdansk, Poland
Submission date: 2023-09-18
Final revision date: 2024-04-20
Acceptance date: 2024-04-21
Online publication date: 2024-06-10
Corresponding author
Agata E. Zdun-Ryżewska   

Medical University of Gdansk, Gdansk, Poland
Cancer-related fatigue is a complex syndrome and the most frequently reported complaint, especially during treatment. Sometimes a large discrepancy in patient fatigue estimations between the patients themselves and medical staff is observed. The main goal of this study was to compare fatigue from the patients’ and the medical staff’s perspectives.

Participants and procedure:
The methods used included author-designed surveys for both the patient (questions about fatigue, intensity, causes and influence on life constructed mostly in the form of numerical rating scales) and the medical staff (the same questions on the perception of the patient’s fatigue), the Chalder Fatigue Questionnaire, and the EORTC QLQ-C30. The study involved 51 cancer patients during chemotherapy treatment.

For 63% of the subjects, there was convergence of fatigue assessments made by patients and staff. Differences were visible in the staff’s and patients’ assessment of the intensity of fatigue experienced by the patients. The simple question “Are you fatigued (yes or no)?” corresponded to all questionnaires and scales in the case of patients. The equivalent question to the staff, “Is the patient fatigued (yes or no)?”, corresponded only to the patients’ current assessment of fatigue and with no other score on the questionnaire or scale that the patients filled out about their fatigue. Also, patients identified more causes of fatigue and staff overestimated the influence of chemotherapy on fatigue. Of the patient subjects, 51.4% did not know of any ways to cope with fatigue, and most of them talked about it only to family and friends.

Despite existing recommendations on the need to screen and educate patients in this matter, the issue of fatigue still re-quires attention.

Al Maqbali, M., Al Sinani, M., Al Naamani, Z., Al Badi, K., & Tanash, M. I. (2021). Prevalence of fatigue in patients with cancer: a systematic review and meta-analysis. Journal of Pain and Symptom Management, 61, 167–189.e14. https://doi.org/10.1016/j.jpai....
Berger, A. M., Mooney, K., Alvarez-Perez, A., Breitbart, W. S., Carpenter, K. M., Cella, D., Cleeland, C., Dotan, E., Eisenberger, M. A., Escalante, C. P., Jacobsen, P. B., Jankowski, C., LeBlanc, T., Ligibel, J. A., Loggers, E. T., Mandrell, B., Murphy, B. A., Palesh, O., Pirl, W. F., Plaxe, S. C., … National Comprehensive Cancer Network (2015). Cancer-related fatigue, version 2.2015. Journal of the National Comprehensive Cancer Network, 13, 1012–1039. https://doi.org/10.6004/jnccn.....
Cella, M., & Chalder, T. (2010). Measuring fatigue in clinical and community settings. Journal of Psychosomatic Research, 69, 17–22. https://doi.org/10.1016/j.jpsy....
Cella, D., Davis, K., Breitbart, W., Curt, G., & Fatigue Coalition (2001). Cancer-related fatigue: Prevalence of pro-posed diagnostic criteria in a United States sample of cancer survivors. Journal of Clinical Oncology, 19, 3385–3391. https://doi.org/10.1200/JCO.20....
Chalder, T., Berelowitz, G., Pawlikowska, T., Watts, L., Wessely, S., Wright, D., & Wallace, E. P. (1993). Develop-ment of a fatigue scale. Journal of Psychosomatic Research, 37, 147–153. https://doi.org/10.1016/0022-3....
Donovan, K. A., McGinty, H. L., & Jacobsen, P. B. (2013). A systematic review of research using the diagnostic criteria for cancer-related fatigue. Psychooncology, 22, 737–744. https://doi.org/10.1002/pon.30....
Fabi, A., Bhargava, R., Fatigoni, S., Guglielmo, M., Horneber, M., Roila, F., Weis, J., Jordan, K., Ripamonti, C. I., & ESMO Guidelines Committee (2020). Cancer-related fatigue: ESMO clinical practice guidelines for diagnosis and treatment. Annals of Oncology, 31, 713–723. https://doi.org/10.1016/j.anno....
Fisher, M. I., Cohn, J. C., Harrington, S. E., Lee, J. Q., & Malone, D. (2022). Screening and assessment of cancer-related fatigue: a clinical practice guideline for health care providers. Physical Therapy, 102, pzac120. https://doi.org/10.1093/ptj/pz....
Flechtner, H., & Bottomley, A. (2003). Fatigue and quality of life: Lessons from the real world. The Oncologist, 8, 5–9. https://doi.org/10.1634/theonc....
Gupta, D., Lis, C. G., & Grutsch, J. F. (2007). The relationship between cancer-related fatigue and patient satisfac-tion with quality of life in cancer. Journal of Pain and Symptom Management, 34, 40–47. https://doi.org/10.1016/j.jpai....
Harrington, S. E., Fisher, M. I., Lee, J. Q., Cohn, J., & Malone, D. (2023). Knowledge regarding cancer-related fa-tigue: a survey of physical therapists and individuals diagnosed with cancer. Physiotherapy: Theory and Prac-tice, 39, 1964–1973. https://doi.org/10.1080/095939....
Hockenberry, M. J., Hinds, P. S., Barrera, P., Bryant, R., Adams-McNeill, J., Hooke, C., Rasco-Baggott, C., Patter-son-Kelly, K., Gattuso, J. S., & Manteuffel, B. (2003). Three instruments to assess fatigue in children with can-cer: The child, parent and staff perspectives. Journal of Pain and Symptom Management, 25, 319–328. https://doi.org/10.1016/s0885-....
Iop, A., Manfredi, A. M., & Bonura, S. (2004). Fatigue in cancer patients receiving chemotherapy: an analysis of published studies. Annals of Oncology, 15, 712–720. https://doi.org/10.1093/annonc....
Newell, S., Sanson-Fisher, R. W., Girgis, A., & Bonaventura, A. (1998). How well do medical oncologists’ percep-tions reflect their patients’ reported physical and psychosocial problems? Data from a survey of five oncolo-gists. Cancer, 83, 1640–1651.
Nolte, S., Liegl, G., Petersen, M. A., Aaronson, N. K., Costantini, A., Fayers, P. M., Groenvold, M., Holzner, B., Johnson, C. D., Kemmler, G., Tomaszewski, K. A., Waldmann, A., Young, T. E., Rose, M., & EORTC Quality of Life Group (2019). General population normative data for the EORTC QLQ-C30 health-related quality of life questionnaire based on 15,386 persons across 13 European countries, Canada and the Unites States. European Journal of Cancer, 107, 153–163. https://doi.org/10.1016/j.ejca....
Oh, H. S., & Seo, W. S. (2011). Systematic review and meta-analysis of the correlates of cancer-related fatigue. Worldviews on Evidence-Based Nursing, 8, 191–201. https://doi.org/10.1111/j.1741....
Passik, S. D., Kirsh, K. L., Donaghy, K., Holtsclaw, E., Theobald, D., Cella, D., Breitbart, W., & Fatigue Coalition (2002). Patient-related barriers to fatigue communication: initial validation of the fatigue management barriers questionnaire. Journal of Pain and Symptom Management, 24, 481–493. https://doi.org/10.1016/s0885-....
Patarca-Montero, R. (2004). Handbook of cancer related fatigue. The Haworth Medical Press.
Piredda, M., De Marinis, M. G., Rocci, L., Gualandi, R., Tartaglini, D., & Ream, E. (2007). Meeting information needs on cancer-related fatigue: an exploration of views held by Italian patients and nurses. Supportive Care in Cancer, 15, 1231–1241. https://doi.org/10.1007/s00520....
Radbruch, L., Strasser, F., Elsner, F., Gonçalves, J. F., Løge, J., Kaasa, S., Nauck, F., Stone, P., & Research Steering Committee of the European Association for Palliative Care (EAPC) (2008). Fatigue in palliative care patients – an EAPC approach. Palliative Medicine, 22, 13–32. https://doi.org/10.1177/026921....
Schmidt, M. E., Bergbold, S., Hermann, S., & Steindorf, K. (2021). Knowledge, perceptions, and management of cancer-related fatigue: the patients’ perspective. Supportive Care in Cancer, 29, 2063–2071. https://doi.org/10.1007/s00520....
Shun, S. C., Lai, Y. H., & Hsiao, F. H. (2009). Patient-related barriers to fatigue communication in cancer patients receiving active treatment. The Oncologist, 14, 936–943. https://doi.org/10.1634/theonc....
Stone, P., Ream, E., Richardson, A., Thomas, H., Andrews, P., Campbell, P., Dawson, T., Edwards, J., Goldie, T., Hammick, M., Kearney, N., Lean, M., Rapley, D., Smith, A. G., Teague, C., & Young, A. (2003). Cancer-related fatigue – a difference of opinion? Results of a multicentre survey of healthcare professionals, patients and caregivers. European Journal of Cancer Care, 12, 20–27. https://doi.org/10.1046/j.1365....
Visser, M. R., & Smets, E. M. (1998). Fatigue, depression and quality of life in cancer patients: how are they relat-ed? Supportive Care in Cancer, 6, 101–108. https://doi.org/10.1007/s00520....
Vogelzang, N. J., Breitbart, W., Cella, D., Curt, G. A., Groopman, J. E., Horning, S. J., Itri, L. M., Johnson, D. H., Scherr, S. L., & Portenoy, R. K. (1997). Patient, caregiver, and oncologist perceptions of cancer-related fatigue: Results of a tripart assessment survey. The Fatigue Coalition. Seminars in Hematology, 34, 4–12.
Waghmare, C. (2022). Why is the EORTC QLQ-C30 (version 3.0) still the most widely used quality of life assess-ment tool in oncology? Cancer Research, Statistics, and Treatment, 5, 376–378. https://doi.org/10.4103/crst.c....
Williams, L. A., Bohac, C., Hunter, S., & Cella, D. (2016). Patient and health care provider perceptions of cancer-related fatigue and pain. Supportive Care in Cancer, 24, 4357–4363. https://doi.org/10.1007/s00520....
Zdun-Ryżewska, A., Basiński, K., & Michalik, A. (2020). A confirmatory factor analysis for an adapted and validat-ed Polish version of the Chalder Fatigue Questionnaire. International Journal of Occupational Medicine and En-vironmental Health, 33, 67–76. https://doi.org/10.13075/ijome....
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