Umor kod pacijentkinja sa karcinomom dojke: ispitivanje uloge demografskih i kliničkih faktora, psiholoških činilaca i socijalne podrške

  • Ivana Novakov Institut za onkologiju Vojvodine
Ključne reči: umor povezan sa rakom, Skala zamora: Fatigue Assessment Scale (FAS Serbian), karcinom dojke, neuroticizam, socijalna podrška

Sažetak


Umor povezan sa rakom predstavlja veoma rasprostranjen problem kod onkoloških pacijenata, koji često ostaje neadekvatno tretiran, budući da su uzroci ovog sindroma još uvek nedovoljno poznati. Cilj ovog rada bio je da se ispitaju demografske, kliničke i psiho-socijalne determinante fizičke i mentalne komponente umora povezanog sa rakom. U istraživanju su učestvovale 64 ispitanice sa dijagnozom karcinoma dojke, starosti između 33 i 79 godina (AS=58.36, SD=11.30) tokom sprovođenja zračne terapije. Za procenu fizičke i mentalne komponente umora primenjena je Skala zamora: Fatigue Assessment Scale (FAS Serbian), a pored obuhvaćenih demografskih i kliničkih podataka, procenjeni su i simptomi anksioznosti i depresije (DASS-21), neuroticizam (BFI), te funkcionalna i strukturalna socijalna podrška (srpski prevod MOS-SSS). Rezultati su pokazali da depresija, anksioznost i neuroticizam pozitivno koreliraju sa obe dimenzije umora, dok strukturalna i funkcionalna podrška negativno koreliraju sa fizičkom dimenzijom. Ispitanice koje imaju partnera izveštavaju o manjem nivou fizičkog umora u odnosu na one koje nemaju partnera, dok ovakva razlika nije detektovana u slučaju mentalnog umora. Kao najznačajniji prediktori fizičke dimenzije umora izdvojili su se neuroticizam i partnerski status, a kao najznačajniji prediktor mentalne komponente izdvojio se neuroticizam. Rezultati su pokazali da fizička i mentalna dimenzija umora imaju različite korelate, te da personološke karakteristike i socijalna podrška mogu imati veći značaj za razumevanje ovog fenomena nego klinički i demografski faktori. Dobijeni nalazi mogu biti od značaja prilikom procene faktora rizika za razvoj sindroma umora, te planiranja psiho-socijalnih intervencija u cilju osnaživanja pacijenata.

Reference

Akechi, T., Kugaya, A., Okamura, H., Yamawaki, S., & Uchitomi, Y. (1999). Fatigue and its associated factors in ambulatory cancer patients: A preliminary study. Journal of pain and symptom management, 17(1), 42–48. https://doi.org/10.1016/s0885-3924(98)00105-5

Atchley, R. C. (2000). Social forces and aging: An introduction to social gerontology (9th ed.). Beaumont, CA: Wadsworth.

Bartsch, H. H., Weis, J., & Moser, M. T. (2003). Cancer-related fatigue in patients attending oncological rehabilitation programs: Prevalence, patterns and predictors. Onkologie, 26(1), 51–57. https://doi.org/10.1159/000069864

Bower, J. E., Ganz, P. A., Desmond, K. A., Rowland, J. H., Meyerowitz, B. E., & Belin, T. R. (2000). Fatigue in breast cancer survivors: Occurrence, correlates, and impact on quality of life. Journal of Clinical Oncology, 18(4), 743–753. https://doi.org/10.1200/JCO.2000.18.4.743

Bower J. E. (2014). Cancer-related fatigue - mechanisms, risk factors, and treatments. Nature Reviews. Clinical Oncology, 11(10), 597–609. https://doi.org/10.1038/nrclinonc.2014.127

Buckwalter, A. E., Karnell, L. H., Smith, R. B., Christensen, A. J., & Funk, G. F. (2007). Patient-reported factors associated with discontinuing employment following head and neck cancer treatment. Archives of Otolaryngology ‒ Head & Neck Surgery, 133(5), 464–470. https://doi.org/10.1001/archotol.133.5.464

Cella, D., Davis, K., Breitbart, W., Curt, G., & Fatigue Coalition (2001). Cancer-related fatigue: Prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. Journal of Clinical Oncology, 19(14), 3385–3391. https://doi.org/10.1200/JCO.2001.19.14.3385

de Jong, N., Courtens, A. M., Abu-Saad, H. H., & Schouten, H. C. (2002). Fatigue in patients with breast cancer receiving adjuvant chemotherapy: A review of the literature. Cancer nursing, 25(4), 283–299. https://doi.org/10.1097/00002820-200208000-00004

de Raaf, P. J., de Klerk, C., & van der Rijt, C. C. D. (2013). Elucidating the behavior of physical fatigue and mental fatigue in cancer patients: A review of the literature. Psycho-Oncology, 22(9), 1919–1929. https://doi.org/10.1002/pon.3225

Echteld, M. A., Passchier, J., Teunissen, S., Claessen, S., de Wit, R., & van der Rijt, C. C. (2007). Multidimensional fatigue and its correlates in hospitalised advanced cancer patients. European Journal of Cancer, 43(6), 1030–1036. https://doi.org/10.1016/j.ejca.2007.01.024

Fürst, C. J., & Ahsberg, E. (2001). Dimensions of fatigue during radiotherapy. An application of the Multidimensional Fatigue Inventory. Supportive Care in Cancer, 9(5), 355–360. https://doi.org/10.1007/s005200100242

Gélinas, C., & Fillion, L. (2004). Factors related to persistent fatigue following completion of breast cancer treatment. Oncology Nursing Forum, 31(2), 269–278. https://doi.org/10.1188/04.ONF.269-278

Ghasemi, A., & Zahediasl, S. (2012). Normality Tests for Statistical Analysis: A Guide for Non-Statisticians. International Journal of Endocrinology and Metabolism, 10, 486 - 489. DOI:10.5812/ijem.3505

Given, C. W., Given, B., Azzouz, F., Kozachik, S., & Stommel, M. (2001). Predictors of pain and fatigue in the year following diagnosis among elderly cancer patients. Journal of Pain and Symptom Management, 21(6), 456–466. https://doi.org/10.1016/s0885-3924(01)00284-6

Glaus, A., Crow, R., & Hammond, S. (1996). A qualitative study to explore the concept of fatigue/tiredness in cancer patients and in healthy individuals. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 4(2), 82–96. https://doi.org/10.1007/BF01845757

Glaus, A. (1998). Fatigue in patients with cancer. Analysis and assessment. Recent Results in Cancer Research, 145, 1-172.

Goldstein, D., Bennett, B. K., Webber, K., Boyle, F., de Souza, P. L., Wilcken, N. R., Scott, E. M., Toppler, R., Murie, P., O'Malley, L., McCourt, J., Friedlander, M., Hickie, I. B., & Lloyd, A. R. (2012). Cancer-related fatigue in women with breast cancer: Outcomes of a 5-year prospective cohort study. Journal of Clinical Oncology, 30(15), 1805–1812. https://doi.org/10.1200/JCO.2011.34.6148

Haghighat, S., Akbari, M. E., Holakouei, K., Rahimi, A., & Montazeri, A. (2003). Factors predicting fatigue in breast cancer patients. Supportive Care in Cancer, 11(8), 533–538. https://doi.org/10.1007/s00520-003-0473-5

Hann, D. M., Jacobsen, P. B., Martin, S. C., Kronish, L. E., Azzarello, L. M., & Fields, K. K. (1997). Fatigue in women treated with bone marrow transplantation for breast cancer: A comparison with women with no history of cancer. Supportive Care in Cancer, 5(1), 44–52. https://doi.org/10.1007/BF01681961

Hann, D. M., Jacobsen, P., Martin, S., Azzarello, L., & Greenberg, H. (1998). Fatigue and quality of life following radiation therapy for breast cancer: A comparative study. Journal of Clinical Psychology in Medical Settings, 5, 19–33. https://doi.org/10.1023/A:1026249702250

Hofman, M., Ryan, J. L., Figueroa-Moseley, C. D., Jean-Pierre, P., & Morrow, G. R. (2007). Cancer-related fatigue: The scale of the problem. The Oncologist, 12(suppl1), 4-10. doi: 10.1634/theoncologist.12-S1-4

Irvine, D. M., Vincent, L., Graydon, J. E., & Bubela, N. (1998). Fatigue in women with breast cancer receiving radiation therapy. Cancer Nursing, 21(2), 127–135. https://doi.org/10.1097/00002820-199804000-00006

Jaremka, L. M., Fagundes, C. P., Glaser, R., Bennett, J. M., Malarkey, W. B., & Kiecolt-Glaser, J. K. (2013). Loneliness predicts pain, depression, and fatigue: Understanding the role of immune dysregulation. Psychoneuroendocrinology, 38(8), 1310–1317. https://doi.org/10.1016/j.psyneuen.2012.11.016

John, O. P., Donahue, E. M., & Kentle, R. L. (1991). The Big Five Inventory – Versions 44 and 54. Berkley, CA: University of California, Berkley, Institute of Personality and Social Research.

Jovanović V., & Gavrilov-Jerković, V. (2015). Validacija srpskog prevoda skale Socijalne podrške MOS-SSS. Primenjena psihologija, 8(3): 245-64. http://primenjena.psihologija.ff.uns.ac.rs/index.php/pp/article/view/1454/1481

Karakoç, T., & Yurtsever, S. (2010). Relationship between social support and fatigue in geriatric patients receiving outpatient chemotherapy. European Journal of Oncology Nursing, 14(1), 61–67. https://doi.org/10.1016/j.ejon.2009.07.001

Kim, S. H., Son, B. H., Hwang, S. Y., Han, W., Yang, J. H., Lee, S., & Yun, Y. H. (2008). Fatigue and depression in disease-free breast cancer survivors: Prevalence, correlates, and association with quality of life. Journal of pain and symptom management, 35(6), 644–655. https://doi.org/10.1016/j.jpainsymman.2007.08.012

Kuhnt, S., Ernst, J., Singer, S., Rüffer, J., Kortmann, R-D., Stolzenburg, J-U., & Schwarz, R. (2009). Fatigue in cancer survivors ‒ prevalence and correlates. Onkologie, 32, 312-317. https://doi.org/10.1159/000215943

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335-43. doi: 10.1016/0005-7967(94)00075-u

Maliski, S. L., Kwan, L., Orecklin, J. R., Saigal, C. S., & Litwin, M. S. (2005). Predictors of fatigue after treatment for prostate cancer. Urology, 65(1), 101–108. https://doi.org/10.1016/j.urology.2004.08.031

Mardanian-Dehkordi, L., & Kahangi, L. (2018). The relationship between perception of social support and fatigue in patients with cancer. Iranian Journal of Nursing and Midwifery Research, 23(4), 261–266. https://doi.org/10.4103/ijnmr.IJNMR_63_17

Miaskowski, C., & Portenoy, R. K. (1998). Update on the assessment and management of cancer-related fatigue. Principles and Practice of Supportive Oncology Updates, 1, 1-10.

Michielsen, H. J., De Vries, J., & Van Heck, G. L. (2003). Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale (FAS). Journal of Psychosomatic Research, 54(4), 345–352. https://doi.org/10.1016/s0022-3999(02)00392-6

Michielsen, H. J., De Vries, J., Van Heck, G. L., Van de Vijver, F. J. R., & Sijtsma, K. (2004). Examination of the dimensionality of fatigue: The construction of the Fatigue Assessment Scale (FAS). European Journal of Psychological Assessment, 20(1), 39–48. https://doi.org/10.1027/1015-5759.20.1.39

Minton, O., Berger, A., Barsevick, A., Cramp, F., Goedendorp, M., Mitchell, S. A., & Stone, P. C. (2013). Cancer-related fatigue and its impact on functioning. Cancer, 119(suppl 11), 2124–2130. https://doi.org/10.1002/cncr.28058

Mock, V., Atkinson, A., Barsevick, A., Cella, D., Cimprich, B., Cleeland, C., Donnelly, J., Eisenberger, M. A., Escalante, C., Hinds, P., Jacobsen, P. B., Kaldor, P., Knight, S. J., Peterman, A., Piper, B. F., Rugo, H., Sabbatini, P., Stahl, C. & National Comprehensive Cancer Network. (2000). NCCN Practice guidelines for cancer-related fatigue. Oncology (Williston Park, N. Y.), 14(11A), 151–161.

Morrow, G. R., Shelke, A. R., Roscoe, J. A., Hickok, J. T., & Mustian, K. (2005). Management of cancer-related fatigue. Cancer Investigation, 23(3), 229–239. https://doi.org/10.1081/cnv-200055960

Okuyama, T., Akechi, T., Kugaya, A., Okamura, H., Imoto, S., Nakano, T., Mikami, I., Hosaka, T., & Uchitomi, Y. (2000). Factors correlated with fatigue in disease-free breast cancer patients: Application of the Cancer Fatigue Scale. Supportive Care in Cancer, 8(3), 215–222. https://doi.org/10.1007/s005200050288

Reuter, K., Classen, C. C., Roscoe, J. A., Morrow, G. R., Kirshner, J. J., Rosenbluth, R., Flynn, P. J., Shedlock, K., & Spiegel, D. (2006). Association of coping style, pain, age and depression with fatigue in women with primary breast cancer. Psycho-oncology, 15(9), 772–779. https://doi.org/10.1002/pon.1012

Rüffer, J. U., Flechtner, H., Tralls, P., Josting, A., Sieber, M., Lathan, B., Diehl, V., & German Hodgkin Lymphoma Study Group (2003). Fatigue in long-term survivors of Hodgkin's lymphoma; A report from the German Hodgkin Lymphoma Study Group (GHSG). European journal of cancer, 39(15), 2179–2186. https://doi.org/10.1016/s0959-8049(03)00545-8

Schaefer, C., Coyne, J. C., & Lazarus, R. S. (1981). The health-related functions of social support. Journal of behavioral medicine, 4(4), 381–406. https://doi.org/10.1007/BF00846149

Schmider, E., Ziegler, M., Danay, E., Beyer, L., & Bühner, M. (2010). Is it really robust? Reinvestigating the robustness of ANOVA against violations of the normal distribution assumption. Methodology: European Journal of Research Methods for the Behavioral and Social Sciences, 6(4), 147–151. https://doi.org/10.1027/1614-2241/a000016

Schmidt, M. E., Chang-Claude, J., Vrieling, A., Heinz, J., Flesch-Janys, D., & Steindorf, K. (2012). Fatigue and quality of life in breast cancer survivors: Temporal courses and long-term pattern. Journal of Cancer Survivorship: Research and Practice, 6(1), 11–19. https://doi.org/10.1007/s11764-011-0197-3

Schmidt, M. E., Wiskemann, J., Schneeweiss, A., Potthoff, K., Ulrich, C. M., & Steindorf, K. (2018). Determinants of physical, affective, and cognitive fatigue during breast cancer therapy and 12 months follow-up. International Journal of Cancer, 142 (6), 1148-1157. https://doi.org/10.1002/ijc.31138

Servaes, P., van der Werf, S., Prins, J., Verhagen, S., & Bleijenberg, G. (2001). Fatigue in disease-free cancer patients compared with fatigue in patients with chronic fatigue syndrome. Supportive Care in Cancer, 9(1), 11–17. https://doi.org/10.1007/s005200000165

Servaes, P., Verhagen, C., & Bleijenberg, G. (2002). Fatigue in cancer patients during and after treatment: Prevalence, correlates and interventions. European Journal of Cancer, 38(1), 27–43. https://doi.org/10.1016/s0959-8049(01)00332-x

Sherbourne, C. D., & Stewart, A. L. (1991). The MOS social support survey. Social Science & Medicine, 32(6), 705–714. https://doi.org/10.1016/0277-9536(91)90150-b

Smets, E. M. A., Visser, M. R. M., Garssen, B., Frijda, N. H., Oosterveld P, & Haes, J. C. J. M. (1998). Understanding the level of fatigue in cancer patients undergoing radiotherapy. Journal of Psychosomatic Research, 45(3), 277–293.

Soltow, D., Given, B. A., & Given, C. W. (2010). Relationship between age and symptoms of pain and fatigue in adults undergoing treatment for cancer, Cancer Nursing, 33(4), 296-303. doi: 10.1097/NCC.0b013e3181ce5a1a

Steinskog, D. J., Tjøstheim, D. B., & Kvamstø, N. G. (2007). A cautionary note on the use of the Kolmogorov-Smirnov test for normality. American Meteorological Society, 135, 1151–1157. DOI: 10.1175/MWR3326.1

Sugawara, Y., Akechi, T., Okuyama, T., Matsuoka, Y., Nakano, T., Inagaki, M., Imoto, S., Fujimori, M., Hosaka, T., & Uchitomi, Y. (2005). Occurrence of fatigue and associated factors in disease-free breast cancer patients without depression. Supportive Care in Cancer, 13(8), 628–636. https://doi.org/10.1007/s00520-004-0763-6

Thode, H. C. (2002). Testing for normality. New York: Marcel Dekker.

Wang, S. H., He, G. P., Jiang, P. L., Tang, L. L., Feng, X. M., Zeng, C., & Wang, G. F. (2013). Relationship between cancer-related fatigue and personality in patients with breast cancer after chemotherapy. Psycho-oncology, 22(10), 2386–2390. https://doi.org/10.1002/pon.3303

Winters-Stone, K., Bennett, J., Nail, L., & Schwartz, A. (2008). Strength, physical activity, and age predict fatigue in older breast cancer survivors. Oncology nursing forum, 35(5), 815-821. DOI:10.1188/08.ONF.815-821

Objavljeno
2021/07/02
Rubrika
Originalni naučni članak