Predictors of the Trajectories of Self-Reported Attentional Fatigue in Women With Breast Cancer Undergoing Radiation Therapy (original) (raw)
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Clinical Nurse Specialist, 2018
The purpose of this study was to examine the incidence of attentional fatigue and the relationship between sleep disturbance and attentional fatigue in working long-term breast cancer survivors (BCS). Methods: A descriptive, correlation design was used. The data for this study were drawn from a larger descriptive study designed to understand the impact of cognitive dysfunction on work-related outcomes. Breast cancer survivors completed questionnaires regarding sleep disturbance, attentional fatigue, and demographic and medical characteristics. Sleep disturbance, a subscale of the Pittsburgh Sleep Quality Index, is measured by asking 9 questions about sleep disturbances. Attentional fatigue was measured by the Attentional Function Index. Descriptive statistics and multiple regression were performed to assess the impact of sleep disturbance on attentional fatigue, controlling for covariates. Results: Sixty-eight female BCS, ranging from 29 to 68 years old (mean [SD], 52.1 [8.6] years old) and, on average, 4.97 (SD, 3.36) years posttreatment, participated. Thirty-four percent of BCS had poor to moderate attention function. Sleep disturbance significantly predicted attentional fatigue (P G .05), explaining 16% of the variance, F 4,57 = 2.68, P G .04, R 2 = 0.16. Conclusions: Clinicians can assess and intervene to decrease sleep disturbance, which may also improve attentional fatigue in BCS. However, sleep disturbance is only 1 contributing factor. Further investigation into factors contributing to attentional fatigue in BCS is warranted.
Factors predicting fatigue in breast cancer patients
Supportive Care in Cancer, 2003
A prospective study was designed to investigate the factors predicting fatigue in breast cancer patients using the Cancer Fatigue Scale (CFS) in addition to the Hospital Anxiety and Depression Scale (HADS) and a questionnaire containing items on demographic and clinical data, and measures of patients' physical symptoms. The CFS measures total fatigue score ranging from 0 (lowest level) to 60 (highest level) and contains three subscales namely: physical, affective and cognitive fatigue. The questionnaires were administered to a consecutive sample of breast cancer patients attending the Iranian Center for Breast Cancer either for their treatment or follow-up examination. In all, 112 patients were studied. The mean age of the respondents was 45.7 years (SD11.0). Most had stage II breast cancer (67%) and had completed their initial treatment (45%). The mean total fatigue score of the pa-
Changes in and predictors of severity of fatigue in women with breast cancer: A longitudinal study
International journal of nursing studies, 2014
Fatigue is the most common symptom experienced by cancer patients. However, longitudinal studies of changes in the severity and predictors of fatigue are limited. The purposes of this study were to evaluate changes in fatigue severity in women with breast cancer prior to and for twelve months after surgery. Factors that affected the severity and the trajectory of fatigue were identified. This observational prospective study approached 334 women who were scheduled for breast cancer surgery in a medical center located in northern Taiwan. Among the 334 women, 239 met the inclusion/exclusion criteria. The final sample size used for the data analysis was 200. Fatigue, depressive symptom, and symptom distress were evaluated in women prior to and at 1, 2, 3, 4, 5, 6, 8, 10, and 12 months after surgery for breast cancer. Hierarchical linear modeling (HLM) was applied where level-1 data consisted of repeated observations of study variables within each subject and level-2 data consisted of st...
Cancer Nursing, 2016
Breast cancer survivors (BCS) have identified attentional fatigue as a frequent and troublesome symptom during and following treatment. 1-4 The ability to pay attention is necessary to complete tasks and activities, and problem solve. Attention requires ongoing mental effort. For BCS, the prolonged or intense use of attention to address the competing mental demands associated with illness, treatment and daily life activties, can lead to attentional fatigue and result in decreased effectiveness in activity. 5 Attentional fatigue, a domain of cognitive function, is often used interchangeably with the terms cognitive dysfunction,cognitive impairment, cognitive fatigue or tiredness. Seminal research, however, delineates attentional fatigue from these other concepts by describing attentional fatigue as a measurable decrease in an individual's ability to focus and concentrate or to block out distractions when carrying out meaningful activities. 6 Hallmark indicators of attentional fatigue are: increased distractibility, difficulty following a train of thought or carrying out usual day-today activities, lapses in working memory, and increased impatience or frustration in personal interactions. 7 Although the two may coexist, physical and attentional fatigue differ in that an individual may not be physically tired but has a reduced ability to exert mental effort. 8 Researchers have noted that BCS incur attentional fatigue more than age-matched controls 9 and prostate cancer patients. 10 Merriman and colleagues, 11 found that up to 63% of
Course of fatigue in women receiving chemotherapy and/or radiotherapy for early stage breast cancer
Journal of Pain and Symptom Management, 2004
Although much has been learned about the complication of fatigue during breast cancer treatment, the possibility that there are differences across treatment modalities in breast cancer patients' experience of fatigue has not yet been established. In this study, fatigue was assessed in 134 women receiving chemotherapy and radiotherapy or radiotherapy only for early stage breast cancer. Comparisons of fatigue during initial treatment indicated that women who received chemotherapy reported greater fatigue severity and disruptiveness than women receiving radiotherapy. Women not pre-treated with chemotherapy experienced increased fatigue over the course of radiotherapy. Results confirmed predictions that fatigue in women with early stage breast cancer differs as a function of the type of treatment and sequencing of treatment. Findings indicating increases in fatigue during radiotherapy only among women not pretreated with chemotherapy suggest a response shift, or a change in internal standards, in women's perceptions of fatigue as a function of prior chemotherapy treatment.
International Journal of Radiation Oncology*Biology*Physics, 2011
Purpose: Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life. Methods and Materials: Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional Assessment of Cancer Therapy-General questionnaires, including breast and fatigue modules. Results: At baseline, 60% of the CT-RT patients expressed fatigue vs. 33% of the RT patients (p <0.001). Corresponding values at the end of RT were statistically similar (61% and 53%), and fatigue was still reported at 1 year by more than 40% of patients in both groups. Risk factors for long-term fatigue included depression (odds ratio [OR] = 6), which was less frequent in the RT group at baseline (16% vs. 28 %, respectively, p = 0.01) but reached a similar value at the end of RT (25% in both groups). Initial mild cognitive impairments were reported by RT (34 %) patients and CT-RT (24 %) patients and were persistent at 1 year for half of them. No biological disorders were associated with fatigue or cognitive impairment. Conclusions: Fatigue was the main symptom in LBC patients treated with RT, whether they received CT previously or not. The correlation of persistent fatigue with initial depressive status favors administering medical and psychological programs for LBC patients treated with CT and/or RT, to identify and manage this main quality-of-life-related symptom. Ó 2011 Elsevier Inc.
Utility of a cognitive-behavioral model to predict fatigue following breast cancer treatment
Health Psychology, 2007
The objective of the current study was twofold: (a) to determine whether subgroups of breast cancer patients could be identified on the basis of their distinct trajectory or pattern of fatigue following treatment for early stage cancer using growth mixture modeling and (b) to examine whether the subgroups could be distinguished on the basis of a cognitive-behavioral model. Growth mixture modeling and a prospective longitudinal design were used to examine the course of fatigue after treatment for early stage breast cancer. Women (n ϭ 261; mean age ϭ 55.2 years) provided fatigue ratings for 6 months following treatment. A low-fatigue group (n ϭ 85) and a high-fatigue group (n ϭ 176) were extracted. Women who were not married, had a lower income, had a higher body mass index, engaged in greater fatigue catastrophizing, and were lower in exercise participation were more likely to be in the high-fatigue group. Only body mass index and catastrophizing remained significant predictors in multivariate analysis. Findings suggest considerable heterogeneity in the experience of fatigue following treatment and support the utility of a cognitive-behavioral model in predicting the course of posttreatment fatigue.
Journal of Pain and Symptom Management, 2009
Fatigue is a common consequence of cancer chemotherapy and radiotherapy. Investigation of the impact of cancer treatment on fatigue is compromised by a potential ''response shift'' in fatigue ratings, involving a recalibration of a respondent's internal standard used to judge their current fatigue experience. Using a prospective, longitudinal research design, repeated assessments of most and average fatigue were obtained from women (n ¼ 102) with early stage breast cancer receiving adjuvant chemotherapy and/or radiotherapy. Thentest ratings of fatigue were also obtained and used to index the presence of a response shift in fatigue ratings. Results suggested a clinically significant response shift in ratings of most and average fatigue of approximately one-half standard deviation. Multiple regression analyses suggested larger response shifts were associated with higher pretreatment fatigue ratings, receipt of chemotherapy, and lower fatigue catastrophizing. Most importantly, consideration of the observed response shift in fatigue ratings significantly altered the conclusions drawn regarding the magnitude and persistence of fatigue during and after adjuvant therapy for breast cancer.
Cancer, 2017
Objective, treatment-independent markers of cancer-related fatigue are needed to advance clinical trials. In the current study, the authors evaluated physical, neurocognitive, and serologic markers for correlation with self-reported fatigue before and after (neo)adjuvant chemotherapy for patients with early-stage breast cancer. Women with AJCC TNM Stage I-III breast cancer consented to assessment before and after the completion of 4 cycles of dose-dense doxorubicin and cyclophosphamide. Assessment included self-reported fatigue (using the Brief Fatigue Inventory), depression (using the Center for Epidemiologic Studies-Depression Scale [CES-D]), Pittsburgh Sleep Quality Index, and 28 objective measures (grip strength in dominant and nondominant hands, 6-minute walk, daily total energy expenditure, 14 neurocognitive tests, and 10 serologic markers). Generalized linear regression models of fatigue were constructed (1 model per marker), and adjusted for depression, timing before/after c...