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Palliative Medicine
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research-article

Fatigue dimensions in patients with advanced cancer in relation to time of survival and quality of life

C Lundh Hagelin

Research & Development unit, Stockholms Sjukhem Foundation, Stockholm; Department of Oncology-Pathology, Karolinska Institutet, Stockholm carina.lundh{at}ki.se

Y Wengström

Institution of Neurobiology, Caring Sciences & Society, Section of Nursing, Karolinska Institutet, Stockholm; Cancer Care Research Centre, Department of Nursing and Midwifery, University of Stirling, Stirling

E Åhsberg

Institute for Evidence-Based Social Work Practice, The National Board of Health and Wellfare, Stockholm

CJ Fürst

Research & Development unit, Stockholms Sjukhem Foundation, Stockholm; Department of Oncology-Pathology, Karolinska Institutet, Stockholm

To understand the relation between fatigue and patients emotional situation at the end of life, this cross-sectional study aimed to explore the association between multidimensional aspects of fatigue, emotional functioning and quality of life (QoL) in patients with advanced cancer at the end of life. Patients with advanced cancer answered fatigue related measurements (Borg Category Ratio-10 scale, Multidimensional Fatigue Inventory-20, Swedish Occupational Fatigue Inventory and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30), when admitted for specialised palliative care. A total of 228 patients with a median length of survival of 63 days were included. In relation to time of survival, fatigue increased closer to death, in both global and multidimensional aspects, as well as the patient’s experience of being sleepy. Marital status was found to affect the experience of fatigue in both global and multidimensional ratings of fatigue. The association between the experience of fatigue and feelings of being tense, worried, irritable or depressed and rated QoL decreased and was not evident closer to death. Fatigue in all dimensions increased, as patients got closer to death. The association between fatigue and both QoL and negative emotions faded away during the last days and weeks of life.

Key Words: emotions • fatigue • neoplasm • palliative care • quality of life • questionnaires

This version was published on March 1, 2009

Palliative Medicine, Vol. 23, No. 2, 171-178 (2009)
DOI: 10.1177/0269216308098794
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