Fatigue and Related Factors in Patients with Stomach Cancer during Chemotherapy

항암화학요법을 받는 위암 환자의 피로 변화 양상과 관련요인

  • Received : 2009.12.08
  • Accepted : 2010.02.01
  • Published : 2010.02.27


Purpose: This study was intended to identify the patterns of fatigue and its related factors in patients with stomach cancer during chemotherapy. Methods: Thirty participants (24 males and 6 females) were recruited for this study which utilized a longitudinal and descriptive approach. The research instruments included the Revised Piper Fatigue Scale, Symptom Distress Scale, and Linear Analogue Self Assessment Scale. The participants received 5-FU and Adriamycin at the first week and 5-FU only at the second and third week. The instruments were measured six times in total. The data were analyzed using SPSS 17.0. Results: It was found that fatigue scores in patients with stomach cancer, receiving 5-FU and Adriamycin (FA) regimen, reached the highest level on the third day (F=9.37, p=.024) after the initial infusion, and decreased gradually afterward. The symptom and psychological distress scores illustrated very similar pattern. The concept of multidimensionality of fatigue in patients with stomach cancer was supported in this study, showing that all four dimensions of the scale were positively correlated. Conclusion: The results of this study provided useful information of patients with stomach cancer on fatigue and other related symptoms which they experienced during weekly scheduled chemotherapy with FA regimen.


  1. Escalante CP, Manzullo EF. Cancer-related fatigue: the approach and treatment. J Gen Intern Med 2009;24:412-6. https://doi.org/10.1007/s11606-009-1056-z
  2. Stone P. The measurement, causes and effective management of cancer-related fatigue. Int J Palliat Nurs 2002;8:120-8.
  3. Bower JE. Cancer-related fatigue: links with inflammation in cancer patients and survivors. Brain, Behave Immune 2007;21: 863-71. https://doi.org/10.1016/j.bbi.2007.03.013
  4. Smith GF, Toonen TR. Primary care of the patients with cancer. Am Tam Physician 2007;75:1207-14.
  5. Al-Majid S, Gray DP. A biobehavioral model for the study of exercise intervention in cancer-related fatigue. Biol Res Nurs 2009;10:381-91. https://doi.org/10.1177/1099800408324431
  6. Korea National Cancer Information Center. National cancer statistics. Available at: http://www.cancer.go.kr [accessed on 27 November 2009].
  7. Statistics Korea. Death rate by cancer. Available at: http://Kosis. kr [accessed on 27 November 2009].
  8. Choi JY. Relationships between fatigue and symptom experience, mental health, family support, and fatigue-regulation behavior in gastric cancer patients [dissertation]. Seoul:Yonsei Univ.;2004.
  9. Sohn, S. Relationship between fatigue and sleep quality in patients with cancer. J Korean Acad Adult Nurs 2002;14:378-89.
  10. Han YB, Rho YJ, Kim MS. Cancer patients: the nursing approach based on pathophysiology and life cycle. Seoul:Soomoonsa; 1992.
  11. National Comprehensive Cancer Network. Clinical practice guidelines in oncology: cancer-related fatigue. 2007. Available at: http://www.nccn.org. [accessed on 25 November 2009].
  12. Piper BF, Linsey AM, Dodd MJ, Ferketich S, Paul SM, Weller S. The development of an instrument to mea sure subjective fatigue. Key aspects of comport: pain, fatigue and nausea. New York:Springer;1989.
  13. Piper BF, Dibble SL, Dodd MJ, Weiss MC, Slaughter RE, Paul SM. The revised piper fatigue scale: psychometric evaluation in women with breast cancer. Oncol Nurs Forum 1998;25:677- 84.
  14. Lee EH. The relationships of fatigue and hope to psychosocial adjustment to breast cancer in Korean women receiving postsurgical follow-up treatment [dissertation]. New York (NY): New York Univ.;1998.
  15. McCorkle R, Young K. Development of a symptom distress scale. Cancer Nurs 1978;1:373-8.
  16. Sutherland HJ, Walker P, Till JE. The development of a method for determining oncology patients emotional distressusing linear analogue scale. Cancer Nurs 1988;11:303-8.
  17. Brown LF, Kroenke K. Cancer-related fatigue and its associations with depression and anxiety: a systemic review. Psychosomatics 2009;50:440-7. https://doi.org/10.1176/appi.psy.50.5.440
  18. Yesibalkan OU, Karadakovan A. The effectiveness of nursing education as an intervention to decrease fatigue in turkish patients receiving chemotherapy. Oncol Nurs Forum 2009;36:E215- 22. https://doi.org/10.1188/09.ONF.E215-E222
  19. Berger AM, Lockhart K, Agrawal S. Variability of patterns of fatigue and quality of life over time based on different breast cancer adjuvant chemotherapy regimens. Oncol Nurs Forum 2009;36:563-70. https://doi.org/10.1188/09.ONF.563-570
  20. Mock V, Pickett M, Ropka ME, Muscari E, Stewart KJ, Rhodes VA, et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract 2001;9:119-27. https://doi.org/10.1046/j.1523-5394.2001.009003119.x
  21. Schwartz AL, Thompson JA, Masood N. Interferon-induced fatigue in patients with melanoma: a pilot study of exercise and methylphenidate. Oncol Nurs Forum 2002;29:E85-E90. https://doi.org/10.1188/02.ONF.E85-E90
  22. Richardson A, Ream E, Wilson-Barnett J. Fatigue in patients receiving chemotherapy: patterns of change. Cancer Nurs 1998; 21:17-30. https://doi.org/10.1097/00002820-199802000-00003
  23. Choi IJ. A study on factors related to fatigue in cancer patients receving chemotherapy [dissertation]. Seoul:Yonsei Univ.;2004.
  24. Stone P, Richards M, A'Hern R, Hardy, J. Fatigue in patients with cancers of the breast or prostate undergoing radical radiotherapy. J Pain Symptom Manage 2001;22:1007-15. https://doi.org/10.1016/S0885-3924(01)00361-X
  25. Tchekmedyian NS, Kallich J, McDermott A, Fayers P, Erder MH. The relationship between psychologic distress and cancerrelated fatigue. Cancer 2003;98:198-203. https://doi.org/10.1002/cncr.11463
  26. So WK, Marsch G, Ling WM, Leung FY, Lo JCK, Yeung M, et al. The symptom cluster of fatigue, pain, anxiety, and depression and the effect on the quality of life of women receiving treatment for breast cancer: a multicenter study. Oncol Nurs Forum 2009;36:E205-14. https://doi.org/10.1188/09.ONF.E205-E214
  27. Seo Y, Oh H, Seo W. Causal relationships among factors associated with cancer-related fatigue. Eur J Oncol Nurs. In press 2009.