Effects of Pain, Sleep Disturbance, and Fatigue on the Quality of Life in Patients with Pancreatic Cancer Undergoing Chemotherapy

항암화학요법을 받는 췌장암 환자의 통증, 수면장애, 피로가 삶의 질에 미치는 영향

  • 김경덕 (동양대학교 간호학과) ;
  • 장현진 (세브란스병원 췌장담도암클리닉)
  • Received : 2012.03.23
  • Accepted : 2012.05.21
  • Published : 2012.06.30


Purpose: The purpose of this study was to assess pain, sleep disturbance, fatigue, and the quality of life and to identify the impact of pain, sleep disturbance and fatigue on the quality of life in patients with pancreatic cancer undergoing chemotherapy. Methods: Data were collected from June to July, 2010. Participants were recruited from Y university hospital in Seoul. Research instruments included numeric rating scale for pain, Functional Assessment Chronic Illness Therapy-Functional Well-Being (FACIT-FWB): General Factor 5 (GF5) for sleep disturbance, Functional Assessment of Cancer Therapy-General (FACT-G) for quality of life, and FACT-Fatigue for fatigue. Results: The quality of life for cancer patients had a significant relationship with pain, sleep disturbance, and fatigue. The significant factors influencing quality of life were pain, sleep disturbance, and fatigue that explained 52.6% of the variance. Conclusion: Patients with pancreatic cancer undergoing chemotherapy experienced pain, fatigue, and sleep disturbance which led to a negative effect on quality of life. The results suggest that intervention program to improve quality of life could reduce pain, fatigue, and sleep disturbance of pancreatic cancer patients undergoing chemotherapy.


  1. National Cancer Information Center. National Cancer Statistics. Available at: http://www.cancer.go. kr/cms/statics/survival_rate/index.html/[accessed on 25 May 2011].
  2. Choi CM. A study on quality of life of advanced hepatobiliary and pancreatic cancer patients who administered for traditional korean cancer treatment [dissertation]. Seoul:Kyunghee Univ.;2008.
  3. Song SY. Pancreatic cancer guide book. Seoul:kugilmedia;2007.
  4. Reyes-Gibby CC, Chan W, Abbruzzese JL, Xiong HQ, Ho L, Evans DB, et al. Patterns of self- reported symptoms in pancreatic cancer patients receiving chemoradiation. J Pain Symptom Manage 2007;34:244-52.
  5. Jia L, Jiang SM, Shang YY, Huang YX, Li YJ, Xie DR, et al. Investigation of incidence of pancreatic cancer-related depression and its relationship with the quality of life of patients. Digestion 2010;82(1):4-9.
  6. Cho YD. Supportive care for symptom relife in pancreatic cancer. Korean J Gastroenterol 2008;51:119-26.
  7. Song HJ. Factors affecting nurse's pain management for cancer patients [dissertation]. Seoul:Yonsei Univ.;2009.
  8. Savard J, Morin CM. Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol 2001;19:895-908.
  9. Son HG. Relationship between quality of sleep and fatigue in patients with hemato-malignancy in receiving chemotheraphy [dissertation]. Busan:Kosin Univ.;2006.
  10. Crippa S, Domínguez I, Rodríguez JR, Razo O, Thayer SP, Ryan DP, et al. Quality of life in pancreatic cancer: analysis by stage and treatment. J Gastro Surgery 2008;12:783-93.
  11. Labori KJ, Hjermstad MJ, Wester T, Buanes T, Loge JH. Symptom profiles and palliative care in advanced pancreatic cancer: a prospective study. Support Care Cancer 2006;14:1126-33.
  12. Bernhard J, Dietrich D, Glimelius B, Hess V, Bodoky G, Scheithauer W, et al. Estimating prognosis and palliation based on tumour marker CA 19-9 and quality of life indicators in patients with advanced pancreatic cancer receiving chemotherapy. Br J Cancer 2010;103:1318-24.
  13. Jang HJ. Information needs, treatment-related decision conflict, and quality of life in pancreatic cancer patient [dissertation]. Seoul:Yonsei Univ.;2010.
  14. FACIT. Functional Assessment of Chronic Illness Therapy. Available at:[accessed on 1 June, 2010].
  15. FACIT. Functional Assessment of Chronic Illness Therapy-Fatigue [Internet]. Elmhurst: Functional Assessment of Chronic Illness Therapy; [cited 2010 June 01]. Available from:[accessed on 1 June, 2010].
  16. Kim GD, Kim KH. Symptom cluster and quality of life with breast cancer undergoing chemotherapy. Korean J Adult Nurs 2011;23:434-45.
  17. So WK, Marsh G, Ling WM, Leung FY, Lo JC, 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.
  18. Ryu JK. Nutrition and drug therapy of pancreatobiliary cancer progression. Korean J Pancreas Biliary Tract 2007;12(1):28-34.
  19. Kwak MJ. A study on the relation of pain, anxiety, abd sleep in the cancer patients [dissertation]. Seoul:Ewha Womans Univ.;2001.
  20. Son SK. The hopelessness of the lung cancer patient. J Korean Acad nurs 1995;35(2):46-9.
  21. Vena C, Parker K, Allen R, Bliwise D, Jain S, Kimble L. Sleep-wake disturbances and quality of life in patients with advanced lung cancer. Oncol Nurs Forum 2006;33:761-9.
  22. Robinson DW, Eisenberg DF, Cella D, Zhao N, DeBoer C, DeWitte M. The prognostic significance of patient-reported outcomes in pancreatic cancer cachexia. J Support Oncol 2008;6:283-90.
  23. Byun HS, Kim GD, Chung BY, Kim KH. Fatigue and quality of life of korean cancer inpatients. Korean J Hosp Palliat Care 2010;13(2):98-108.
  24. Sun V, Ferrell B, Juarez G, Wagman LD, Yen Y, Chung V. Symptom concerns and quality of life in hepatobiliary cancers. Oncol Nurs Forum 2008;35(3):E45-52.
  25. Steel JL, Eton DT, Cella D, Olek MC, Carr BI. Clinically meaningful changes in health-related quality of life in patients diagnosed with hepatobiliary carcinoma. Ann Oncol 2006;17:304-12.
  26. Banthia R, Malcarne VL, Ko CM, Varni JW, Sadler GR. Fatigued breast cancer survivors: The role of the sleep quality, depressed mood, stage and age. Psychol Health, 2009;24:965-80.
  27. Cheng KK, Lee DT. Effects of pain, fatigue, insomnia, and mood disturbance on functional status and quality of life of elderly patients with cancer. Crit Rev Oncol Hematol 2011;78:127-37.
  28. Beck SL, Dudley WN, Barsevick A. Pain, sleep disturbance, and fatigue in patients with cancer: Using a mediation model to test a symptom cluster. Oncol Nurs Forum 2005;32:E48-55.