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Chronische Fatigue bei Krebspatienten*

Chronic Fatigue in Cancer Patients

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Zusammenfassung

Hintergrund:

Aufgrund der langfristig ansteigenden Überlebensraten bei Krebspatienten treten zunehmend chronische Folgesymptome, wie die tumorbedingte Fatigue auch bei Patienten nach Abschluss der Tumortherapie in den Vordergrund. In dieser Patientengruppe liegt die Fatigue-Prävalenz zwischen 17 und 56 %. Obwohl Fatigue ein multifaktorielles Kausalgeschehen zugrunde liegt, mangelt es bisher noch an entsprechend komplexen Behandlungsangeboten.

Patienten und Methodik:

Auf der Grundlage einer Bedarfsanalyse wurde ein Schulungsprogramm entwickelt und evaluiert. Geschult wurden Krebspatienten nach Therapieabschluss, die unter chronischer Fatigue leiden. Das Selbstmanagementprogramm FIBS besteht aus sechs Modulen. Neben Informationen über Fatigue enthält es verhaltenstherapeutisch orientierte Strategien und Übungen. Die Zufriedenheit der Patienten, die an der Schulung teilgenommen hatten, war hoch. Die Patienten waren im Mittel zu 84,0 % mit der thematischen Auswahl und zu 84,25 % mit den Schulungsbedingungen zufrieden. 95,8 % der Patienten erzielten einen subjektiv eingeschätzten persönlichen Gewinn durch die Schulung, im Mittel 8,14 von 12 möglichen Punkten. Die Patientenzufriedenheit mit dem Schulungsprogramm betrug 78,72 %.

Schlussfolgerung:

Mit dem neu entwickelten Selbstmanagementprogramm kann eine Versorgungslücke für Krebspatienten mit chronischer Fatigue geschlossen werden, für die es bislang kaum Therapieansätze gab. Das Programm zeichnet sich durch zielgruppengerechte Inhalte und Methoden und eine hohe Patientenzufriedenheit aus.

Abstract

Background:

Due to improvements in long-term survival in cancer patients, emphasis is increasingly placed on chronic symptoms such as cancer-related fatigue in patients after completion of cancer treatment. Fatigue prevalence in these patients ranges from 17% to 56%. However, there is a lack of complex treatments that take the multifactorial character of fatigue causation into account.

Patients and Methods:

Based on a needs analysis, a patient education program was developed and evaluated. The study aimed at cancer patients after completion of the cancer treatment who suffer from chronic fatigue. The self-management program FIBS consists of six modules. Information about fatigue and behavioural therapy orientated strategies and exercises are included. Patients who attended the program were highly satisfied. They were satisfied with the selected topics at an average of 84.0%, and with the conditions at 84.25%. 95.8% of the patients achieved a subjectively perceived personal benefit, on average 8.14 of 12 possible points. The overall patient education satisfaction scored 78.72%.

Conclusion:

The newly developed self-management program closes a gap in health care of cancer patients with chronic fatigue for whom there are hardly any intervention options to date. The program is characterised by target group-specific contents and methods and a high satisfaction of the patients.

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Literatur

  1. Barth J, Lubbe S, Krischke NR et al. Changes in quality of life and functional outcome during inpatient rehabilitation of breast cancer patients. Psycho-Oncology 2001;10(4):S: 67–67, Suppl. S., C13

    Google Scholar 

  2. National Comprehensive Cancer Network. Cancer-Related Fatigue. Clinical Practice Guidelines in Oncology TM, 2010.

  3. de Vries U, Reif K, Stuhldreher N et al. Tumorbedingte Fatigue. Zeitschrift für Gesundheitspsychologie 2009;17(4):170–184.

    Article  Google Scholar 

  4. Bertz J, Dahm S, Haberland J et al. Verbreitung von Krebserkrankungen in Deutschland.: Humboldt Universität, Berlin, 2010.

    Google Scholar 

  5. Bower J, Ganz P, Desmond K et al. Fatigue in breast cancer survivors: occurrence, correlates, and impact on quality of life. J Clin Oncol 2000;18(4):743.

    CAS  PubMed  Google Scholar 

  6. Broeckel JA, Jacobsen PB, Horton J et al. Characteristics and correlates of fatigue after adjuvant chemotherapy for breast cancer. J Clin Oncol 1998; 16(5):1689–1696.

    CAS  PubMed  Google Scholar 

  7. Fossa SD, Dahl AA, Loge JH. Fatigue, anxiety, and depression in long-term survivors of testicular cancer. J Clin Oncol 2003;21(7):1249–1254.

    Article  PubMed  Google Scholar 

  8. Rüffer JU, Flechtner H, Tralls P et al. Fatigue in long-term survivors of Hodgkin's lymphoma; a report from the German Hodgkin Lymphoma Study Group (GHSG). Eur J Cancer 2003;39(15): 2179–2186.

    Article  PubMed  Google Scholar 

  9. Servaes P, Verhagen S, Schreuder HW et al. Fatigue after treatment for malignant and benign bone and soft tissue tumors. J Pain Symptom Manage 2003; 26(6):1113–1122.

    Article  PubMed  Google Scholar 

  10. Servaes P, Gielissen MF, Verhagen S et al. The course of severe fatigue in disease-free breast cancer patients: a longitudinal study. Psychooncology 2007; 16(9):787–795.

    Article  CAS  PubMed  Google Scholar 

  11. Jacobsen PB, Stein K. Is Fatigue a Long-term Side Effect of Breast Cancer Treatment? Cancer Control 1999;6(3):256–263.

    PubMed  Google Scholar 

  12. Okuyama T, Akechi T, Kugaya A et al. Factors correlated with fatigue in disease-free breast cancer patients: application of the Cancer Fatigue Scale. Support Care Cancer 2000;8(3):215–222.

    Article  CAS  PubMed  Google Scholar 

  13. Loge JH, Abrahamsen AF, Ekeberg O et al. Hodgkin's disease survivors more fatigued than the general population. J Clin Oncol 1999;17(1):253–261.

    CAS  PubMed  Google Scholar 

  14. Cella D, Davis K, Breitbart W et al. Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol 2001;19(14):3385–3391.

    CAS  PubMed  Google Scholar 

  15. Servaes P, van der Werf S, Prins J et al. Fatigue in disease-free cancer patients compared with fatigue in patients with chronic fatigue syndrome. Support Care Cancer 2001;9(1):11–17.

    Article  CAS  PubMed  Google Scholar 

  16. Hjermstad MJ, Fossa SD, Oldervoll L et al. Fatigue in long-term Hodgkin's Disease survivors: a followup study. J Clin Oncol 2005;23(27):6587–6595.

    Article  PubMed  Google Scholar 

  17. Bower JE, Ganz PA, Desmond KA et al. Fatigue in long-term breast carcinoma survivors. A longitudinal investigation. Cancer 2006;106(4):751–758.

    Article  PubMed  Google Scholar 

  18. Patarca-Montero R, Hrsg. Handbook of cancer related fatigue. Binghamton: Haworth Medical Press, 2004.

    Google Scholar 

  19. Jager A, Sleijfer S, van der Rijt C. The pathogenesis of cancer related fatigue: Could increased activity of pro-inflammatory cytokines be the common denominator? Eur J Cancer 2008;44(2):175–81.

    Article  CAS  PubMed  Google Scholar 

  20. Bower J. Cancer-related fatigue: links with inflammation in cancer patients and survivors. Brain Behav Immun 2007;21(7):863–871.

    Article  CAS  PubMed  Google Scholar 

  21. Schubert C, Hong S, Natarajan L et al. The association between fatigue and inflammatory marker levels in cancer patients: a quantitative review. Brain Behav Immun 2007;21(4):413–427.

    Article  CAS  PubMed  Google Scholar 

  22. Miller AH, Ancoli-Israel S, Bower JE et al. Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol 2008;26(6):971–982.

    Article  CAS  PubMed  Google Scholar 

  23. al-Majid S, McCarthy DO. Cancer-induced fatigue and skeletal muscle wasting: the role of exercise. Biol Res Nurs 2001;2(3):186–197.

    Article  CAS  PubMed  Google Scholar 

  24. Berger AM, Wielgus K, Hertzog M et al. Patterns of circadian activity rhythms and their relationships with fatigue and anxiety/depression in women treated with breast cancer adjuvant chemotherapy. Support Care Cancer 2009.

  25. Rich T. Symptom clusters in cancer patients and their relation to EGFR ligand modulation of the circadian axis. J Support Oncol 2007;5:167–174.

    CAS  PubMed  Google Scholar 

  26. Mendoza TR, Wang XS, Cleeland CS et al. The rapid assessment of fatigue severity in cancer patients: use of the Brief Fatigue Inventory. Cancer 1999; 85(5):1186–1196.

    Article  CAS  PubMed  Google Scholar 

  27. Dodd MJ, Miaskowski C, Paul SM. Symptom clusters and their effect on the functional status of patients with cancer. Oncol Nurs Forum 2001;28(3): 465–470.

    CAS  PubMed  Google Scholar 

  28. Fox SW, Lyon DE. Symptom clusters and quality of life in survivors of lung cancer. Oncol Nurs Forum 2006;33(5):931–936.

    Article  PubMed  Google Scholar 

  29. Fox SW, Lyon D. Symptom clusters and quality of life in survivors of ovarian cancer. Cancer Nurs 2007;30(5):354–361.

    Article  PubMed  Google Scholar 

  30. Minton O, Richardson A, Sharpe M et al. A systematic review and meta-analysis of the pharmacological treatment of cancer-related fatigue. J Natl Cancer Inst 2008;100(16):1155.

    Article  CAS  PubMed  Google Scholar 

  31. Spence RR, Heesch KC, Brown WJ. Exercise and cancer rehabilitation: A systematic review. Cancer Treat Rev. 2010 Apr;36(2):185–194.

    Article  PubMed  Google Scholar 

  32. Knols R, Aaronson N, Uebelhart D et al. Physical exercise in cancer patients during and after medical treatment: a systematic review of randomized and controlled clinical trials. J Clin Oncol 2005;23(16): 3830–3842.

    Article  PubMed  Google Scholar 

  33. Dimeo F, Thiel E. Körperliche Aktivität und Sport bei Krebspatienten. Der Onkologe 2008;14(1): 31–37.

    Article  Google Scholar 

  34. Fasching P, Hübner J, Kleeberg U. Körperliche Bewegung und Sport zur Prävention und Behandlung von Krebskrankheiten. Der Onkologe 2009; 15(7):696–701.

    Article  Google Scholar 

  35. Adamietz IA. Sport bei Krebspatienten. Der Onkologe 2010;16(2):189–204.

    Article  Google Scholar 

  36. Kangas M, Bovbjerg D, Montgomery G. Cancerrelated fatigue: A systematic and meta-analytic review of non-pharmacological therapies for cancer patients. Psych Bull 2008;134(5):700–741.

    Article  Google Scholar 

  37. Brown JK. A systematic review of the evidence on symptom management of cancer-related anorexia and cachexia. Oncol Nurs Forum 2002;29(3): 517–532.

    Article  PubMed  Google Scholar 

  38. Cella D, Peterman A, Passik S et al. Progress toward guidelines for the management of fatigue. Onco logy 1998;12(11A):369–377.

    CAS  Google Scholar 

  39. Barsevick AM, Dudley W, Beck S et al. A randomized clinical trial of energy conservation for patients with cancer-related fatigue. Cancer 2004;100(6): 1302–1310.

    Article  PubMed  Google Scholar 

  40. Stuhldreher N, Reif K, de Vries U et al. Development and evaluation of a cancer-related fatigue patient education program: protocol of a randomized controlled trial. BMC Nurs 2008;7:12.

    Article  PubMed  Google Scholar 

  41. Glaus A, Müller S. Messung der Müdigkeit bei Krebskranken im Deutschen Sprachraum: Die Entwicklung des Fatigue Assessment Questionnaires. Pflege 2001;14(3):161–170.

    Article  CAS  PubMed  Google Scholar 

  42. Jerusalem M, Schwarzer R. Selbstwirksamkeit. In: Schwarzer R, Hrsg. Skalen zur Befindlichkeit und Persönlichkeit. Berlin: Institut für Psychologie, Freie Universität Berlin, 1986:15–28.

    Google Scholar 

  43. Frey I, Berg A, Grathwohl D et al.. Freiburger Fragebogen zur körperlichen Aktivität — Entwicklung, Prüfung und Anwendung. Sozial-und Präventivmedizin 1999;44(2):55–64.

    CAS  PubMed  Google Scholar 

  44. Aaronson NK, Ahmedzai S, Bergman B et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85(5): 365–376.

    Article  CAS  PubMed  Google Scholar 

  45. Herrmann C, Buss U. Vorstellung und Validierung einer deutschen Version der“ Hospital Anxiety and Depression Scale“(HAD-Skala): ein Fragebogen zur Erfassung des psychischen Befindens bei Patienten mit körperlichen Beschwerden. Diagnostica 1994; 40(2):143–154.

    Google Scholar 

  46. Rehse B, Reuter E, Schneider B et al. Inanspruchnahme und Akzeptanzvergleich eines psychoonkologischen Nachsorgeangebots bei von Brustkrebs betroffenen Frauen. Geburtsh Frauenheilk 2008;68: 907–914.

    Article  Google Scholar 

  47. Rau J, Teichmann J, Petermann F, Motivation for exercise of cancer patients — A longitudinal study of the transtheoretical model (TTM). Psychother Psych Med 2008;58(2):58–62.

    Article  Google Scholar 

  48. de Vries U, Mühlig S, Waldmann H et al. Patient satisfaction with different asthma-training variants. Patient Educ Couns 2008;70(2):266–275.

    Article  PubMed  Google Scholar 

  49. Goedendorp M, Gielissen M, Verhagen C et al. Psychosocial interventions for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev. 2009 Jan 21;(1):CD006953.

    Google Scholar 

  50. Schmitz K, Holtzman J, Courneya K et al. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2005;14(7):1588.

    Article  PubMed  Google Scholar 

  51. Fitzpatrick R. Surveys of patients satisfaction: I-Important general considerations. BMJ 1991;302(6781): 887.

    Article  CAS  PubMed  Google Scholar 

  52. Ross C, Steward C, Sinacore J. A comparative study of seven measures of patient satifaction. Med Care 1995;33(4):392–406.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Institut für Public Health und Pflegeforschung der Universität Bremen, Bremen, Germany

    Karl Reif, Ulrike de Vries & Stefan Görres

  2. Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany

    Ulrike de Vries & Franz Petermann

  3. Institut für Public Health und Pflegeforschung, Universität Bremen, Grazer Straße 4, 28359, Bremen, Germany

    Karl Reif

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  1. Karl Reif
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  2. Ulrike de Vries
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  3. Franz Petermann
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  4. Stefan Görres
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Correspondence to Karl Reif.

Additional information

* Die Studie wird vom Bundesministerium für Bildung und Forschung gefördert (FKZ: 01GT0605). Sie wurde von der Ethik-Kommission der Universität Bremen positiv bewertet und bei ClinicalTrials.gov registriert (Identifier: NCT00552552).

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Reif, K., de Vries, U., Petermann, F. et al. Chronische Fatigue bei Krebspatienten*. Med Klin 105, 779–786 (2010). https://doi.org/10.1007/s00063-010-1132-5

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  • DOI: https://doi.org/10.1007/s00063-010-1132-5

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