Fatigue and its associated factors in hospice cancer patients in Taiwan

Fatigue is one of the most distressful problems faced by terminally ill cancer patients, but few studies have explored fatigue experiences in this population. The purpose of this descriptive correlational study was to examine fatigue status and its related factors in terminally ill cancer patients in an institutionalized hospice in Northern Taiwan. Data were collected using the Fatigue subscale of the Profile of Mood States, modified Symptom Distress Scale, Hospital Anxiety and Depression Scale, Karnofsky's Performance Status Index and a background information form. We found that patients generally had moderate to severe levels of fatigue. Fatigue was associated with the overall symptom distress, depression, anxiety, and performance status. Furthermore, fatigue was significantly correlated with 8 individual distressful symptoms: nausea, vomiting, lack of appetite, sleep disturbance, dyspnea, dry mouth, restlessness, and problems of concentration. These results suggest that fatigue is still a problem faced by terminally ill cancer patients. To provide better care to this population, the above-mentioned fatigue-related factors should be simultaneously assessed and cared for. The authors recommend examining the causal relationship between these factors and fatigue, using symptom cluster concepts and skills to examine the possible shared mechanisms among fatigue and related symptoms and developing interventions to decrease fatigue in terminally ill cancer patients.