Barriers to discussing fatigue in oncological care: a comparative study of patient perspectives after two decades

Healthcare providers and oncology patients may assess fatigue differently without direct communication. This study was performed to compare patient barriers to discussing cancer-related fatigue with healthcare providers in 2002 and 2023/24 using the Polish adaptation of the Fatigue Management Barriers Questionnaire (FMBQ). The FMBQ measures the intensity of barriers in communicating with medical staff about fatigue.

This cross-sectional study with a historical comparison utilized the FMBQ, the Chalder Fatigue Questionnaire (CFQ-PL), the Multidimensional Scale of Perceived Social Support (MSPSS), and a custom-designed questionnaire. The study was conducted at the turn of 2023 and 2024, with participants recruited during hospitalization in the preoperative period as part of their treatment process.

The study included 54 women with histopathologically confirmed reproductive organ malignancies (68% ovarian cancer, 28% endometrial and cervical cancer). The Polish adaptation of the FMBQ demonstrated good psychometric properties, which have been preliminarily confirmed. No significant correlations were found between barriers to communication and fatigue intensity, illness duration, or length of treatment. Two decades after the first study on barriers to discussing fatigue, these barriers persist and have intensified. This is particularly evident in concerns regarding the futility of addressing fatigue, the fear of jeopardizing cancer treatment, and the avoidance of the topic due to concerns that fatigue may signal disease progression. Additionally, patients report an increased need to maintain the image of a "good patient" by avoiding complaints, along with growing concerns about excessive medication use. The percentage of patients not asked about fatigue by medical staff has remained consistent over time (25%-33%). Present-day key barriers to discussing fatigue include the desire to limit medication intake (53%), the effort to maintain a "good patient" image (49%), the belief that fatigue is a less important issue (42%), and fears that it is either a side effect of treatment (38%) or an indicator of disease progression (36%).

Barriers to discussing fatigue remain a significant issue in cancer care. Addressing these barriers through education and structured communication strategies could enhance supportive care for oncology patients.