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Pain and Fatigue Interrelations in Terminally Ill Inpatients: A PCOC-Based Analysis
Meng-Chen Chan1, Cheng-Fu Lin2, Jia-Jyun Wu3
1Department of Medical Education (M.C.C.), Taichung Veterans General Hospital, Taichung, Taiwan.
Journal of Pain and Symptom Management
|November 6, 2025
Summary
Pain and fatigue are common in advanced illness. Standardized assessment revealed factors like sex, age, and other symptoms influence their severity, highlighting the need for comprehensive care.
Area of Science:
- Palliative Care Medicine
- Symptom Management
- Geriatric Medicine
Background:
- Pain and fatigue are prevalent and burdensome symptoms in advanced serious illness.
- Daily fluctuations of these symptoms are often not captured using standardized tools.
Purpose of the Study:
- To examine factors associated with daily pain and fatigue severity in advanced serious illness.
- Utilized the Palliative Care Outcomes Collaboration (PCOC) framework in a Taiwanese palliative care setting.
Main Methods:
- Retrospective observational study of 755 patients in a Taiwanese palliative care unit.
- Daily assessments using validated PCOC instruments.
- Generalized estimating equations (GEE) analyzed associations between symptoms, demographics, clinical factors, and functional status.
Main Results:
- Fatigue and pain were the highest-scoring symptoms.
- Pain severity linked to female sex, younger age, unstable phase, sleep disturbance, appetite loss, bowel problems, and fatigue.
- Fatigue severity associated with breathlessness, pain, appetite loss, and functional impairments, differing between cancer and non-cancer patients.
Conclusions:
- Pain and fatigue are interconnected symptoms in advanced serious illness.
- Standardized assessment using the PCOC framework is crucial for comprehensive symptom management.
- Treating one symptom may positively impact the other, emphasizing integrated care approaches.
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