Kanser Hastalarında Yorgunluğa Bağlı Psikososyal Sorunlar ve Çözüm Önerileri

Kanser hastalarında yorgunluk semptomu hastalığın başlangıcından itibaren bireyi etkileyebilmekte ve tedavi tamamlandıktan aylar hatta yıllar sonra bile devam edebilmektedir. Kanserin tedavisi ve tedaviden kaynaklanan yan etkilerle ilgili sevindirici gelişmeler yaşanmasına karşın yorgunluğun giderilmesinde halen etkili tedavi girişimlerinden söz etmek olası değildir. Yorgunlukla bağlantılı psiko-sosyal sorunlar günlük yaşam aktivitelerinden meslek yaşamına kadar geniş bir yelpazede hastanın yaşamını sınırlayarak yaşam kalitesini olumsuz yönde etkiler. Uluslararası standartlara göre geliştirilmiş bir ölçüm aracıyla yorgunluğun saptanıp hastanın tıbbi tedavinin yanı sıra davranış terapisi, hasta eğitimi gibi diğer tedavi ve yöntemlerden yararlanması sağlanmalıdır. Bu derlemede çoğunlukla hastalarda göz ardı edilen buna karşın hastanın yaşam kalitesini olumsuz etkileyen yorgunluk semptomu ve beraberinde getirdiği psiko-sosyal sorunların tanımlanması, tedavi ve bakımıyla ilgili çözüm önerilerinin tartışılması amaçlanmıştır.

Anahtar Kelimeler:

Yorgunluk, kanser, Psiko-sosyal sorunlar, kanser hastaları, psiko-onkoloji

Fatigue Related Psychosocial Problems in Cancer Patients and their Solutions

Fatigue in cancer patients may influence the individual from the very beginning of the disease, and may then continue months or even years after the treatment. Despite good progress in cancer therapy and reduction of side effects from the treatment, it still is not possible to talk about effective fatigue treatment. Fatigue related psycho-social problems limit the patient and negatively affect his/her quality of life: from daily activities to professional life. Fatigue measurement tool is developed according to international standards. For the patient's benefit it should be introduced into all stages of their medical treatment, behavior therapy and education. This review paper aims to discuss proposed solutions related to identification, treatment and care for the fatigue syndrome and concomitant psycho-social problems that are commonly overlooked despite having adverse effects on the patients' quality of life.

Keywords:

Fatigue, Cancer, Psychosocial problems, Cancer patient, Psycho-oncology,

PDF

___

Fox SW, Lyon D. Symptom clusters and quality of life in survivors of ovarian cancer. Cancer Nurs 2007;30:354–61.
Bag, B. Psiko-Onkoloji, Psikososyal Sorunlar ve Ölçüm Yöntemleri. Psikiyatride Güncel Yaklaşımlar-Current Approaches in Psychiatry 2012; 4:449-64.
Vogelzang NJ, Breitbart W, Cella D. Patient, caregiver, and oncologist perceptions of cancer related fatigue: results of a tripart assessment survey: The fatigue coalition. Semin Hematol 1997; 34:4–12.
Barton-Burke M. Cancer-related fatigue and sleep disturbances. Further research on the prevalence of these two symptoms in long-term cancer survivors can inform education, policy, and clinical practice. Am J Nurs. 2006; 106:72–7.
Prue G, Rankin J, Allen J. Cancer-related fatigue: a critical appraisal. Eur J Cancer. 2006; 42:846–63.
National Comprehensive Cancer Network. Clinical practice guidelines in oncology. Cancer related fatigue. 2011. Online http://www.nccn. org.
Stone P, Richards M, A’Hern R, Hardy J. A study to investigate the prevalence, severity and
correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Ann Oncol. 2000; 11:561–7.
Servaes P, Verhagen C, Bleijenberg G. Fatigue in cancer patient during and after treatment: prevalence, correlates and interventions. Eur J Cancer. 2002; 38:27–43.
Loge JH, Abrahamsen AF, Ekeberg O, Kaasa S. Hodgkin’s disease survivors more fatigued
than the general population. J Clin Oncol. 1999; 17: 253 –61.
Cella D. Factors influencing quality of life in cancer patients: anemia and fatigue. Semin Oncol. 1998; 25: 43–6.
Gabrilove JL, Cleeland CS, Livingston RB et al. Clinical evaluation of once-weekly dosing of epoetin alfa in chemotherapy patients: improvements in hemoglobin and quality of life are similar to three-times-weekly dosing. J Clin Oncol. 2001 ; 19: 2875–82.
Rüffer JU, Flechtner H, Heim M et al. Cancer fatigue syndrome. Versicherungsmed. 2003;55: 3 –7.
Forkel S, Krischke NR, Berger D et al. Do control beliefs suggest good quality of life? Psychooncology. 2001; 10:46.
Rüffer JU, F H. Fatigue-Diagnostik, klinische Implikationen und Therapie. Onkologe. 2006; 12: 36 –40.
Roscoe JA, Morrow GR, Hickok JT et al. Temporal interrelationships among fatigue, circadian rhythm and depression in breast cancer patients undergoing chemotherapy treatment. Support Care Cancer. 2002; 10:329–36.
de Vries U de, Reif K, Stuhldreher N et al. Tumorbedingte Fatigue. Z Gesundheitspsychol. 2009; 17:170–184.
Visser MR, Smets EM. Fatigue, depression and quality of life in cancer patients: how are they related? Support Care Cancer. 1998; 6:101.
Piper B, Lindsey A, Dodd M et al. The development of an instrument to measure the subjective dimension of fatigue. In: Key Aspects Of Comfort : Management Of Pain, Fatigue And Nausea. Funk S, Tornquist E, Champagne M et al. (eds.). Springer, New York. 1989.
Glaus A. Fatigue in patients with cancer. Analysis and assessment. Recent Results Cancer Res. 1998; 145: 72.
Okuyama T, Akechi T, Kugaya A, Okamura H, Shima Y, Maruguchi M et al. (2000): Development and validation of thecancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. J Pain Symptom Manage.2000; 19: 5.
Cella D, Davis K, Breitbart W, Curt G (2001) Cancer-related fatigue: prevalence of proposed diagnostic criteria in a United States sample of cancer survivors. J Clin Oncol. 2001;19: 3385.
Loge JH, Abrahamsen AF, Ekeberg O, Kaasa S. Fatigue and psychiatric morbidity among Hodgkin’s disease survivors. J Pain Symptom Manage. 2000; 19:91–9.
Higgins SC, Montgomery GH, Raptis G, Bovbjerg DH. Effect of pretreatment distress on daily fatigue after chemotherapy for breast cancer. J Oncol Pract.2008; 4:59–63.
Crawford J, Gabrilove JL. Therapeutic options for anemia and fatigue. 2000. http://oncology.medscape. com/.
Stone P, Richards M, A’Hern R, Hardy J. A study to investigate the prevalence, severity and
correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Ann Oncol. 2000; 11:561–7.
Hopwood P, Stephens RJ. Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol. 2000;18:893–903.
Brown MS, Kroenke MD. Cancer-related fatigue and its associations with depression and anxiety: a systematic review. Psychosomatics. 2009; 50:440–7.
Ryan JL, Carroll JK, Ryan EP et al. Mechanisms of cancer-related fatigue. Oncologist. 2007; 12:22–34.
Beck SL, Dudley WN, Barsevick A (2005) Pain, sleep disturbance, and fatigue in patients with cancer: using a mediation model to test a symptom cluster. Oncol Nurs Forum. 2005; 32:48–55.
Mallinson T, Cella D, Cashy J, Holzner B. Giving meaning to measure: linking self-reported fatigue and function to performance of everyday activities. J Pain Symptom Manage. 2006; 31:229–41.
Ahlberg K, Ekman T, Gaston-Johansson F. Fatigue, psychological distress, coping resources, and functional status during radiotherapy for uterine cancer. Oncol Nurs Forum.2005; 32:633–640.
Savard J, Simard S, Blanchet J et al. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 2001; 24:583–90.
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: 1155-66.
Bruera E, Valero V, Driver L et al. Patient-controlled methylphenidate for cancer fatigue: a double-blind, randomized, placebo-controlled trial. J Clin Oncol. 2006; 24: 2073-78.
Jones M, Schenkel B, Just J, Fallowfield L. Epoetin alfa improves quality of life in patients with cancer. Cancer. 2004; 101: 1720-32.
Mock V, Pickett M, Ropka ME et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Pract. 2001; 9:119–27.
Morrow GR, Andrews PL, Hickok JT et al. Fatigue associated with cancer and its treatment. Support Care Cancer 2002; 10: 389-98.
Brown P, Clark MM, Atherton P et al. Will improvement in quality of life (QOL) impact fatigue in patients receiving radiation therapy for advanced cancer? Am J Clin Oncol.2006; 29: 52–8.
de Vriesu, Reif K, Petermann F. Tumorbedingte Fatigue und ihre psychosozialen Hilfen. Urologe 2012; 51:413–421.

ISSN: 1300-3755
Yayın Aralığı: Yılda 4 Sayı
Başlangıç: 1992
Yayıncı: Çukurova Üniversitesi Tıp Fakültesi

Arşiv