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International Journal of Palliative... May 2016Cancer-related fatigue (CRF) in a palliative care setting is a distressing symptom that can have a negative impact on a patient's quality of life. A range of setting-... (Review)
Review
Cancer-related fatigue (CRF) in a palliative care setting is a distressing symptom that can have a negative impact on a patient's quality of life. A range of setting- and disease-specific factors, unknown aetiology and absence of unilateral guidelines make CRF treatment a challenge for clinicians. In the absence of high-quality evidence in favour of any pharmacological and nonpharmacological measures, except exercise, cognitive behavioural therapy and psychosocial interventions, a personalised integrative oncology approach can lead to effective management. Findings suggest adoption of a severity-based symptom-stage adjusted CRF management care pathway, highlighting best practices to illustrate the lived experience of this symptom. Overcoming barriers by staff training, patient education, facilitating communication and patients' self-care, will increase CRF management effectiveness. Future CRF multisymptom or multidimensional nature investigation trials of its underlying mechanisms and new pharmacological and nonpharmacological strategies applied separately or in combination, will help reveal the best approach to CRF diagnosis, assessment and management.
Topics: Fatigue; Humans; Neoplasms; Palliative Care; Surveys and Questionnaires
PubMed: 27233012
DOI: 10.12968/ijpn.2016.22.5.244 -
Canadian Journal of Surgery. Journal... Apr 2016
Topics: Canada; Caregivers; Decision Making; Fatigue; Humans; Proxy; Terminal Care
PubMed: 27007086
DOI: 10.1503/cjs.002616 -
The Oncologist 2007Cancer-related fatigue (CRF) is one of the most prevalent symptoms patients with cancer experience, both during and after treatment. CRF is pervasive and affects... (Review)
Review
Cancer-related fatigue (CRF) is one of the most prevalent symptoms patients with cancer experience, both during and after treatment. CRF is pervasive and affects patients' quality of life considerably. It is important, therefore, to understand the underlying pathophysiology of CRF in order to develop useful strategies for prevention and treatment. At present, the etiology of CRF is poorly understood and the relative contributions of the neoplastic disease, various forms of cancer therapy, and comorbid conditions (e.g., anemia, cachexia, sleep disorders, depression) remain unclear. In any individual, the etiology of CRF probably involves the dysregulation of several physiological and biochemical systems. Mechanisms proposed as underlying CRF include 5-HT neurotransmitter dysregulation, vagal afferent activation, alterations in muscle and ATP metabolism, hypothalamic-pituitary-adrenal axis dysfunction, circadian rhythm disruption, and cytokine dysregulation. Currently, these hypotheses are largely based on evidence from other conditions in which fatigue is a characteristic, in particular chronic fatigue syndrome and exercise-induced fatigue. The mechanisms that lead to fatigue in these conditions provide a theoretical basis for future research into the complex etiology of this distressing and debilitating symptom. An understanding of relevant mechanisms may offer potential routes for its prevention and treatment in patients with cancer.Disclosure of potential conflicts of interest is found at the end of this article.
Topics: Circadian Rhythm; Cytokines; Fatigue; Humans; Muscles; Neoplasms; Quality of Life; Serotonin
PubMed: 17573453
DOI: 10.1634/theoncologist.12-S1-22 -
PloS One 2016Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007-2010 Q-fever outbreak in the Netherlands with... (Review)
Review
BACKGROUND
Long-term fatigue with detrimental effects on daily functioning often occurs following acute Q-fever. Following the 2007-2010 Q-fever outbreak in the Netherlands with over 4000 notified cases, the emphasis on long-term consequences of Q-fever increased. The aim of this study was to provide an overview of all relevant available literature, and to identify knowledge gaps regarding the definition, diagnosis, background, description, aetiology, prevention, therapy, and prognosis, of fatigue following acute Q-fever.
DESIGN
A systematic review was conducted through searching Pubmed, Embase, and PsycInfo for relevant literature up to 26th May 2015. References of included articles were hand searched for additional documents, and included articles were quality assessed.
RESULTS
Fifty-seven articles were included and four documents classified as grey literature. The quality of most studies was low. The studies suggest that although most patients recover from fatigue within 6-12 months after acute Q-fever, approximately 20% remain chronically fatigued. Several names are used indicating fatigue following acute Q-fever, of which Q-fever fatigue syndrome (QFS) is most customary. Although QFS is described to occur frequently in many countries, a uniform definition is lacking. The studies report major health and work-related consequences, and is frequently accompanied by nonspecific complaints. There is no consensus with regard to aetiology, prevention, treatment, and prognosis.
CONCLUSIONS
Long-term fatigue following acute Q-fever, generally referred to as QFS, has major health-related consequences. However, information on aetiology, prevention, treatment, and prognosis of QFS is underrepresented in the international literature. In order to facilitate comparison of findings, and as platform for future studies, a uniform definition and diagnostic work-up and uniform measurement tools for QFS are proposed.
Topics: Disease Outbreaks; Fatigue; Humans; Netherlands; Q Fever; Time Factors
PubMed: 27223465
DOI: 10.1371/journal.pone.0155884 -
Anaesthesia Sep 2021
Topics: Critical Care; Critical Illness; Fatigue; Humans; Quality of Life; Self-Management; Survivors
PubMed: 33878209
DOI: 10.1111/anae.15474 -
Biomedicine & Pharmacotherapy =... Dec 2022Cancer-related fatigue (CRF) is one of the common complications of cancer patients, with occult onset, long duration, and unfavorable treatment outcomes, which is... (Review)
Review
Cancer-related fatigue (CRF) is one of the common complications of cancer patients, with occult onset, long duration, and unfavorable treatment outcomes, which is disturbing to patients and clinicians. Chinese medicine has natural and unique advantages in improving CRF symptoms. Bu-Zhong-Yi-Qi decoction is commonly applied for treating CRF. In this study, we intend to further study the effect and mechanism of Bu-Zhong-Yi-Qi decoction in the treatment of CRF, and explore the active chemical components of the medicinal herbs. To this end, we reviewed the previous clinical research and experiments, analyzed the molecular mechanism, pharmacological effect, active chemical composition and its target of action in the treatment of CRF with tonic and Bu-Zhong-Yi-Qi decoction, which provided a theoretical basis for future research and practice.
Topics: Humans; Drugs, Chinese Herbal; Fatigue; Neoplasms
PubMed: 36411646
DOI: 10.1016/j.biopha.2022.113969 -
International Journal of Environmental... Feb 2023Airline cabin crew operate in dynamic work environments that are continuously changing, from unpredictable shift work hours to travelling through multiple time zones.... (Review)
Review
Airline cabin crew operate in dynamic work environments that are continuously changing, from unpredictable shift work hours to travelling through multiple time zones. These likely impact cabin crews' overall health and may affect their performance on safety-related tasks. Research on this population has been limited; therefore, the aim was to summarise the relevant literature regarding fatigue, sleepiness and mental health of cabin crew. This review followed the PRISMA-ScR guidelines and conducted a systematic search utilising five databases. The initial search identified 1223 studies, and through vigorous screening processes, 27 studies were selected for this review. Over half of the selected studies focused on international or long-haul flights, and a large proportion of the sample participants were women. Findings suggested a high prevalence of fatigue and sleepiness as well as unsatisfactory sleep quality with elevated susceptibility to sleep disorders. Factors identified with health outcomes were associated with flight operations (e.g., rosters) and individual differences (e.g., age and coping strategies). Regarding mental health, cabin crews are potentially at a greater risk for depression and anxiety compared to the general public. This review draws attention to the importance of using a standardised approach, such as validated measures for fair and consistent inferences.
Topics: Humans; Female; Male; Sleepiness; Sleep; Wakefulness; Fatigue
PubMed: 36768014
DOI: 10.3390/ijerph20032652 -
Ear and Hearing 2016Fatigue is common in individuals with a variety of chronic health conditions and can have significant negative effects on quality of life. Although limited in scope,... (Review)
Review
Fatigue is common in individuals with a variety of chronic health conditions and can have significant negative effects on quality of life. Although limited in scope, recent work suggests persons with hearing loss may be at increased risk for fatigue, in part due to effortful listening that is exacerbated by their hearing impairment. However, the mechanisms responsible for hearing loss-related fatigue, and the efficacy of audiologic interventions for reducing fatigue, remain unclear. To improve our understanding of hearing loss-related fatigue, as a field it is important to develop a common conceptual understanding of this construct. In this article, the broader fatigue literature is reviewed to identify and describe core constructs, consequences, and methods for assessing fatigue and related constructs. Finally, the current knowledge linking hearing loss and fatigue is described and may be summarized as follows: Hearing impairment may increase the risk of subjective fatigue and vigor deficits; adults with hearing loss require more time to recover from fatigue after work and have more work absences; sustained, effortful, listening can be fatiguing; optimal methods for eliciting and measuring fatigue in persons with hearing loss remain unclear and may vary with listening condition; and amplification may minimize decrements in cognitive processing speed during sustained effortful listening. Future research is needed to develop reliable measurement methods to quantify hearing loss-related fatigue, explore factors responsible for modulating fatigue in people with hearing loss, and identify and evaluate potential interventions for reducing hearing loss-related fatigue.
Topics: Classification; Cognition; Fatigue; Hearing Loss; Humans; Mental Fatigue; Quality of Life
PubMed: 27355763
DOI: 10.1097/AUD.0000000000000289 -
PloS One 2017Multiple Sclerosis (MS) is an inflammatory and neurodegenerative disease often causing decreased quality of life, social withdrawal and unemployment. Studies examining... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Multiple Sclerosis (MS) is an inflammatory and neurodegenerative disease often causing decreased quality of life, social withdrawal and unemployment. Studies examining the effect of pharmacological interventions demonstrated only minor effects, whereas non-pharmacological interventions as e.g. patient education programs have shown promising results.
OBJECTIVE
We aim to systematically review the literature to determine the effect of patient education programs on fatigue in MS.
METHODS
We conducted a comprehensive search in PubMed for randomized controlled trials (RCTs) that evaluated patient education programs for MS-related fatigue. Interventions evaluating physical exercise and/or pharmacological treatments were not included. Meta-analyses were performed using the generic inverse variance method.
RESULTS
The search identified 856 citations. After full-text screening we identified ten trials that met the inclusion criteria. Data of 1021 participants were analyzed. Meta-analyses showed significant positive effects on fatigue severity (weighted mean difference -0.43; 95% CI -0.74 to -0.11) and fatigue impact (-0.48; -0.82 to -0.15), but not for depression (-0.35 (95% CI -0.75 to 0.05; p = 0.08). Essentially, we categorized patient education programs into two types: firstly, interventions with a focus on cognitive-behavioral therapy (CBT) and secondly, interventions that teach patients ways of managing daily fatigue. CBT-based approaches seem to generate better results in reducing patient-reported fatigue severity. Analysing CBT studies only, the pooled weighted mean difference for fatigue severity was -0.60 (95% CI; -1.08 to -0.11) compared to non-CBT approaches (-0.20; 95% CI; -0.60 to -0.19). Furthermore, interventions employing an individual approach seem to reduce fatigue more effectively than group-based approaches (pooled weighted mean difference for fatigue severity in face-to-face studies was -0.80 (95% CI; -1.13 to -0.47) compared to group-based studies with -0,17 (95% CI; -0,39 to 0,05). Longest follow-up data were available for 12 months post-intervention.
CONCLUSION
Overall, included studies demonstrated that educational programs and especially CBT-based approaches have a positive effect on reducing fatigue. Since fatigue is thought to be a multidimensional symptom, it should be treated with a multidimensional approach targeting patients' behavior as well as their emotional and mental attitude towards fatigue. However, the clinical relevance of the treatment effects i.e. the relevance for patients' daily functioning remains unclear and long-term effects, i.e. sustainability of effects beyond 6 months, warrants further work. This review has been registered in the PROSPERO international prospective register of systematic reviews data base (Registration number: CRD42014014224).
Topics: Depression; Disease Management; Fatigue; Humans; Multiple Sclerosis; Patient Education as Topic; Patient Outcome Assessment; Quality of Life; Severity of Illness Index
PubMed: 28267811
DOI: 10.1371/journal.pone.0173025 -
Srpski Arhiv Za Celokupno Lekarstvo 2012Fatigue is a prominent symptom in a large number of medical conditions, malignant and infectious diseases. Fatigue is also a prominent symptom of sarcoidosis. The... (Review)
Review
Fatigue is a prominent symptom in a large number of medical conditions, malignant and infectious diseases. Fatigue is also a prominent symptom of sarcoidosis. The occurrence of fatigue in sarcoidosis is well known but exact incidence has not been established and varies from 30-70% of patients depending on age, sex and organ involvement by the granulomatous process. The exact definition of fatigue varies broadly. It can be both physical and mental. The patients describe their sensation of fatigue qualitatively different from that fatigue they experienced before they became sick. Fatigue has a major impact on the quality of life in sarcoidosis. Establishing the extent of fatigue in sarcoidosis provides relevant insight regarding the patient's quality of life. Unfortunately there is no objective parameter for assessing fatigue in sarcoidosis. Generally, fatigue is detected by means of questionnaires. Regarding the therapy, there is no effective treatment for fatigue in sarcoidosis.
Topics: Fatigue; Humans; Sarcoidosis
PubMed: 22462358
DOI: No ID Found