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Open Access Research article

An examination of cancer-related fatigue through proposed diagnostic criteria in a sample of cancer patients in Taiwan

En-Tien Yeh12, Shu-Chuen Lau13, Wei-Ju Su4, Duu-Jian Tsai5, Ying-Yueh Tu6 and Yuen-Liang Lai45789*

Author Affiliations

1 Department of Family Medicine, Cardinal Tien Hospital, 362 Zhongzheng Rd, Xindian District, New Taipei City, 231 Taiwan

2 Department of Hospice and Palliative Care, Cardinal Tien Hospital, 362 Zhongzheng Rd, Xindian District, New Taipei City, 231 Taiwan

3 School of Medicine, Fu Jen Catholic University, 510 Zhongzheng Rd, Xinzhuang District, New Taipei City, 242 Taiwan

4 Graduate Institute of Humanities in Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110 Taiwan

5 School of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110 Taiwan

6 Department of Family Medicine, Taipei Medical University-Shuang Ho Hospital, 291 Jhongjheng Rd, Jhonghe District, New Taipei City, 235 Taiwan

7 Department of Radiation Oncology, Taipei Medical University-Shuang Ho Hospital, 291 Jhongjheng Rd, Jhonghe District, New Taipei City, 235 Taiwan

8 Education Center for Humanities and Social Sciences, National Yang-Ming University, 155 Linong Street, Sec 2, Taipei, 112 Taiwan

9 Mackay Medical College, 46 Zhongzheng Rd, Sec 3, Sanzhi District, New Taipei City, 252 Taiwan

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BMC Cancer 2011, 11:387  doi:10.1186/1471-2407-11-387

Published: 6 September 2011

Abstract

Background

Fatigue among cancer patients has often been reported in the literature; however, great variations have been documented, ranging from 15% to 90%, probably due to the lack of a widely accepted definition and established diagnostic criteria for cancer-related fatigue. The objective of this study was to evaluate the proposed International Statistical Classification of Diseases and Related Health Problems (10th revision) (ICD-10) criteria in a sample of cancer patients from a medical center and a regional teaching hospital in northern Taiwan. More accurate prevalence estimates of CRF may result in improved diagnoses and management of one of the most common symptoms associated with cancer and its treatment.

Methods

Since self-reporting from patients is the most effective and efficient method to measure fatigue, the ICD-10 criteria for fatigue were used. The ICD-10 criteria questionnaire was translated into Chinese and was approved by experts. Patients were recruited from outpatient palliative and oncology clinics and from palliative and oncology inpatient units.

Results

Of the 265 cancer patients that were interviewed between 21 October 2008 and 28 October 2009, 228 (86%) reported having at least 2 weeks of fatigue in the past month, and further evaluation with the ICD-10 criteria showed that 132 (49.8%) had cancer-related fatigue. Internal consistency was very good, which was indicated by a Cronbach alpha of 0.843.

Conclusion

The prevalence of diagnosable CRF in the patients in this sample, of whom most were under palliative treatment, was 49.8%, which was probably somewhat lower than in some of the previous reports that have used less-strict criteria. In addition, among the various criteria of the proposed diagnostic criteria, the most frequently reported symptoms in our sample populations were regarding sleep disturbance and physical factors. Although they will require further replication in other samples, these formal diagnostic criteria can serve as a step toward a common language and a better understanding of the severity range of CRF.

Keywords:
fatigue; prevalence; diagnosis; cancer