Cancer-related fatigue in breast cancer patients after surgery: a multicomponent model using partial least squares-path modeling

Psychooncology. 2014 Apr;23(4):444-51. doi: 10.1002/pon.3438. Epub 2013 Oct 22.

Abstract

Objective: The aim of this study is to examine factors contributing to cancer-related fatigue (CRF) in breast cancer patients who have undergone surgery.

Methods: Sixty women (mean age: 50.0) completed self-rated questionnaires assessing components of CRF, muscular and cognitive functions. Also, physiological and subjective data were gathered. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to CRF after breast surgery.

Results: The tested model was robust in terms of its measurement quality (reliability and validity). According to the structural model results, emotional distress (β = 0.59; p < 0.001), pain (β = 0.23; p < 0.05), and altered vigilance (β = 0.30; p < 0.05) were associated with CRF, accounting for 61% of the explained variance. Also, emotional distress (β = 0.41; p < 0.05) and pain (β = 0.40; p < 0.05) were related to low physical function and accounted for 41% of the explained variance. However, the relationship between low physical function and CRF was weak and nonsignificant (β = 0.01; p > 0.05).

Conclusion: Emotional distress, altered vigilance capacity, and pain are associated with CRF in postsurgical breast cancer. In addition, emotional distress and pain are related to diminished physical function, which, in turn, has no significant impact on CRF. The current model should be examined in subsequent phases of the treatment (chemotherapy and/or radiotherapy) when side effects are more pronounced and may lead to increased intensity of CRF and low physical function.

Keywords: breast cancer; distress; fatigue; oncology; physical function; structural equation model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Arousal
  • Breast Neoplasms / complications
  • Breast Neoplasms / physiopathology
  • Breast Neoplasms / surgery*
  • Cognition / physiology*
  • Fatigue / complications
  • Fatigue / physiopathology*
  • Female
  • Humans
  • Least-Squares Analysis
  • Mastectomy
  • Mastectomy, Segmental
  • Memory, Short-Term
  • Middle Aged
  • Motor Activity / physiology
  • Muscle Strength / physiology
  • Pain / complications
  • Pain / physiopathology*
  • Reproducibility of Results
  • Stress, Psychological / complications
  • Stress, Psychological / physiopathology*
  • Surveys and Questionnaires