The Effects of Health State, Hemoglobin, Global Symptom Distress, Mood Disturbance, and Treatment Site on Fatigue Onset, Duration, and Distress in Patients Receiving Radiation Therapy

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Abstract
To describe the fatigue experience of patients with cancer receiving radiation therapy and determine to what extent diverse correlates of fatigue affect fatigue onset, duration, and distress. Descriptive correlational study completed by secondary data analysis. Data were obtained from 384 subjects recruited from two urban, university-affiliated, radiation oncology clinics located in a large, Midwestern city. The effects of health indicators and treatment site on fatigue onset, duration, and distress were examined using correlational analyses and analyses of variance. Hemoglobin, health status, global symptom distress, mood disturbance, treatment site, and fatigue onset, duration, and distress. Fatigue started near the middle of the second week of treatment, was moderately distressing, and lasted approximately 32 days. Higher levels of health and hemoglobin at the start of therapy were associated with a delayed onset, shorter duration, and lower levels of fatigue distress. In contrast, higher pretreatment levels of global symptom distress and mood disturbance were associated with an earlier onset, longer duration, and greater severity of fatigue distress. The fatigue experience in patients undergoing radiation therapy is highly individualized. Variations in the health states of patients as well as the area of the body being treated can influence fatigue onset, duration, and distress. Pretreatment screening for fatigue and its correlates is needed to identify patients at risk for an earlier onset, longer duration, and more distressing levels of fatigue.