Do Terminally Ill Cancer Patients' Self-Assessments and Nurses' Assessments Agree on Cancer-Related Fatigue? A Cross-Sectional Study.

Abstract

Background: Cancer-related fatigue (CRF) is a distressing symptom in patients with terminal cancer. It is often under-assessed or remains unrecognized among health care professionals due to difficulties in identifying symptoms. However, fatigue ratings have not been studied extensively in incurable, terminally ill cancer patients with palliative intent or in nurses who provide daily care in palliative care teams or units.

Objective: This study examined the agreement between nurses' assessments and terminally ill cancer patients' self-assessments of CRF.

Methods: The correlation between patients' scores on the Cancer Fatigue Scale (CFS) and nurses' scores on the Japanese version of the Support Team Assessment Schedule (STAS-J) was matched in patient-nurse pairs. Paper versions of the questionnaires were answered by the patients and nurses at the time of the temperature check.

Results: Twenty-eight participants in 14 pairs with valid responses were included. There were 10 cases (71.4%) of agreement between the patients' and nurses' assessments of fatigue via the CFS and STAS-J, respectively. Among the four cases (28.6%) of incongruence, two (14.3%) were underestimated, and two were overestimated. Significant correlations were observed between the STAS-J and physical fatigue (rs = 0.66, p < 0.01), but total fatigue (rs = 0.47, p = 0.09), affective fatigue (rs= -0.09, p = 0.75), and cognitive fatigue (rs = 0.52, p = 0.06) showed no significant correlation.

Conclusion: Differences were primarily observed in affective fatigue; therefore, nurses must carefully consider affective fatigue when assessing fatigue in patients with terminal cancer.