Effect of perception control and self-management on cancer-related fatigue in breast cancer patients with chemotherapy

Objective To understand the status quo of perception control, self-management and cancer-related fatigue (CRF) in breast cancer patients receiving chemotherapy, and to investigate the impacts of perception control and self-management on CRF. Methods In this study, 246 breast cancer patients undergoing chemotherapy from Shandong Cancer Hospital and Institute were investigated by means of cross-sectional survey. Cancer experience and efficiency scale was used to evaluate the patients′ perception control; cancer patients′ self-management scale was used to assess their self-management; and Piper Fatigue Scale was used to evaluate their CRF. Finally, the scores of CRF among the patients with different demographic data were compared, and the effects of perception control and self-management behavior on CRF were analyzed. Results In univariate analysis, there were statistically significant differences of CRF scores resulting from different educational backgrounds (F=3.392, P=0.019), sources of medical cost (F=4.368, P=0.005), disease stages (F=4.376, P=0.005), chemotherapy periods (F=3.865, P=0.010) and courses of disease (F=3.094, P=0.028). The differences in each dimension of perceived control cancer experience (F=7.248, P=0.001), control efficacy (F=96.595, P<0.001), self-management level of cancer patients (F=65.009, P<0.001) and CRF (F=130.973, P<0.001) were statistically significant. Cancer experience in perception control was positively correlated with CRF (r=0.467, P<0.001); control effectiveness and self-management of cancer patients were negatively correlated with CRF (r=-0.505, P<0.001; r=-0.564, P<0.001). Multiple linear regression showed that source of medical expenses (setting commercial insurance as the reference group), chemotherapy cycle (setting chemotherapy cycle ≥ 6 cycles as the reference group), cancer experience, control effectiveness, and self-management were entered in regression models, which could explain 55.5% of the total variation in CRF scores, and there was a significant linear relationship (F=17.100, P<0.001). Conclusion Medical staff should focus on CRF in patients at their own expense and in the 2-5 chemotherapy cycles. Cancer experience is positively correlated with CRF. Control effectiveness and self-management behavior are negatively correlated with CRF. Key words: Breast neoplasms; Fatigue; Analysis of influence factor; Perception control