Network structures of general, physical and psychological fatigue in patients with metastatic colorectal cancer: Implications for targeted coping strategies

转移性结直肠癌患者的一般疲劳、生理疲劳和心理疲劳的网络结构:对有针对性的应对策略的启示

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Abstract

BACKGROUND: Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by many patients, affecting both their physical and psychological well-being. This study aims to explore the network organization of three dimensions of CRF (i.e., general, physical, and psychological) and to examine how patient's resources such as coping strategies interact with these distinct aspects of fatigue. METHOD: This study involves data from a previous observational study on patients with metastatic colorectal cancer undergoing chemotherapy. Participants (N = 169) completed several questionnaires at baseline. Partial correlation network analysis was used to model the relationships between patients' symptoms (i.e., CRF, emotional distress) and resources (i.e., perceived control of the illness, coping strategies, perceived social support), in three distinct networks, each of them including one dimension of fatigue (i.e., general, physical, or psychological). In each network, a core variable (i.e., a symptom or a resource) was identified based on the highest centrality indices. RESULTS: Coping strategies emerged as the core variable in the three networks, while depression was the symptom with the strongest association with CRF. These findings underline the interconnection between emotional state and fatigue, but most of all suggest the centrality of the patients' resources, specifically coping strategies used to manage their symptoms, and their potential role in influencing the symptoms. CONCLUSION: Our findings are expected to provide insights into targeted therapeutic approaches and enhance patient care. Understanding the complex interplay between the dimensions of fatigue and the coping strategies employed by patients is crucial for developing effective interventions.

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