A prospective longitudinal study of the changes in multidimensional fatigue and its associated factors in patients undergoing brachytherapy for cervical cancer
The changes of multidimensional fatigue and associated factors in patients undergoing brachytherapy for cervical cancer are unknown. This study aimed to evaluate changes in multidimensional fatigue with associated factors during and one month after the brachytherapy. This prospective longitudinal study recruited 188 patients undergoing brachytherapy for cervical cancer. They were assessed before the brachytherapy began (T0), after three sessions of brachytherapy (T1), after five sessions of brachytherapy (T2), one month after the whole brachytherapy (T3). Generalized estimating equation analysis was used to determine the factors associated with changes in multidimensional fatigue over time. In this study, total fatigue and five dimensions slightly increased from T0 to T2, with the lowest levels observed at T3. Anxiety, depression, and multidimensional fatigue showed statistically significant differences between T3 and T0, T1, T2. Family adaptability and cohesion showed non-significant changes across four time points. Participants who were older and had more severe anxiety and depression were more likely to experience worse total fatigue (β = 0.084, 0.509, 0.596, respectively), physical fatigue (β = 0.025, 0.078, 0.126, respectively), and reduced motivation (β = 0.027, 0.092, 0.104, respectively). Participants with more severe anxiety and depression were more likely to experience worse general fatigue (β = 0.144 and 0.144, respectively), mental fatigue (β = 0.107 and 0.112, respectively), and reduced activity (β = 0.087 and 0.110, respectively). Older age, more severe anxiety and depression, were significantly associated with worse multidimensional fatigue in patients undergoing brachytherapy for cervical cancer. Healthcare professionals need to continuously monitor multidimensional fatigue, anxiety, and depression during and after brachytherapy.