Fatigue and its correlates in cancer patients who had returned to work--a cohort study

Fatigue and other symptoms in cancer patients often interfere with social and occupational activities. Only a few studies, however, have examined relationship between fatigue and work-related outcomes. The aim of this study was to investigate which disease-related factors (treatment, diagnosis, cognitive dysfunction, depression, pain, and sleep disturbance) and work-related factors (work-load, work pressure, relationship to supervisor and colleagues, size of the company, and workplace accommodations) were related to fatigue in employed cancer survivors. Data was collected by questionnaire at 6 months (baseline) and 18 months (end of the follow-up) after cancer diagnosis from 135 people with different types of cancer who had returned to work at follow-up. Fatigue was measured with a four-item sub-scale of MFI. Scores ranged from 4 to 20, with higher scores indicating more fatigue. The mean rate of general fatigue was 11.9 at baseline decreasing to 10.4 at the end of the follow-up (p <0.0001). At 6 months, higher work pressure (p = 0.02), physical workload (p <0.05) and less workplace accommodations (p = 0.03) were related to higher levels of fatigue. From disease-related factors, depression was associated with fatigue (p <0.0001) at baseline. Lack of workplace accommodations was the only factor affecting higher levels of fatigue at 18 months (p <0.001) and was also related to higher levels of depression at 6 months (p = 0.02) and at 18 months (p <0.001). Lack of workplace accommodations was significantly related to fatigue at the end of the follow-up, which suggests that accommodations for illness can help to reduce fatigue and depression