Management of fatigue in palliative care patientsManagementul fatigabilității la pacienții în îngrijiri palliative

Management of fatigue in palliative care patients

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[:en]Loredana Aracs Tamaș, MD, oncologist, competence in palliative care, Emergency Hospital Satu Mare, Romania

Address for correspondence: e-mail: atloredana@yahoo.com

Abstract

Fatigue is a multidimensional phenomenon that develops over time, diminishes energy, mental ability, and psychological condition of cancer patients.

There are multiple scales that assess fatigue. One of the easiest is ESAS scale.

The possible interventions in the treatment of fatigue are divided into: non-pharmacological (physical activity, acupuncture and acupressure) and pharmacological (bupropion, dexamethasone, dexmetilfenidat, methylphenidate, modafinil, erythropoietin, ginseng).

Physical activity and acupuncture show a more pronounced reduction in fatigue compared to acupressure. Bupropion has proven efficacy in non-depressed patients compared to the depressed. Dexmetilfenidatul produces significant improvements in fatigue among patients previously treated with chemotherapy. Regarding methylphenidate we found two articles in antithesis. Patients with severe fatigue received modafinil treatment, while patients with moderate or mild fatigue not. The number of patients in the ginseng group perceived more benefit and were more satisfied with ginseng treatment compared with the placebo group. Increases in serum haemoglobin were associated with significant improvement of fatigue. Dexamethasone is more effective than placebo in improving cancer-induced fatigue and quality of life.

In conclusion, there is a small number of randomized controlled trials, and a small number of studies that address the effectiveness in the treatment of fatigue, but the results were positive, which offers further opportunities to improve the quality of life of cancer patients.

Key words: fatigue, cancer, scales, intervention, quality of life

(Full text in Romanian)

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