Effects of cognitive behavior therapy in severely fatigued disease-free cancer patients compared with patients waiting for cognitive behavior therapy: a randomized controlled trial.
until further notice
SourceJournal of Clinical Oncology, 24, 30, (2006), pp. 4882-4887
Article / Letter to editor
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Journal of Clinical Oncology
SubjectEBP 3: Effective Primary Care and Public Health; EBP 4: Quality of Care; NCEBP 10: Human Movement & Fatigue; NCEBP 1: Molecular epidemiology; NCEBP 7: Effective primary care and public health; NCEBP 8: Psychological determinants of chronic illness; ONCOL 1: Hereditary cancer and cancer-related syndromes; ONCOL 3: Translational research; ONCOL 4: Quality of Care; ONCOL 5: Aetiology, screening and detection; UMCN 1.1: Functional Imaging; UMCN 1.2: Molecular diagnosis, prognosis and monitoring; UMCN 1.5: Interventional oncology; UMCN 4.1: Microbial pathogenesis and host defense; NCEBP 10: Human Movement & Fatigue
PURPOSE: Persistent fatigue is a long-term adverse effect experienced by 30% to 40% of patients cured of cancer. The main objective of this randomized controlled trial was to show the effectiveness of cognitive behavior therapy (CBT) especially designed for fatigue in cancer survivors. PATIENTS AND METHODS: A total of 112 cancer survivors with somatically unexplained fatigue were allocated randomly to immediate cognitive behavior therapy or to a waiting list condition for therapy. Both conditions were assessed two times, at baseline and 6 months later. The primary outcome variables were fatigue severity (Checklist Individual Strength) and functional impairment (Sickness Impact Profile). Data were analyzed by intention to treat. RESULTS: Analyses were based on 50 patients in the intervention condition and 48 patients in the waiting list condition. Patients in the intervention condition reported a significantly greater decrease than patients in the waiting list condition in fatigue severity (difference, 13.3; 95% CI, 8.6 to 18.1) and in functional impairment (difference, 383.2; 95% CI, 197.1 to 569.2). Clinically significant improvement for the CBT group compared with the waiting list group was seen in fatigue severity (54% v 4% of the patients, respectively) and in functional impairment (50% v 18% of the patients, respectively). CONCLUSION: Cognitive behavior therapy has a clinically relevant effect in reducing fatigue and functional impairments in cancer survivors.
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