Cancer-related fatigue and functional impairment – Towards an understanding of cognitive and behavioural factors: Hughes, Chalder et al May 2020

Sly Saint

Sly Saint

Senior Member (Voting Rights)
Abstract
Objective
Fatigue is a highly prevalent and debilitating problem in women with breast cancer. This study investigated the cognitive, behavioural, interpersonal and affective responses associated with fatigue and functional impairment for women with breast cancer undergoing chemotherapy. A nested prospective study examined factors predictive of cancer-related fatigue after three cycles of chemotherapy.

Method
159 women with breast cancer who were about to begin or undergoing chemotherapy completed a range of measures. Correlational and multiple regression analyses explored associations between fatigue severity, functioning and a range of psychological, behavioural, demographic and clinical variables. Forty-two patients were followed-up prospectively to examine the relationship between psychosocial variables, fatigue and functioning after three cycles of chemotherapy.

Results
A range of cognitive, behavioural and affective variables were associated with increased fatigue severity and poorer functioning. Key cognitive and behavioural correlates included, all-or-nothing behaviour, avoidance behaviour, cancer-related catastrophising and critical/punishing responses from others. For the women in the nested prospective study, fatigue significantly increased after three cycles of chemotherapy. Increased fatigue was predicted by increased anxiety before starting chemotherapy.

Conclusions
Behavioural factors and cancer-specific cognitions make important contributions to cancer-related fatigue and associated impairments. Such factors are potentially amenable to change within the context of cognitive behavioural therapy.
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https://www.sciencedirect.com/science/article/abs/pii/S0022399919309183

(not yet available on sci-hub)
 
If two things correlate, one can definitely and always assume that one causes the other. That's how these people think :rofl:.

Satire: I've discovered that people that enter the hospital can be divided into low and high worry groups, and that the high worry group is much more likely to die in the short term. Clearly that demonstrates the existence of a powerful mind-body effect. If we can get people to worry less, they'll be more likely to survive!
 
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Key cognitive and behavioural correlates included, all-or-nothing behaviour, avoidance behaviour, cancer-related catastrophising and critical/punishing responses from others.
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Just out of curiosity, I'd like to see what their image of a patient they'd define as not having pathological behaviour is..

Edited for clarity.
 
Kalliope said:
Just out of curiosity, I'd like to see what their image of a patient they'd define as not having pathological behaviour is..
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Probably they think that they themselves are the perfect image of a patient without pathological behaviour. I hate this victim blaming, self righteous attitude of Chalder et al.

Has it never occurred to them that correlation does not imply causation.

And a lot of the factors listed are not psychological flaws in the individual, they are either artefacts of poor questionnaires, or, I suspect, linked to third factors outside the individuals' control, like the amount of home support, financial worries, difficult living conditions, etc. Not weaknesses in the individual's psyche.

I wonder how many would much rather have some home support provided so they can rest as much as they need to after all that chemo, rather than be given CBT.
 
Ah, I see the latest edition of cheap psychological experiment cut-and-paste is out. How odd that the conclusions of every such Chalder experiment are always the same. The exact same. And they play out exactly the same way. As if the process were a formality that has no impact on the conclusions. Which are the same every time.
For the women in the nested prospective study, fatigue significantly increased after three cycles of chemotherapy. Increased fatigue was predicted by increased anxiety before starting chemotherapy.
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I just can't with this. There are centuries of painful lessons in science about exactly this, about being able to tell what factors play a role in the outcome and what is superfluous to outcome. The chemotherapy is clearly the relevant factor. Anxiety, whatever is actually meant by this and nothing that can be measured or evaluated in a meaningful way, is entirely superfluous and yet it has been decided that the superfluous thing is relevant while the relevant thing is not.

Good grief this is pathetic, flat Earth level of disconnect from reality.
 
the real question here is who is paying for this one trick pony show . only vested financial interest would waste time and effort into such simplistic thinking . in order to other sick and disabled groups so we can be abandoned and left to rot with little or no cost to the insurance industry as well as creating the framework that allows benefit agencies to dump all over us .
 
For the women in the nested prospective study, fatigue significantly increased after three cycles of chemotherapy. Increased fatigue was predicted by increased anxiety before starting chemotherapy.
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So, we'll ignore the myriad of reasonable possible explanations, including

- They were more severely affected by side effects, including fatigue, the first time round and were understandably concerned

- They had no support at home, knew what a struggle they'd be facing

- They have cancer & a nice lady in a blue cardi came and asked them to answer questions about their anxiety, they wanted to please the nice lady and make her feel relevant and so agreed they were very anxious. Demonstrating some are more susceptible to blue cardigans.
 
Chalder and co are all getting older themselves. At some stage they will succumb to the diseases of old age, and for some of them they will get cancer and other illnesses or diseases themselves at an earlier age (earlier than old age that is). I'll be interested to see how they cope when it happens to them. What? Catastrophise? No way! :rofl:

Something makes me think that when they themselves are affected they will think that they deserve the very benefits that their research prevents or makes it very difficult to get for "ordinary patients". Let's hope they have as much difficulty as we do. (I'm a really horrible person - I'd love to see them suffer the way they've made us suffer)
 
Snow Leopard said:
The notable part is not what is written in the manuscript, but the fact that it will mostly be ignored in clinical practise as most readers will recognise it for what it is: mediocre quality research.
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I suppose that if this paper was shown to an oncologist, or any doctor who cares about their patients with cancer really, they would brush it off as nonsense based on their clinical experience. At least I hope so!
 
cassava7 said:
I suppose that if this paper was shown to an oncologist, or any doctor who cares about their patients with cancer really, they would brush it off as nonsense based on their clinical experience. At least I hope so!
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I think the point here is to be able to point at cancer papers that show the "same" to be able to give it more credibility since "it's also true for cancer". I have every expectation that everyone involved in this weak paper knows for sure that no one involved in cancer research or care will pay any attention to it and would in fact likely laugh it off. Publishing it in a garbage journal like psychosomatics guarantees no one outside the circle jerk will even see it.

When your evidence base is paper thin, all you can do is stretch it around.
 
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