Network structures of general, physical and psychological fatigue in patients with metastatic colorectal cancer: Implications for targeted coping strategies
Grégoire, Charlotte; Cousson-Gélie, Florence; Baussard, Louise
2025 • In International Journal of Clinical and Health Psychology, 25 (2), p. 100590
[en] Background: Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by many patients, affecting both their physical and psychological well-being. This study aims to explore the network organization of three dimensions of CRF (i.e., general, physical, and psychological) and to examine how patient's resources such as coping strategies interact with these distinct aspects of fatigue. Method: This study involves data from a previous observational study on patients with metastatic colorectal cancer undergoing chemotherapy. Participants (N = 169) completed several questionnaires at baseline. Partial correlation network analysis was used to model the relationships between patients’ symptoms (i.e., CRF, emotional distress) and resources (i.e., perceived control of the illness, coping strategies, perceived social support), in three distinct networks, each of them including one dimension of fatigue (i.e., general, physical, or psychological). In each network, a core variable (i.e., a symptom or a resource) was identified based on the highest centrality indices. Results: Coping strategies emerged as the core variable in the three networks, while depression was the symptom with the strongest association with CRF. These findings underline the interconnection between emotional state and fatigue, but most of all suggest the centrality of the patients’ resources, specifically coping strategies used to manage their symptoms, and their potential role in influencing the symptoms. Conclusion: Our findings are expected to provide insights into targeted therapeutic approaches and enhance patient care. Understanding the complex interplay between the dimensions of fatigue and the coping strategies employed by patients is crucial for developing effective interventions.
Disciplines :
Social & behavioral sciences, psychology: Multidisciplinary, general & others
Author, co-author :
Grégoire, Charlotte ; Université de Liège - ULiège > GIGA > GIGA Neurosciences - Conscious Care Lab
Cousson-Gélie, Florence; Epidaure-Prevention Department of the Montpellier Cancer Institute, Montpellier Cancer Institute, Montpellier, France ; Univ. Paul Valéry Montpellier 3, EPSYLON UR 4556, Montpellier, France
Baussard, Louise ; Univ. Paul Valéry Montpellier 3, EPSYLON UR 4556, Montpellier, France
Language :
English
Title :
Network structures of general, physical and psychological fatigue in patients with metastatic colorectal cancer: Implications for targeted coping strategies
Publication date :
June 2025
Journal title :
International Journal of Clinical and Health Psychology
Baldwin, J.R., Pingault, J.-B., Schoeler, T., Sallis, H.M., Munafò, M.R., Protecting against researcher bias in secondary data analysis: Challenges and potential solutions. European Journal of Epidemiology 37:1 (2022), 1–10, 10.1007/s10654-021-00839-0.
Baussard, L., Psychological determiners of distincts fatigue trajectories in colorectal patients undergoing chemotherapy. BMC ISRCTN Registry, 2018, 10.1186/ISRCTN18044948.
Baussard, L., Ernst, M., Diep, A., Jerusalem, G., Vanhaudenhuyse, A., Marie, N., Bragard, I., Faymonville, M.-E., Gosseries, O., Grégoire, C., Network analyses applied to the dimensions of cancer-related fatigue in women with breast cancer. Cancer Medicine, 13(19), 2024, e70268, 10.1002/cam4.70268.
Baussard, L., Proust-Lima, C., Philipps, V., Portales, F., Ychou, M., Mazard, T., Cousson-Gélie, F., Determinants of distinct trajectories of fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: 6-month follow-up using growth mixture modeling. Journal of Pain and Symptom Management 63:1 (2022), 140–150, 10.1016/j.jpainsymman.2021.06.019.
Baussard, L., Stoebner-Delbarre, A., Bonnabel, L., Huteau, M.-E., Gastou, A., Cousson-Gélie, F., Development and validation of the daily fatigue cancer scale (DFCS): Single-item questions for clinical practice. European Journal of Oncology Nursing 26 (2017), 42–48, 10.1016/j.ejon.2016.12.004.
Berger, A.M., Abernethy, A.P., Atkinson, A., Barsevick, A.M., Breitbart, W.S., Cella, D., Cimprich, B., Cleeland, C., Eisenberger, M.A., Escalante, C.P., Jacobsen, P.B., Kaldor, P., Ligibel, J.A., Murphy, B.A., O'Connor, T., Pirl, W.F., Rodler, E., Rugo, H.S., Thomas, J., Wagner, L.I., Cancer-related fatigue. Journal of the National Comprehensive Cancer Network 8:8 (2010), 904–931, 10.6004/jnccn.2010.0067.
Bickel, E.A., Schellekens, M.P.J., Smink, J.G., Mul, V.E.M., Ranchor, A.V., Fleer, J., Schroevers, M.J., Looking at individual symptoms: The dynamic network structure of depressive symptoms in cancer survivors and their preferences for psychological care. Journal of Cancer Survivorship: Research and Practice, 2022, 10.1007/s11764-022-01246-4.
Bjelland, I., Dahl, A.A., Haug, T.T., Neckelmann, D., The validity of the Hospital Anxiety and Depression Scale. An updated literature review. Journal of Psychosomatic Research 52:2 (2002), 69–77.
Bootsma, T.I., Schellekens, M.P.J., van Woezik, R.A.M., Slatman, J., van der Lee, M.L., Using smartphone-based ecological momentary assessment and personalized feedback for patients with chronic cancer-related fatigue: A proof-of-concept study. Internet Interventions, 30, 2022, 100568, 10.1016/j.invent.2022.100568.
Borsboom, D., Cramer, A.O.J., Network analysis: An integrative approach to the structure of psychopathology. Annual Review of Clinical Psychology 9 (2013), 91–121, 10.1146/annurev-clinpsy-050212-185608.
Bower, J.E., Prevalence and causes of fatigue after cancer treatment: The next generation of research. Journal of Clinical Oncology 23:33 (2005), 8280–8282, 10.1200/JCO.2005.08.008.
Bower, J.E., Ganz, P.A., Irwin, M.R., Kwan, L., Breen, E.C., Cole, S.W., Inflammation and behavioral symptoms after breast cancer treatment: Do fatigue, depression, and sleep disturbance share a common underlying mechanism?. Journal of Clinical Oncology 29:26 (2011), 3517–3522, 10.1200/JCO.2011.36.1154.
Brown, A.J., Thaker, P.H., Sun, C.C., Urbauer, D.L., Bruera, E., Bodurka, D.C., Ramondetta, L.M., Nothing left to chance? The impact of locus of control on physical and mental quality of life in terminal cancer patients. Supportive Care in Cancer 25:6 (2017), 1985–1991, 10.1007/s00520-017-3605-z.
Bruchon-Schweitzer, M., Boujut, E., Psychologie de la santé - 2e éd. Concepts, méthodes et modèles, 2e édition, 2014, DUNOD.
Carver, C.S., Scheier, M.F., Weintraub, J.K., Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology 56:2 (1989), 267–283, 10.1037//0022-3514.56.2.267.
Castelli, L., Binaschi, L., Caldera, P., Mussa, A., Torta, R., Fast screening of depression in cancer patients: The effectiveness of the HADS. European Journal of Cancer Care 20:4 (2010), 528–533, 10.1111/j.1365-2354.2010.01217.x.
Cheng, C., Cognitive and motivational processes underlying coping flexibility: A dual-process model. Journal of Personality and Social Psychology 84:2 (2003), 425–438, 10.1037/0022-3514.84.2.425.
Cheng, C., Chan, N., Chio, J.H., Chan, P., Chan, A.O., Hui, W., Being active or flexible? Role of control coping on quality of life among patients with gastrointestinal cancer. Psycho-Oncology 21:2 (2012), 211–218, 10.1002/pon.1892.
Chirico, A., Palombi, T., Alivernini, F., Lucidi, F., Merluzzi, T.V., Emotional distress symptoms, coping efficacy, and social support: A network analysis of distress and resources in persons with cancer. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine 58:10 (2024), 679–691, 10.1093/abm/kaae025.
Cohen, S., Janicki-Deverts, D., Miller, G.E., Psychological stress and disease. JAMA 298:14 (2007), 1685–1687, 10.1001/jama.298.14.1685.
Corbett, T., Groarke, A., Walsh, J.C., McGuire, B.E., Cancer-related fatigue in post-treatment cancer survivors: Application of the common sense model of illness representations. BMC Cancer, 16(1), 2016, 919, 10.1186/s12885-016-2907-8.
Cousson-Gélie, F., Évolution du contrôle religieux la première année suivant l'annonce d'un cancer du sein: Quels liens avec les stratégies de coping, l'anxiété, la dépression et la qualité de vie ?. Psychologie Française 59:4 (2014), 331–341, 10.1016/j.psfr.2012.01.001.
Cousson-Gélie, F., Cosnefroy, O., Christophe, V., Segrestan-Crouzet, C., Merckaert, I., Fournier, E., Libert, Y., Lafaye, A., Razavi, D., The ways of coping checklist (WCC): Validation in French-speaking cancer patients. Journal of Health Psychology 15:8 (2010), 1246–1256, 10.1177/1359105310364438.
Cousson-Gelie, F., Irachabal, S., Bruchon-Schweitzer, M., Dilhuydy, J.M., Lakdja, F., Dimensions of cancer locus of control scale as predictors of psychological adjustment and survival in breast cancer patients. Psychological Reports, 97(7), 2005, 699, 10.2466/PR0.97.7.699-711.
Curtis, E.B., Krech, R., Walsh, T.D., Common symptoms in patients with advanced cancer. Journal of Palliative Care 7:2 (1991), 25–29.
Dahal, A., Meheta, R.K., Fatigue experience and coping strategies among cancer patients receiving chemotherapy. Journal of Nepal Health Research Council, 16(3), 2018 Article 3.
de Rooij, B.H., Oerlemans, S., van Deun, K., Mols, F., de Ligt, K.M., Husson, O., Ezendam, N.P.M., Hoedjes, M., van de Poll-Franse, L.V., Schoormans, D., Symptom clusters in 1330 survivors of 7 cancer types from the PROFILES registry: A network analysis. Cancer 127:24 (2021), 4665–4674, 10.1002/cncr.33852.
Dev, R., Agosta, M., Fellman, B., Reddy, A., Baldwin, S., Arthur, J., Haider, A., Carmack, C., Hui, D., Bruera, E., Coping strategies and associated symptom burden among patients with advanced cancer. The Oncologist 29:2 (2024), 166–175, 10.1093/oncolo/oyad253.
Eto, M., Yamamoto, S., Arao, H., Flexible coping in cancer care: A concept analysis. Cancer Care Research Online, 2(1), 2022, e016, 10.1097/CR9.0000000000000016.
Fang, C.Y., Daly, M.B., Miller, S.M., Zerr, T., Malick, J., Engstrom, P., Coping with ovarian cancer risk: The moderating effects of perceived control on coping and adjustment. British Journal of Health Psychology 11 (2006), 561–580, 10.1348/135910705x60517 Pt 4.
Fasano, J., Shao, T., Huang, H.-H., Kessler, A.J., Kolodka, O.P., Shapiro, C.L., Optimism and coping: Do they influence health outcomes in women with breast cancer? A systemic review and meta-analysis. Breast Cancer Research and Treatment 183:3 (2020), 495–501, 10.1007/s10549-020-05800-5.
Faye, B.J.D., Wilson, K.G., Chater, S., Viola, R.A., Hall, P., Stress and coping with advanced cancer. Palliative & Supportive Care 4:3 (2006), 239–249, 10.1017/S1478951506060317.
Folkman, S., Lazarus, R.S., An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior 21:3 (1980), 219–239, 10.2307/2136617.
Folkman, S., Lazarus, R.S., Coping as a mediator of emotion. Journal of Personality and Social Psychology 54:3 (1988), 466–475, 10.1037/0022-3514.54.3.466.
Freire, C., Ferradás, M.D.M., Valle, A., Núñez, J.C., Vallejo, G., Profiles of psychological well-being and coping strategies among university students. Frontiers in Psychology, 7, 2016, 10.3389/fpsyg.2016.01554.
Götze, H., Friedrich, M., Taubenheim, S., Dietz, A., Lordick, F., Mehnert, A., Depression and anxiety in long-term survivors 5 and 10 years after cancer diagnosis. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer 28:1 (2020), 211–220, 10.1007/s00520-019-04805-1.
Grégoire, C., Baussard, L., Ernst, M., Diep, A., Faymonville, M.-E., Devos, M., Jerusalem, G., Vanhaudenhuyse, A., Evaluation of a psychoneurological symptom cluster in patients with breast or digestive cancer: A longitudinal observational study. BMC Cancer, 24(51), 2024, 10.1186/s12885-023-11799-x.
Grusdat, N.P., Stäuber, A., Tolkmitt, M., Schnabel, J., Schubotz, B., Wright, P.R., Schulz, H., Routine cancer treatments and their impact on physical function, symptoms of cancer-related fatigue, anxiety, and depression. Supportive Care in Cancer 30:5 (2022), 3733–3744, 10.1007/s00520-021-06787-5.
Hardy, S.J., Krull, K.R., Wefel, J.S., Janelsins, M., Cognitive changes in cancer survivors. American Society of Clinical Oncology Educational Book. American Society of Clinical Oncology. Annual Meeting, 38, 2018, 795–806, 10.1200/EDBK_201179.
Henselmans, I., Sanderman, R., Baas, P.C., Smink, A., Ranchor, A.V., Personal control after a breast cancer diagnosis: Stability and adaptive value. Psycho-Oncology 18:1 (2009), 104–108, 10.1002/pon.1333.
Hevey, D., Network analysis: A brief overview and tutorial. Health Psychology and Behavioral Medicine 6:1 (2018), 301–328, 10.1080/21642850.2018.1521283.
Hjermstad, M.J., Fayers, P.M., Haugen, D.F., Caraceni, A., Hanks, G.W., Loge, J.H., Fainsinger, R., Aass, N., Kaasa, S., Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: A systematic literature review. Journal of Pain and Symptom Management 41:6 (2011), 1073–1093, 10.1016/j.jpainsymman.2010.08.016.
Iop, A., Manfredi, A.M., Bonura, S., Fatigue in cancer patients receiving chemotherapy: An analysis of published studies. Annals of Oncology 15:5 (2004), 712–720, 10.1093/annonc/mdh102.
Kangas, M., Gross, J.J., The Affect Regulation in Cancer framework: Understanding affective responding across the cancer trajectory. Journal of Health Psychology 25:1 (2020), 7–25, 10.1177/1359105317748468.
Kanter, N.G., Cohen-Woods, S., Balfour, D., Burt, M.G., Waterman, A.L., Koczwara, B., Hypothalamic–Pituitary–Adrenal axis dysfunction in people with cancer: A systematic review. Cancer Medicine, 13(22), 2024, e70366, 10.1002/cam4.70366.
Keane, K.F., Wickstrom, J., Livinski, A.A., Blumhorst, C., Wang, T., Saligan, L.N., The definitions, assessment, and dimensions of cancer-related fatigue: A scoping review. Supportive Care in Cancer, 32(7), 2024, 457, 10.1007/s00520-024-08615-y.
Kwekkeboom, K.L., Cancer symptom cluster management. Seminars in Oncology Nursing 32:4 (2016), 373–382, 10.1016/j.soncn.2016.08.004.
Lengacher, C.A., Reich, R.R., Post-White, J., Moscoso, M., Shelton, M.M., Barta, M., Le, N., Budhrani, P., Mindfulness based stress reduction in post-treatment breast cancer patients: An examination of symptoms and symptom clusters. Journal of Behavioral Medicine 35:1 (2012), 86–94, 10.1007/s10865-011-9346-4.
Lin, Y., Bruner, D.W., Paul, S., Miller, A.H., Saba, N.F., Higgins, K.A., Shin, D.M., Zhang, W., Miaskowski, C., Xiao, C., A network analysis of self-reported psychoneurological symptoms in patients with head and neck cancer undergoing intensity-modulated radiotherapy. Cancer 128:20 (2022), 3734–3743, 10.1002/cncr.34424.
Ma, Y., He, B., Jiang, M., Yang, Y., Wang, C., Huang, C., Han, L., Prevalence and risk factors of cancer-related fatigue: A systematic review and meta-analysis. International Journal of Nursing Studies, 111, 2020, 103707, 10.1016/j.ijnurstu.2020.103707.
Mayordomo-Rodríguez, T., Viguer, P., Sales-Galán, A., Satorres, E., Melendez, J., Resilience and coping as predictors of well-being in adults. The Journal of Psychology 150 (2016), 809–821, 10.1080/00223980.2016.1203276.
Mayrbäurl, B., Giesinger, J.M., Burgstaller, S., Piringer, G., Holzner, B., Thaler, J., Quality of life across chemotherapy lines in patients with advanced colorectal cancer: A prospective single-center observational study. Supportive Care in Cancer 24:2 (2016), 667–674, 10.1007/s00520-015-2828-0.
Mehnert, A., Hartung, T.J., Friedrich, M., Vehling, S., Brähler, E., Härter, M., Keller, M., Schulz, H., Wegscheider, K., Weis, J., Koch, U., Faller, H., One in two cancer patients is significantly distressed: Prevalence and indicators of distress. Psycho-Oncology 27:1 (2018), 75–82, 10.1002/pon.4464.
Mehnert, A., Lehmann, C., Graefen, M., Huland, H., Koch, U., Depression, anxiety, post-traumatic stress disorder and health-related quality of life and its association with social support in ambulatory prostate cancer patients. European Journal of Cancer Care 19:6 (2010), 736–745, 10.1111/j.1365-2354.2009.01117.x.
Miaskowski, C., Barsevick, A., Berger, A., Casagrande, R., Grady, P.A., Jacobsen, P., Kutner, J., Patrick, D., Zimmerman, L., Xiao, C., Matocha, M., Marden, S., Advancing symptom science through symptom cluster research: Expert panel proceedings and recommendations. Journal of the National Cancer Institute, 109(4), 2017, 10.1093/jnci/djw253.
Mitchell, A.J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., Meader, N., Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet. Oncology 12:2 (2011), 160–174, 10.1016/S1470-2045(11)70002-X.
National Comprehensive Cancer Network (NCCN). (2022). NCCN Clinical Practice Guidelines in Oncology—Cancer-related fatigue v2.2022 (No. 2.2022). https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf.
Nipp, R.D., El-Jawahri, A., Fishbein, J.N., Eusebio, J., Stagl, J.M., Gallagher, E.R., Park, E.R., Jackson, V.A., Pirl, W.F., Greer, J.A., Temel, J.S., The relationship between coping strategies, quality of life, and mood in patients with incurable cancer. Cancer 122:13 (2016), 2110–2116, 10.1002/cncr.30025.
Person, H., Guillemin, F., Conroy, T., Velten, M., Rotonda, C., Factors of the evolution of fatigue dimensions in patients with breast cancer during the 2 years after surgery. International Journal of Cancer 146:7 (2020), 1827–1835, 10.1002/ijc.32527.
Peters, M.E.W.J., Goedendorp, M.M., Verhagen, S.A.H.H.V.M., van der Graaf, W.T.A., Bleijenberg, G., Exploring the contribution of psychosocial factors to fatigue in patients with advanced incurable cancer. Psycho-Oncology 23:7 (2014), 773–779, 10.1002/pon.3481.
Pinar, G., Okdem, S., Buyukgonenc, L., Ayhan, A., The relationship between social support and the level of anxiety, depression, and quality of life of Turkish women with gynecologic cancer. Cancer Nursing 35:3 (2012), 229–235, 10.1097/NCC.0b013e31822c47bd.
Procidano, M.E., The nature of perceived social support: Findings of meta-analytic studies. Advances in personality assessment, 1992, Routledge.
Pruyn, J.F.A., Van Den Borne, H.W., De Reuver, R.S.M., De Boer, M.F., Bosman, L.J., De Jong, P.C., The locus of control scale for cancer patients. Tijdschift Woor Sociales Gezondheidszorj 66 (1988), 404–408.
Ranchor, A.V., Wardle, J., Steptoe, A., Henselmans, I., Ormel, J., Sanderman, R., The adaptive role of perceived control before and after cancer diagnosis: A prospective study. Social Science & Medicine 70:11 (2010), 1825–1831, 10.1016/j.socscimed.2009.10.069.
Rha, S.Y., Lee, J., Stable symptom clusters and evolving symptom networks in relation to chemotherapy cycles. Journal of Pain and Symptom Management 61:3 (2021), 544–554, 10.1016/j.jpainsymman.2020.08.008.
Riba, M.B., Donovan, K.A., Andersen, B., Braun, Ii., Breitbart, W.S., Brewer, B.W., Buchmann, L.O., Clark, M.M., Collins, M., Corbett, C., Fleishman, S., Garcia, S., Greenberg, D.B., Handzo, R.G.F., Hoofring, L., Huang, C.-H., Lally, R., Martin, S., McGuffey, L., Darlow, S.D., Distress Management, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. Journal of the National Comprehensive Cancer Network: JNCCN 17:10 (2019), 1229–1249, 10.6004/jnccn.2019.0048.
Robinaugh, D.J., Millner, A.J., McNally, R.J., Identifying highly influential nodes in the complicated grief network. Journal of Abnormal Psychology 125:6 (2016), 747–757, 10.1037/abn0000181.
Ryan, J.L., Carroll, J.K., Ryan, E.P., Mustian, K.M., Fiscella, K., Morrow, G.R., Mechanisms of cancer-related fatigue. The Oncologist 12 (2007), 22–34, 10.1634/theoncologist.12-S1-22 Supplement 1.
Saligan, L.N., Kim, H.S., A systematic review of the association between immunogenomic markers and cancer-related fatigue. Brain, Behavior, and Immunity 26:6 (2012), 830–848, 10.1016/j.bbi.2012.05.004.
Schaab, M., Wijlens, K.A.E., Bode, C., Psychological coping factors associated with breast cancer-related fatigue: A systematic review of recent evidence for stages 0 to III. Clinical Breast Cancer 23:7 (2023), e401–e411, 10.1016/j.clbc.2023.06.005.
Schellekens, M.P.J., Wolvers, M.D.J., Schroevers, M.J., Bootsma, T.I., Cramer, A.O.J., van der Lee, M.L., Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: A network approach. Journal of Behavioral Medicine 43:4 (2020), 553–563, 10.1007/s10865-019-00084-7.
Schmidt, M.E., Wiskemann, J., Schneeweiss, A., Potthoff, K., Ulrich, C.M., Steindorf, K., Determinants of physical, affective, and cognitive fatigue during breast cancer therapy and 12 months follow-up. International Journal of Cancer 142:6 (2018), 1148–1157, 10.1002/ijc.31138.
Segrestan, C., Rascle, N., Cousson-Gélie, F., & Trouette, R. (2007). Analyse exploratoire du soutien des patients cancéreux et de leurs proches. Congrès international de psychologie de la santé de langue française, Toulouse.
Segrestan-Crouzet, C. (2010). Evolution et différences dans l'ajustement des couples au cancer du sein: Rôle des facteurs psychosociaux et influence réciproque des deux membres de la dyade [These de doctorat, Bordeaux 2]. https://theses.fr/2010BOR21729.
Shim, E.-J., Ha, H., Suh, Y.-S., Kong, S.-H., Lee, H.-J., Yang, H.-K., Hahm, B.-J., Network analyses of associations between cancer-related physical and psychological symptoms and quality of life in gastric cancer patients. Psycho-Oncology 30:6 (2021), 946–953, 10.1002/pon.5681.
Soares, A., Biasoli, I., Scheliga, A., Baptista, R.L., Brabo, E.P., Morais, J.C., Werneck, G.L., Spector, N., Association of social network and social support with health-related quality of life and fatigue in long-term survivors of Hodgkin lymphoma. Supportive Care in Cancer 21:8 (2013), 2153–2159, 10.1007/s00520-013-1775-x.
Spiegel, D., Giese-Davis, J., Taylor, C.B., Kraemer, H., Stress sensitivity in metastatic breast cancer: Analysis of hypothalamic–pituitary–adrenal axis function. Psychoneuroendocrinology 31:10 (2006), 1231–1244, 10.1016/j.psyneuen.2006.09.004.
Stone, P., Richards, M., A'Hern, R., Hardy, J., A study to investigate the prevalence, severity and correlates of fatigue among patients with cancer in comparison with a control group of volunteers without cancer. Annals of Oncology 11:5 (2000), 561–568, 10.1023/A:1008331230608.
Taylor, S.E., Stanton, A.L., Coping resources, coping processes, and mental health. Annual Review of Clinical Psychology 3 (2007), 377–401, 10.1146/annurev.clinpsy.3.022806.091520.
Tomás, J.M., Sancho, P., Melendez, J.C., Mayordomo, T., Resilience and coping as predictors of general well-being in the elderly: A structural equation modeling approach. Aging & Mental Health 16:3 (2012), 317–326, 10.1080/13607863.2011.615737.
Ventafridda, V., De Conno, F., Ripamonti, C., Gamba, A., Tamburini, M., Quality-of-life assessment during a palliative care programme. Annals of Oncology: Official Journal of the European Society for Medical Oncology 1:6 (1990), 415–420, 10.1093/oxfordjournals.annonc.a057794.
Wagland, R., Richardson, A., Armes, J., Hankins, M., Lennan, E., Griffiths, P., Treatment-related problems experienced by cancer patients undergoing chemotherapy: A scoping review. European Journal of Cancer Care 24:5 (2015), 605–617, 10.1111/ecc.12246.
Wagland, R., Richardson, A., Ewings, S., Armes, J., Lennan, E., Hankins, M., Griffiths, P., Prevalence of cancer chemotherapy-related problems, their relation to health-related quality of life and associated supportive care: A cross-sectional survey. Supportive Care in Cancer 24:12 (2016), 4901–4911, 10.1007/s00520-016-3346-4.
Wagner, L.I., Cella, D., Fatigue and cancer: Causes, prevalence and treatment approaches. British Journal of Cancer 91:5 (2004), 822–828, 10.1038/sj.bjc.6602012.
Wang, X.S., Zhao, F., Fisch, M.J., O'Mara, A.M., Cella, D., Mendoza, T.R., Cleeland, C.S., Prevalence and characteristics of moderate to severe fatigue: A multicenter study in cancer patients and survivors. Cancer 120:3 (2014), 425–432, 10.1002/cncr.28434.
Wright, F., Kober, K.M., Cooper, B.A., Paul, S.M., Conley, Y.P., Hammer, M., Levine, J.D., Miaskowski, C., Higher levels of stress and different coping strategies are associated with greater morning and evening fatigue severity in oncology patients receiving chemotherapy. Supportive Care in Cancer 28:10 (2020), 4697–4706, 10.1007/s00520-020-05303-5.
Zamanian, H., Amini-Tehrani, M., Jalali, Z., Daryaafzoon, M., Ala, S., Tabrizian, S., Foroozanfar, S., Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model. European Journal of Oncology Nursing, 50, 2021, 101892, 10.1016/j.ejon.2020.101892.
Zhou, E.S., Penedo, F.J., Bustillo, N.E., Benedict, C., Rasheed, M., Lechner, S., Soloway, M., Kava, B.R., Schneiderman, N., Antoni, M.H., Longitudinal effects of social support and adaptive coping on the emotional well-being of survivors of localized prostate cancer. The Journal of Supportive Oncology 8:5 (2010), 196–201.
Zhu, Z., Sun, Y., Kuang, Y., Yuan, X., Gu, H., Zhu, J., Xing, W., Contemporaneous symptom networks of multidimensional symptom experiences in cancer survivors: A network analysis. Cancer Medicine, 2022, 10.1002/cam4.4904.
Zigmond, A.S., Snaith, R.P., The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica 67:6 (1983), 361–370.