Tendencies in the association between fatigue and quality of life in terminally ill patients with cancer admitted to a palliative care unit

Palliat Support Care. 2026 Jun 9:24:e161. doi: 10.1017/S1478951526102740.

Abstract

Background: Cancer-related fatigue (CRF) is a distressing symptom in terminally ill patients with cancer. While many studies have been conducted on the relationship between fatigue and quality of life (QOL) among patients undergoing treatment, only a few have been conducted to measure fatigue from multiple perspectives or clarify its impact on patients in advanced stages or those receiving palliative care.

Objectives: To examine the impact of fatigue on QOL in terminally ill patients with cancer, using a questionnaire that measures CRF from 3 perspectives.

Methods: CRF and QOL were measured using the Cancer Fatigue Scale (CFS) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative (EORTCQLQ-C15-PAL), respectively, and the correlation between them was evaluated. Web-based questionnaires were completed by patients receiving hospice and palliative care.

Significance of results: Twenty-nine participants provided valid responses. Median CFS and global health status/QOL scores were as follows: total fatigue 25.0, physical fatigue 11.0, affective fatigue 9.0, cognitive fatigue 5.0, and global health status/QOL 50.0. QOL showed significant correlations with total fatigue (rs = -0.44, p = 0.017, 95% CI: -0.70, -0.09) and physical fatigue (rs = -0.38, p = 0.038, 95% CI: -0.66, -0.02), but none with affective fatigue (rs = -0.02, p = 0.917, 95% CI: -0.38, 0.35) and cognitive fatigue (rs = -0.33, p = 0.074, 95% CI: -0.63, 0.03).

Conclusions: Of the 3 aspects of fatigue, physical fatigue may be most closely related to QOL; however, its accurate assessment may depend on the scale used. Therefore, it is necessary to select an appropriate scale for patients with terminal cancer.

Keywords: Cancer-related fatigue; assessment; physical fatigue; quality of life; terminal cancer.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Fatigue* / complications
  • Fatigue* / etiology
  • Fatigue* / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms* / complications
  • Neoplasms* / psychology
  • Palliative Care* / methods
  • Palliative Care* / psychology
  • Palliative Care* / standards
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Quality of Life* / psychology
  • Surveys and Questionnaires
  • Terminally Ill* / psychology