Yan-ting Liou¹, Yun-jen Chou¹, Shiow-ching Shun¹, Wen-chi Chou², Yi-fang Chang³, Cheng-hsu Wang⁴, Chang-hsien Lu⁵, Wei-hsu Ko⁶

¹Department of Nursing,National Taiwan University College of Medicine, ²Division of Hematology-Oncology, Department of Internal Medicine, LinKo Chang Gung Memorial Hospital, ³MacKay Memorial Hospital, Taipei 104, ⁴Division ofHematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelong, Keelong, Taiwan, ⁵Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Chiayi and Chang Gung University, Taoyuan, ⁶Division of Gastroenterology, Department of Internal Medicine, Shin‐Kong Wu Ho‐Su Memorial Hospital

Objective:Patient with different age could affect the ability to manage the symptom distress and their level of quality of life (QOL). Furthermore, cancer-related fatigue (CRF) is the most experienced symptom by cancer patients. However, there is no study to the role of age affecting quality of life and fatigue. Therefore, the aim of this study was toexplore if the age differences (≥ 65 and < 65 years old) was the significant factors associated with quality of life and fatigue among Taiwanese cancer patients. Method: A cross-sectional design with a national survey was used in this study. Patients were recruited from 20 hospitals with cancer patients in Taiwan. A structured questionnaire was used to collect patients'demographic and clinical characteristics, cancer-related fatigue, and QOL. TheCRF were assessed by International Classification of Diseases 10th Revision(ICD-10) and Brief Fatigue Inventory–Taiwan Form (BFI-T). QOL was assessed byFACT-general. The generalized estimating equation (GEE) was used to examine the significant associated factors with QOL for overall and two age groups (youngand elderly groups). Result: Totally, 1207 patients participated in this study with 889 patients in young group and 318 patients in elderly group. There were no significant statistics differences in fatigue between two groups. Inoverall, the significant associated factors with QOL were age group, functional status, stage, level of fatigue interference and symptom distress. In young group, patients lack of job (β= .565, P=0.035), with lower level of functional status (β = -.530, P=0.003), higher level of fatigue interference (β= -.065, P<0.0001) and symptom distress (β= -.146, P<0.0001), and who were fatigue case based on ICD-10 criteria (β= -1.000, P=0.005) had lower level of QOL. In elderly group, patients with lower level of functional status (β = -.758, P=0.024), higher level of fatigue interference (β=-.098, P<0.0001) and symptom distress (β= -.136, P<0.0001) had lower level of QOL. Conclusion: Daily fatigue interferences were the significant factor affecting QOL in the two groups. In addition, young group had lower level of QOL than elderly group, especially in who lack of job.Therefore, the healthcare providers should pay more attention in helping cancer patients how to manage interferences caused by fatigue, especially for young group.

Key Words: quality of life  cancer-related fatigue  symptom distress