Cancer-related fatigue in a couples’ context:The role of daily cognitions and partner behaviors

Abstract

The group of people living with a history of cancer is growing. Fatigue is not only among the most prevalent symptoms cancer patients experience, it also impairs their quality of life and can remain for years after completion of treatment. Evidence suggests that cancer and its treatment initially trigger fatigue, but how patients and their partners cope explains how fatigue remains. In this thesis, we examined how patients’ and their partners’ daily cognitions and behaviors impact patients’ cancer-related fatigue and also the couples’ relationship. To study this, colorectal cancer survivors and their partners (n = 101) filled in digital diaries during 14 days about their daily coping with fatigue. The results showed that both patients’ and partners’ negative thoughts about fatigue (e.g., ‘I cannot bear my (partner’s) fatigue any longer’) worsened patients’ fatigue. Negative thoughts of partners could worsen patients’ fatigue because these lead to couples’ ruminative conversations about fatigue. The way partners responded to patients’ behaviors (e.g., resting or being active despite fatigue) influenced patients’ fatigue burden as well as their relationship satisfaction. Responses that encouraged resting worsened fatigue, but were beneficial for the relationship. The only response that had positive outcomes for patients’ fatigue as well as their relationship satisfaction were partners’ encouragement for patients to be active. These results on the impact of daily coping processes can help us improve the treatment of fatigue in cancer survivors. Effective treatment should involve the patients’ partners and target couples’ negative thoughts about fatigue, their ruminative conversations and partner responses