Managing cancer and living meaningfully (CALM) as an intervention for severe fatigue in gastrointestinal cancer survivors

Abstract

This study aimed to evaluate the effectiveness and feasibility of CALM (managing cancer and living meaningfully), which is a psychotherapeutic intervention used to reduce cancer-related fatigue (CRF) and improve quality of life (QOL) in Chinese gastrointestinal cancer survivors (GCs). A total of 115 GCs were enrolled in this study. All patients were randomly assigned to either the CALM group or the usual care (UC) group. All patients were evaluated using the Piper Fatigue Scale (PFS) and Quality of Life Assessment Scale before and after 2, 4, and 6 CALM or UC sessions with GCs presenting with severe fatigue. We compared the differences in these scores between the CALM group and the UC group and analyzed the correlations between CRF and QOL scores. Compared with the UC group, the CALM group showed significant differences in total CRF, behavioral/daily life CRF, emotional/affective CRF, sensory/physical CRF, cognitive CRF and QOL scores before and after 2, 4, and 6 CALM sessions (F=3106.434, F=1113.831, F=1159.919, F=1502.266, F=820.275, F=606.513, respectively; P<0.001). Finally, negative correlations were found between CRF and QOL scores in the GCs in the CALM group (before treatment: r=-0.46, P=0.0002; after 2 sessions: r=-0.46, P=0.0002; after 4 sessions: r=-0.51, P<0.0001; after 6 sessions: r =-0.44, P=0.0004). The CALM intervention effectively reduced fatigue in cancer patients and improved their QOL. This study suggests that CALM as a psychotherapeutic intervention may be an effective way to reduce CRF.

Keywords: CALM; cancer-related fatigue; gastrointestinal cancer; quality of life.

Figure 1

Research flowchart.

Figure 2

Changes in the piper fatigue scale and quality of life assessment scale scores with an increasing number of sessions in the CALM group and the usual care group.

Figure 3

Relationships between QOL and CRF in the CALM group. Note: A. Before CALM treatment; B. After 2 CALM sessions; C. After 4 CALM sessions; D. After 6 CALM sessions.

Figure 4

Relationships between QOL and CRF in the usual care group. Note: A. Before UC treatment; B. After 2 UC sessions; C. After 4 UC sessions; D. After 6 UC sessions.