OBJECTIVE Cancer-related fatigue (CRF) is among the most distressing symptoms reported by cancer survivors as compromising their quality of life. This study investigates the complex interplay between CRF and functional health (FH) in survivors of Hodgkin lymphoma by using longitudinal data to clarify the etiology of CRF. METHODS Data from N = 3596 survivors (HD13-15) from the German Hodgkin Study Group was analyzed using bivariate latent curve models with structured residuals to model how the interplay between CRF and FH unfolds over time across and within individuals. CRF and FH were measured with the EORTC QLQ-C30. Assessed FH domains were physical, cognitive, emotional, social, and role functioning. Age at diagnosis, gender, country, baseline fatigue, and cancer stage were included as covariates. RESULTS The latent curve models with structured residuals had an adequate model fit (χ² = 416.63-548.28, df = 114, p < .001, root mean square error of approximation = .03, comparative fit index = .98-.99, Tucker-Lewis index = .97-.98). On the between-person level, CRF and all FH domains were strongly negatively correlated (r = -.72 to r = -.84). On the within-person level, earlier CRF (ρF = -.05 to ρF = -.12) and FH deviations (ρFH = -.05 to ρFH = -.13) negatively predicted subsequent deviations of the respective other variable. Time-specific within-person improvements in physical, cognitive, and emotional functioning reduced CRF more than vice versa, whereas the effect of CRF was stronger for social functioning. Role functioning had a balanced relation with CRF. CONCLUSIONS This analysis reveals a complex reciprocal relation between CRF and FH with distinct between- and within-person effects. The results contribute to a better understanding of CRF in survivors of Hodgkin lymphoma and could inform the development of much-needed targeted interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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霍奇金淋巴瘤幸存者中与癌症相关的疲劳与功能健康之间的相互作用。

目的癌症相关的疲劳（CRF）是癌症幸存者报告的最令人痛苦的症状之一，它们损害了他们的生活质量。本研究通过使用纵向数据阐明CRF的病因，研究了霍奇金淋巴瘤幸存者中CRF与功能健康（FH）之间的复杂相互作用。方法使用具有结构残差的双变量潜曲线模型分析了来自德国霍奇金研究小组的N = 3596名幸存者（HD13-15）的数据，以模拟CRF和FH之间的相互作用如何随时间在个体内和个体内展开。CRF和FH用EORTC QLQ-C30测量。评估的FH领域是身体，认知，情感，社交和角色功能。将诊断时的年龄，性别，国家/地区，基线疲劳和癌症分期作为协变量。结果具有结构残差的潜曲线模型具有足够的模型拟合度（χ²= 416.63-548.28，df = 114，p <.001，均方根近似值= .03，比较拟合指数= .98-.99，Tucker -刘易斯指数= .97-.98）。在人际关系方面，CRF和所有FH域均呈显着负相关（r = -.72至r = -.84）。在人际层面上，较早的CRF（ρF= -.05至ρF= -.12）和FH偏差（ρFH= -.05至ρFH= -.13）对各个其他变量的后续偏差做出了负面预测。在身体，认知和情感功能上有针对性的特定时间内人改善比其他方式对CRF的降低更大，而对于社会功能，CRF的作用更强。角色运行与CRF具有平衡的关系。结论该分析揭示了CRF和FH之间复杂的相互关系，具有明显的人际和人际影响。这些结果有助于更好地了解霍奇金淋巴瘤幸存者的CRF，并可以为急需的靶向干预措施的发展提供信息。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。