Evidence map›Paper›PMID 31435892›Full record

ArticleJournal of behavioral medicine2020

Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach.

Melanie P J Schellekens, Marije D J Wolvers, Maya J Schroevers, Tom I Bootsma, Angélique O J Cramer, Marije L van der Lee

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of behavioral medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 2 pooled it
4.2field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 87 citations in OpenAlex.

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  16. Relationship between core symptoms, function, and quality of life in colorectal cancer patients: a network analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Melanie P J SchellekensScientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands. mschellekens@hdi.nl.ORCID 0000-0001-8397-7674
Marije D J WolversScientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands.
Maya J SchroeversDepartment of Health Psychology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Tom I BootsmaScientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands.
Angélique O J CramerDepartment of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.
Marije L van der LeeScientific Research Department, Centre for Psycho-Oncology, Helen Dowling Institute, Professor Bronkhorstlaan 20, Postbus 80, 3720 AB, Bilthoven, The Netherlands.
Tilburg University · NLBronkhorst (Netherlands) · NLUniversity Medical Center Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Researchers have extensively studied fatigue, depression and anxiety in cancer patients. Several risk and protective factors have been identified for these symptoms. As most studies address these constructs, independently from other symptoms and potential risk and protective factors, more insight into the complex relationships among these constructs is needed. This study used the multivariate network approach to gain a better understanding of how patients' symptoms and risk and protective factors (i.e. physical symptoms, social withdrawal, illness cognitions, goal adjustment and partner support) are interconnected. We used cross-sectional data from a sample of cancer patients seeking psychological care (n = 342). Using network modelling, the relationships among symptoms of fatigue, depression and anxiety, and potential risk and protective factors were explored. Additionally, centrality (i.e. the number and strength of connections of a construct) and stability of the network were explored. Among risk factors, the relationship of helplessness and physical symptoms with fatigue stood out as they were stronger than most other connections in the network. Among protective factors, illness acceptance was most centrally embedded within the network, indicating it had more and stronger connections than most other variables in the network. The network identified key connections with risk factors (helplessness, physical symptoms) and a key protective factor (acceptance) at the group level. Longitudinal studies should explore these risk and protective factors in individual dynamic networks to further investigate their causal role and the extent to which such networks can inform us on what treatment would be most suitable for the individual cancer patient.

Indexed as

AdultAnxietyAnxiety DisordersCross-Sectional StudiesDepressionEmotionsFatigueFemaleHumansLongitudinal StudiesMaleMiddle AgedNeoplasmsProtective FactorsRisk FactorsAcceptanceAnxietyCancerCancer-related fatigueCopingDepressionHelplessnessNetwork analysis

Identifiers

PMID31435892
PMCPMC7366596
OpenAlexW2969840533

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.