Cancer-related fatigue: benefits of information booklets to improve patients' knowledge and empowerment.

PURPOSE: To investigate cancer patients' knowledge and attitudes regarding fatigue and the potential benefits and acceptability of a brief information booklet. METHODS: The CARPE DIEM study assessed knowledge and attitudes regarding fatigue in a diverse group of 50 cancer patients before (T0) and about one (T1) and four months (T2) after reading the booklet. At T1, participants additionally rated its usefulness. RESULTS: At baseline, 37.5% of respondents did not know the term "fatigue" or what it meant. Those who already knew something about fatigue mainly had obtained their information from booklets, books, or articles (63.3%) and/or the internet (46.7%). Overall, knowledge gaps existed, particularly about potential fatigue treatment options and whether fatigue is an indicator of cancer progression. Furthermore, 56.4% felt poorly informed, and 46.1% reported feeling helpless in the face of fatigue. Lower knowledge at baseline was significantly associated with lower education and older age. At T1 and T2, there were significant improvements in several knowledge questions and attitudes. Patient-reported benefits included getting new information about fatigue (91.1%), awareness of not being alone with their problems (89.7%), taking appropriate actions (72.9%), and encouragement to talk about their fatigue with family/friends (55.3%) or with a health professional (52.7%). CONCLUSIONS: Specific gaps were identified in the provision of information and education for cancer patients about fatigue. A low-cost intervention asking to read a brief information booklet was associated with improved knowledge. This could be considered as a first step offered as part of a bundle of further efforts to improve knowledge and care of fatigue.

[Memory diseases]. / Maladies de la mémoire.

MEMORY DISEASES. There are many diseases that permanently affect longterm memory and all of them have in common that they permanently and usually bilaterally disrupt specific neural circuits that underlie it. In the forefront is the Papez circuit, or hippocampo-mamillo-thalamo-cingular circuit, which is also connected to the fronto-basal regions. Its impairment leads to disorders of episodic memory, with relative preservation of semantic memory and implicit learning. The anterior temporal pole is a hub allowing access to general knowledge distributed in the cortex. Its damage results in an amnesic picture in which the loss of semantic memory dominates. The richness of memory disorders is largely deduced, in its nuances, from the lesion topographies. The most frequent aetiology of memory diseases is represented by neurodegenerative diseases, dominated by Alzheimer's disease, but the semiology of these is by far not limited to a memory disorder, because of the diffusion of lesions. Dysimmune, infectious or toxic encephalitis affecting the hippocampi, Korsakoff's syndrome affecting the thalamus and mamillary bodies, « semantic dementia ¼ affecting the temporal pole, give pictures where memory disorders are in the foreground with remarkable semiological nuances. Post-traumatic amnesia, due to the heterogeneity of the lesions, offers a more complex picture, where memory disorders are complemented by executive disorders, sometimes major.

MALADIES DE LA MÉMOIRE. Les maladies qui affectent durablement la mémoire à long terme sont nombreuses et ont en commun de perturber de façon permanente et, en règle, bilatérale des circuits neuronaux spécifiques qui en sont le substratum. Au premier rang figure le circuit de Papez, ou circuit hippocampo-mamillo-thalamo-cingulaire, par ailleurs connecté aux régions frontobasales. Son atteinte engendre des troubles de la mémoire épisodique, avec une relative préservation de la mémoire sémantique et des apprentissages implicites. Le pôle temporal antérieur est quant à lui un noeud fonctionnel permettant d'accéder aux connaissances générales distribuées dans le cortex. Son atteinte donne un tableau amnésique où domine la perte de la mémoire sémantique. La richesse sémiologique des troubles de la mémoire se déduit largement, dans ses nuances, des topographies lésionnelles. La cause la plus fréquente des maladies de la mémoire est représentée par des maladies neurodégénératives, dominées par la maladie d'Alzheimer, mais la sémiologie de celles-ci ne se limite, de loin, pas à un trouble de la mémoire, du fait de la diffusion des lésions. Les encéphalites dysimmunitaires, infectieuses ou toxiques touchant les hippocampes, le syndrome de Korsakoff touchant les thalamus et corps mamillaires, la « démence sémantique ¼ donnent des tableaux où les troubles mnésiques sont au premier plan, avec des nuances sémiologiques remarquables. L'amnésie post-traumatique, en raison de l'hétérogénéité des lésions, offre un tableau plus complexe, où les troubles de la mémoire se complètent de troubles exécutifs parfois majeurs.