{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T11:06:28Z","timestamp":1785323188709,"version":"3.55.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Cancer\u2010related fatigue (CRF) is highly prevalent and often insufficiently addressed in routine survivorship care. This study examined whether patient activation and patient\u2010physician communication quality in early survivorship are associated with subsequent CRF among cancer survivors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The observational German LIFT study enrolled 1175 adult survivors of various cancer types. CRF was assessed 4\u20136, 9, 12, and 24\u00a0months post\u2010diagnosis using the EORTC QLQ\u2010FA12. Patient activation was assessed with the German Patient Activation Measure (PAM\u201013\u2010D (PAM)) and communication quality with an exploratory five\u2010item scale (ComQ) 9\u00a0months after diagnosis. Multiple linear regression models examined associations of PAM and ComQ with physical and total CRF 12\u00a0months (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01132) and 24\u00a0months (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01067) after diagnosis, adjusting for sociodemographic and clinical covariates. Sensitivity analyses additionally adjusted for previous CRF 4\u20136\u00a0months after diagnosis. Missing data among alive participants were multiply imputed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>PAM at 9\u00a0months was negatively associated with physical and total CRF at both 12 and 24\u00a0months after diagnosis, whereas ComQ at 9\u00a0months was negatively associated with physical and total CRF at 12\u00a0months only. After additional adjustment for previous CRF at 4\u20136\u00a0months, negative associations for PAM with physical and total CRF persisted at 12\u00a0months but were attenuated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Higher patient activation and better perceived patient\u2010physician communication were associated with lower subsequent CRF, particularly within the first year after diagnosis. Activation\u2010oriented and communication\u2010focused strategies may complement existing CRF interventions and warrant further evaluation in pragmatic trials across different survivor groups and settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70542","type":"journal-article","created":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T06:16:37Z","timestamp":1784096197000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Activation, Patient\u2010Physician Communication Quality, and Cancer\u2010Related Fatigue: A Longitudinal Study of Cancer Survivors"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8207-2189","authenticated-orcid":false,"given":"Duc Truong","family":"Nguyen","sequence":"first","affiliation":[{"name":"Division of Physical Activity, Cancer Prevention and Survivorship German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg a Partnership Between DKFZ and University Medical Center Heidelberg  Heidelberg Germany"},{"name":"Department of Internal Medicine II Chair of Integrated Psychosomatic Medicine and Psychotherapy University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2095-2426","authenticated-orcid":false,"given":"Martina E.","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Physical Activity, Cancer Prevention and Survivorship German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg a Partnership Between DKFZ and University Medical Center Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlena","family":"Milzer","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy Central Institute of Mental Health Medical Faculty Mannheim\/Heidelberg University  Mannheim Germany"},{"name":"University Medical Center Mannheim Mannheim Cancer Center  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9272-4036","authenticated-orcid":false,"given":"Anna S.","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Chair of Integrated Psychosomatic Medicine and Psychotherapy University Hospital W\u00fcrzburg  W\u00fcrzburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5815-5713","authenticated-orcid":false,"given":"Senta","family":"Kiermeier","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II Chair of Integrated Psychosomatic Medicine and Psychotherapy University Hospital W\u00fcrzburg  W\u00fcrzburg 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Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201039046\u20100"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(17)33326\u20103"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00432\u2010023\u201005555\u20108"},{"key":"e_1_2_12_5_1","volume-title":"NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Cancer\u2010Related Fatigue (Version 1.2026) Plymouth Meeting, PA","author":"National Comprehensive Cancer 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