TY - JOUR
T1 - Subgroups of chemotherapy patients with distinct morning and evening fatigue trajectories
AU - Kober, Kord M.
AU - Cooper, Bruce A.
AU - Paul, Steven M.
AU - Dunn, Laura B.
AU - Levine, Jon D.
AU - Wright, Fay
AU - Hammer, Marilyn J.
AU - Mastick, Judy
AU - Venook, Alan
AU - Aouizerat, Bradley E.
AU - Miaskowski, Christine
N1 - Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Purpose: Purposes of this study were to identify subgroups of patients with distinct trajectories for morning and evening fatigue, evaluate for differences in demographic and clinical characteristics among these subgroups, and compare and contrast the predictors of subgroup membership for morning and evening fatigue. Methods: Outpatients with breast, gastrointestinal, gynecological, or lung cancer (n = 582) completed questionnaires, a total of six times over two cycles of chemotherapy (CTX). Morning and evening fatigue severity were evaluated using the Lee Fatigue Scale. Latent profile analysis (LPA) was used to identify distinct subgroups. Results: Three latent classes were identified for morning fatigue (i.e., low (31.8 %), high (51.4 %), and very high (16.8 %)) and for evening fatigue (i.e., moderate (20.0 %), high (21.8 %), and very high (58.2 %)). Most of the disease and treatment characteristics did not distinguish among the morning and evening fatigue classes. Compared to the low class, patients in the high and very high morning fatigue classes were younger, had a lower functional status, and higher level of comorbidity. Compared to the moderate class, patients in the very high evening fatigue class were younger, more likely to be female, had child care responsibilities, had a lower functional status, and a higher level of comorbidity. Conclusion: LPA allows for the identification of risk factors for more severe fatigue. Since an overlap was not observed across the morning and evening fatigue classes and unique predictors for morning and evening fatigue were identified, these findings suggest that morning and evening fatigue may have distinct underlying mechanisms.
AB - Purpose: Purposes of this study were to identify subgroups of patients with distinct trajectories for morning and evening fatigue, evaluate for differences in demographic and clinical characteristics among these subgroups, and compare and contrast the predictors of subgroup membership for morning and evening fatigue. Methods: Outpatients with breast, gastrointestinal, gynecological, or lung cancer (n = 582) completed questionnaires, a total of six times over two cycles of chemotherapy (CTX). Morning and evening fatigue severity were evaluated using the Lee Fatigue Scale. Latent profile analysis (LPA) was used to identify distinct subgroups. Results: Three latent classes were identified for morning fatigue (i.e., low (31.8 %), high (51.4 %), and very high (16.8 %)) and for evening fatigue (i.e., moderate (20.0 %), high (21.8 %), and very high (58.2 %)). Most of the disease and treatment characteristics did not distinguish among the morning and evening fatigue classes. Compared to the low class, patients in the high and very high morning fatigue classes were younger, had a lower functional status, and higher level of comorbidity. Compared to the moderate class, patients in the very high evening fatigue class were younger, more likely to be female, had child care responsibilities, had a lower functional status, and a higher level of comorbidity. Conclusion: LPA allows for the identification of risk factors for more severe fatigue. Since an overlap was not observed across the morning and evening fatigue classes and unique predictors for morning and evening fatigue were identified, these findings suggest that morning and evening fatigue may have distinct underlying mechanisms.
KW - Cancer
KW - Chemotherapy
KW - Diurnal variations
KW - Evening fatigue
KW - Fatigue
KW - Latent class analysis
KW - Latent profile analysis
KW - Morning fatigue
UR - http://www.scopus.com/inward/record.url?scp=84959121423&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959121423&partnerID=8YFLogxK
U2 - 10.1007/s00520-015-2895-2
DO - 10.1007/s00520-015-2895-2
M3 - Article
C2 - 26361758
AN - SCOPUS:84959121423
SN - 0941-4355
VL - 24
SP - 1473
EP - 1485
JO - Supportive Care in Cancer
JF - Supportive Care in Cancer
IS - 4
ER -