Distinct Co-occurring Morning and Evening Fatigue Profiles in Patients With Gastrointestinal Cancers Receiving Chemotherapy.
Yufen Lin, Donald E Bailey, Canhua Xiao and 7 others
PMID 36076314WHAT IT FOUND
Among 405 patients with gastrointestinal cancers on chemotherapy, 40% had a high morning and evening fatigue profile, associated with younger age, female sex, childcare, lower function, comorbidities, anemia, depression, and higher stress.
Key findings
01Two co-occurring fatigue profiles were identified: Low-Moderate in 60.0% of patients and Both High in 40.0%.
02Compared with the Low-Moderate class, the Both High class was younger, more often female, less likely to be married or partnered, more likely to have childcare responsibilities, less likely to be employed, reported lower annual household income, was less likely to exercise regularly, had lower performance status, had more comorbidities, had received more prior cancer treatments, and was more likely to report anemia or depression.
03The Both High class reported higher stress, lower resilience, higher state and trait anxiety, more depressive symptoms, more sleep disturbance, lower morning and evening energy, lower attentional function, and more pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was an observational study, so it cannot show that any risk factor caused the fatigue profile. No fatigue treatment was tested, so it cannot show that any intervention reduced fatigue. Patients were approached during their first or second chemotherapy cycle, not before chemotherapy began, so risk profiles from the start of treatment were not evaluated. Most patients were White and well educated, and only English-speaking patients were included, so the findings may not generalise to other groups. The analysis included different gastrointestinal cancers, so it may not apply to a specific cancer type such as pancreatic or gastric cancer. Of 2234 patients approached, 1343 consented and 405 were analysed, and refusal was often because treatment was overwhelming, so the analysed sample may differ from patients who did not participate.
Declared interests
The authors declared no conflicts of interest. The paper does not report a funding source.
The easy way to misread this
Do not read the 40% high fatigue group as proof that an intervention will help. The study only grouped patients by self-reported fatigue and associated risk factors; it did not test treatment.