Distinct Trajectories of Fatigue and Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer.
Meagan Whisenant, Bob Wong, Sandra A Mitchell and 2 others
PMID 29052653WHAT IT FOUND
Many women during breast cancer chemotherapy had mild fatigue that improved, but some started moderate to high and remained more symptomatic; a smaller group had sleep problems that worsened over 14 days.
Track early severity.
Key findings
01Most women had mild decreasing fatigue, but 11% in both cycles were in a high moderate decreasing fatigue class.
02A smaller group had increasing disturbed sleep, including 11% in cycle 2 and 19% in cycle 3.
03Doxorubicin use was the only demographic or clinical variable associated with fatigue class membership.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis of data collected for other studies, not a study designed to test symptom trajectories. The sample was modest and fairly homogeneous. Symptoms were measured with single daily items, which can add measurement error. No adjustments were made for multiple statistical tests. Several relevant variables were not available, such as comorbidities, menopausal status, symptom management, and previous sleep patterns. The analysis could not separate effects of different chemotherapy regimens because of sample size. Only 37% of the sample was employed.
Declared interests
No conflict of interest statement is provided in the supplied text. The publication types list N.I.H. extramural research support.
The easy way to misread this
Do not read the doxorubicin association as proof that doxorubicin caused worse fatigue. This was an exploratory secondary analysis, and the authors state that they could not separate dose effects or other agents received with doxorubicin.