Higher Levels of Multiple Types of Stress Are Associated With Worse State Anxiety and Morning Fatigue Profiles in Patients Receiving Chemotherapy.
Philip Garcia, Astrid Block, Sueann Mark and 7 others
PMID 38259094WHAT IT FOUND
Patients with high anxiety and morning fatigue had higher stress, lower resilience, and more trauma history than those with low symptoms.
Nurses should screen for adverse childhood experiences and cancer-related distress to identify patients needing psychosocial support.
Key findings
01Patients in the high anxiety and high morning fatigue class reported significantly higher scores for global stress, cancer-related distress, and lifetime trauma exposure compared to those in the low class.
02Higher symptom burden was associated with lower resilience scores and greater use of disengagement coping strategies such as denial, venting, and self-blame.
03Patients with moderate to high anxiety and morning fatigue had lower functional status and a higher comorbidity burden than those with low symptoms.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is observational, so it cannot prove that stress causes anxiety and fatigue, only that they are associated. Stress and coping measures were taken only at enrollment, not repeated over time, so changes in stress levels could not be linked to symptom changes. Patients who refused participation were overwhelmed by treatment, suggesting the study may underestimate the true burden of symptoms and stress in the general chemotherapy population. Follow-up was limited to two cycles of chemotherapy, so long-term patterns of anxiety and fatigue were not assessed.
Declared interests
The study was supported by the National Institutes of Health (N.I.H., Extramural). No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume that treating the stress will automatically reduce the anxiety and fatigue. The study shows an association, not a causal link, and the stress measures were taken only at the start, so we do not know if changing stress levels changes symptoms over time.