Morning Fatigue Severity Profiles in Oncology Outpatients Receiving Chemotherapy.
Fay Wright, Laura B Dunn, Steven M Paul and 6 others
PMID 30024437WHAT IT FOUND
Half of chemotherapy outpatients had severe morning fatigue.
Those in the worst group were younger, had higher BMI and more comorbidities, and reported worse anxiety, sleep, and attention. Assess fatigue separately from evening symptoms to catch this high-risk group.
Key findings
01High and Very High morning fatigue classes comprised 50.2% of the sample, with scores above the clinically meaningful cutoff across all six assessments.
02Patients in the Very High fatigue class were more likely to be younger, have higher BMI and comorbidities, and be less likely to exercise regularly compared to lower fatigue classes.
03Morning fatigue severity was associated with worse functional status, higher depression, and lower attentional function across the four identified classes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
Patients were recruited at various points in their chemotherapy cycle, so the study did not evaluate risk profiles from the start of treatment through completion. Information on exercise and pain was limited, so the strength of these associations should be interpreted with caution. Participants did not report the exact time they completed the morning questionnaires, though the difference between morning and evening ratings supported the validity of the diurnal measurements.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institute of Nursing Research and the National Cancer Institute.
The easy way to misread this
Do not assume that assessing general fatigue captures the full picture. This study shows morning and evening fatigue are distinct, and half the patients had high morning fatigue despite varying evening levels. Screening only for evening fatigue may miss the high-risk group.