Donovan Kristine A, Small Brent J, Andrykowski Michael A, Munster Pamela, Jacobsen Paul B
Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA.
Health Psychol. 2007 Jul;26(4):464-72. doi: 10.1037/0278-6133.26.4.464.
The objective of the current study was twofold: (a) to determine whether subgroups of breast cancer patients could be identified on the basis of their distinct trajectory or pattern of fatigue following treatment for early stage cancer using growth mixture modeling and (b) to examine whether the subgroups could be distinguished on the basis of a cognitive-behavioral model. Growth mixture modeling and a prospective longitudinal design were used to examine the course of fatigue after treatment for early stage breast cancer. Women (n = 261; mean age = 55.2 years) provided fatigue ratings for 6 months following treatment. A low-fatigue group (n = 85) and a high-fatigue group (n = 176) were extracted. Women who were not married, had a lower income, had a higher body mass index, engaged in greater fatigue catastrophizing, and were lower in exercise participation were more likely to be in the high-fatigue group. Only body mass index and catastrophizing remained significant predictors in multivariate analysis. Findings suggest considerable heterogeneity in the experience of fatigue following treatment and support the utility of a cognitive-behavioral model in predicting the course of posttreatment fatigue.
(a)使用生长混合模型确定能否根据早期癌症治疗后乳腺癌患者疲劳的不同轨迹或模式识别出亚组,以及(b)检验能否根据认知行为模型区分这些亚组。采用生长混合模型和前瞻性纵向设计来研究早期乳腺癌治疗后的疲劳过程。女性(n = 261;平均年龄 = 55.2岁)在治疗后6个月提供疲劳评分。提取出一个低疲劳组(n = 85)和一个高疲劳组(n = 176)。未婚、收入较低、体重指数较高、疲劳灾难化程度较高且运动参与度较低的女性更有可能属于高疲劳组。在多变量分析中,只有体重指数和灾难化仍然是显著的预测因素。研究结果表明治疗后疲劳体验存在相当大的异质性,并支持认知行为模型在预测治疗后疲劳过程中的效用。