School of Nursing, University of California, San Francisco, CA, USA.
School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
Support Care Cancer. 2022 Dec;30(12):9929-9944. doi: 10.1007/s00520-022-07431-6. Epub 2022 Nov 10.
Pain and fatigue are common symptoms in oncology patients. In a sample of oncology outpatients receiving chemotherapy (n = 1342), the study purposes were to identify subgroups of patients with distinct worst pain and morning fatigue profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, as well as the severity of common symptoms and quality of life (QOL) outcomes.
Oncology outpatients receiving chemotherapy (n = 1342) completed self-report questionnaires to assess pain and morning fatigue, a total of six times over two cycles of chemotherapy. Joint latent profile analysis was used to identify subgroups of patients with distinct pain and morning fatigue profiles. Differences among the classes were evaluated using parametric and non-parametric tests.
Five distinct profiles were identified (no pain and low morning fatigue (27.6%), moderate pain and low morning fatigue (28.2%), moderate pain and morning fatigue (28.0%), moderate pain and increasing and decreasing morning fatigue (6.9%), severe pain and very high morning fatigue (9.3%)). Patients with the three worst profiles had clinically meaningful levels of depression and sleep disturbance and decrements in QOL.
Over 44% of the sample had moderate to high levels of both pain and morning fatigue. Unrelieved pain may contribute to disturbed sleep which results in higher levels of morning fatigue. Clinicians need to assess for pain and fatigue, as well as sleep disturbance during chemotherapy.
疼痛和疲劳是肿瘤科患者的常见症状。在接受化疗的肿瘤科门诊患者样本（n=1342）中，本研究旨在确定具有不同最严重疼痛和清晨疲劳特征的患者亚组，并评估亚组之间在人口统计学和临床特征方面的差异，以及常见症状和生活质量（QOL）结果的严重程度。
接受化疗的肿瘤科门诊患者（n=1342）完成了自我报告问卷，以评估疼痛和清晨疲劳，在两个化疗周期中总共进行了六次评估。联合潜在剖面分析用于确定具有不同疼痛和清晨疲劳特征的患者亚组。使用参数和非参数检验评估类之间的差异。
确定了五个不同的特征（无疼痛和低清晨疲劳（27.6%）、中度疼痛和低清晨疲劳（28.2%）、中度疼痛和清晨疲劳（28.0%）、中度疼痛和清晨疲劳增加和减少（6.9%）、严重疼痛和极高清晨疲劳（9.3%））。三个最严重特征的患者具有有临床意义的抑郁和睡眠障碍水平以及 QOL 下降。
超过 44%的样本同时存在中度到高度的疼痛和清晨疲劳。未缓解的疼痛可能导致睡眠障碍，从而导致更高水平的清晨疲劳。临床医生在化疗期间需要评估疼痛、疲劳和睡眠障碍。
