Asakitogum David Ayangba, Nutor Jerry J, Hammer Marilyn J, Pozzar Rachel, Paul Steven M, Cooper Bruce A, Conley Yvette P, Levine Jon, Miaskowski Christine
Author Affiliations: School of Nursing, University of California, San Francisco (Mr Asakitogum and Drs Nutor, Paul, Cooper, and Miaskowski); Dana Farber Cancer Institute, Boston, Massachusetts (Drs Hammer and Pozzar); School of Nursing, University of Pittsburgh, Pennsylvania (Dr Conley); School of Medicine, University of California, San Francisco (Drs Levine and Miaskowski).
Cancer Nurs. 2024 Nov 6. doi: 10.1097/NCC.0000000000001420.
Decrements in energy are a significant problem associated with chemotherapy. To date, no study examined the variability of energy in patients with gynecologic cancers.
To identify distinct morning and evening energy profiles in patients with gynecologic cancers and evaluate for differences in demographic and clinical characteristics, other common symptoms, and quality-of-life (QOL) outcomes.
A sample of 232 patients with gynecologic cancers completed questionnaires 6 times over 2 cycles of chemotherapy. Latent profile analysis was used to identify distinct morning and evening energy profiles. Differences in demographic and clinical characteristics, other common symptoms, and QOL outcomes were evaluated using parametric and nonparametric tests.
Three distinct morning (ie, high [9.2%], low [63.1%], very low [27.1%]) and 2 distinct evening (moderate [30.6%], very low [69.4%]) energy classes were identified. Clinical risk factors associated with the worst morning energy profiles included lower functional status and a higher comorbidity burden. Less likely to exercise on a regular basis was the only characteristic associated with the worst evening energy profile. For both symptoms, the worst profiles were associated with higher levels of depression and sleep disturbance, lower levels of cognitive function, and poorer QOL.
Approximately 70% of patients with gynecologic cancers experienced decrements in morning and evening energy. The study identified modifiable risk factors associated with more decrements in morning and evening energy.
Clinicians can use these findings to identify higher-risk patients and develop individualized energy conservation interventions for these vulnerable patients.
能量下降是与化疗相关的一个重要问题。迄今为止，尚无研究考察妇科癌症患者能量的变异性。
识别妇科癌症患者不同的早晚能量特征，并评估人口统计学和临床特征、其他常见症状以及生活质量（QOL）结果的差异。
232例妇科癌症患者样本在2个化疗周期内完成了6次问卷调查。采用潜在特征分析来识别不同的早晚能量特征。使用参数检验和非参数检验评估人口统计学和临床特征、其他常见症状以及QOL结果的差异。
识别出三种不同的早晨能量类别（即高能量[9.2%]、低能量[63.1%]、极低能量[27.1%]）和两种不同的晚上能量类别（中等能量[30.6%]、极低能量[69.4%]）。与最差早晨能量特征相关的临床风险因素包括较低的功能状态和较高的合并症负担。唯一与最差晚上能量特征相关的特征是较少定期锻炼。对于这两种症状，最差特征都与较高水平的抑郁和睡眠障碍、较低水平的认知功能以及较差的QOL相关。
约70%的妇科癌症患者早晚能量出现下降。该研究识别出了与早晚能量更多下降相关的可改变风险因素。
临床医生可利用这些发现识别高危患者，并为这些脆弱患者制定个性化的能量节约干预措施。
