UCSF

Background – Pain and fatigue are common symptoms in oncology patients.Objective – Study purposes, in a sample of oncology outpatients receiving chemotherapy (n=1342), 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. Methods – 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. Results – Five distinct profiles were identified (no pain and no morning fatigue (27.6%), moderate pain and no morning fatigue (28.2%), moderate pain and morning fatigue (28%), moderate pain and increasing and decreasing morning fatigue (6.9%), severe pain and very high morning fatigue (9.3%). Patients in the three highest profiles had clinically meaningful levels of depression and sleep disturbance and decrements in QOL. Conclusions – 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. Implications for practice – Clinicians need to assess for pain and fatigue, as well as sleep disturbance during chemotherapy.