Identification of Distinct Profiles of Cancer-Related Fatigue and Associated Risk Factors for Breast Cancer Patients Undergoing Chemotherapy

Abstract

Background Cancer-related fatigue is a complex, multidimensional, subjective experience that affects patients physically, emotionally, and mentally. The interindividual variability in symptoms of cancer-related fatigue merits further exploration. Objective Our objective was to identify distinct profiles of cancer-related fatigue experienced by breast cancer patients undergoing chemotherapy and to evaluate how subgroups vary demographically in clinical characteristics and in modifiable factors such as physical activity, sleep quality, and exercise self-efficacy. Methods Fatigue was assessed with the Chinese Cancer-Related Fatigue Scale, and a latent class analysis was performed to identify subgroups of patients with distinct fatigue profiles. Results A total of 427 breast cancer patients were included in the data analyses. Five different fatigue profiles were identified: all low-risk fatigue, all high-risk fatigue, high-risk physical fatigue, high-risk emotional fatigue, and high-risk mental fatigue. Patients in different subgroups were characterized by different risk factors. For example, patients in the high-risk emotional fatigue group had less education, lower monthly household incomes, lower exercise self-efficacy scores, less sedentary behavior, poorer sleep, and poorer quality-of-life outcomes compared with those in the all low-risk fatigue group. Conclusion These findings reveal that breast cancer patients undergoing chemotherapy show significant heterogeneity in their experience of cancer-related fatigue. Implications for Practice Characteristics associated with different fatigue profiles, in particular the high-risk profiles, can be used by clinicians to target patients at greater risk of poorer symptom and quality-of-life outcomes to provide interventions tailored to their different needs.