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Multicenter Study
. 2014 Oct;48(4):558-68.
doi: 10.1016/j.jpainsymman.2013.10.025. Epub 2014 Apr 21.

Subgroups of cancer patients with unique pain and fatigue experiences during chemotherapy

Hee-Ju Kim  1 , Patrick S Malone  2 , Andrea M Barsevick  3
Affiliations
Multicenter Study

Subgroups of cancer patients with unique pain and fatigue experiences during chemotherapy

Hee-Ju Kim et al. J Pain Symptom Manage. 2014 Oct.

Abstract

Context: Some cancer patients experience pain and fatigue, whereas others experience only one of the two symptoms. Yet, it is not clear who experiences these unique patterns and why.

Objectives: This study aimed to identify subgroups of cancer patients with unique pain and fatigue experiences in two different chemotherapy cycles to examine how selected factors influenced subgroup membership and identify how subgroups differed in concurrently measured functional limitation outcome.

Methods: The sample included 276 patients with diverse cancer types from four U.S. sites. To investigate subgroups, latent profile analyses were performed. Multinomial logistic regression and one-way analysis of variance-type analyses were conducted to examine the influencing variables of subgroup membership and to examine differences among subgroups in patient outcome.

Results: The high-pain/high-fatigue (HPHF) and low-pain/low-fatigue subgroups were found at both time points. The low-pain/high-fatigue subgroup was present only in the first chemotherapy cycle. Pain and fatigue levels significantly differentiated subgroups at each time point (all P<0.05). Across the two time points, experiencing higher depressed mood increased the risk to be in the HPHF subgroup (all P<0.01). The HPHF subgroup had the most serious limitations in activities (all P<0.01).

Conclusion: This study confirmed the existence of a unique symptom experience of pain and fatigue. This pattern should be acknowledged for symptom assessment and management.

Keywords: Pain; cancer; depressed mood; fatigue; symptom assessment; symptom cluster; symptom management.

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Conflict of interest statement

There is no conflict of interest for this work.

Figures

Figure 1
Figure 1
Statistical model of the study Note. athe direct influence of the hemoglobin level on fatigue was allowed in this statistical model but its effect was not tested.
Figure 2
Figure 2
Pain and Fatigue Subgroups Based on the Most Likely (expected a posteriori) Subgroup Membership of Each Respondent Note: Intensity of each symptom is raw score and patients are classified based on the estimated model; The ranges of scores for fatigue and pain were 1–10; Higher scores indicated more intense symptoms.
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