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. 2023 Mar;65(3):203-215.
doi: 10.1016/j.jpainsymman.2022.11.017. Epub 2022 Nov 22.

Higher Stress in Oncology Patients is Associated With Cognitive and Evening Physical Fatigue Severity

Lisa Morse  1 , Steven M Paul  1 , Bruce A Cooper  1 , Kate Oppegaard  1 , Joosun Shin  1 , Alejandra Calvo-Schimmel  1 , Carolyn Harris  2 , Marilyn Hammer  3 , Yvette Conley  2 , Fay Wright  4 , Jon D Levine  5 , Kord M Kober  1 , Christine Miaskowski  6
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Higher Stress in Oncology Patients is Associated With Cognitive and Evening Physical Fatigue Severity

Lisa Morse et al. J Pain Symptom Manage. 2023 Mar.

Abstract

Context: Cognitive and physical fatigue are common symptoms experienced by oncology patients. Exposure to stressful life events (SLE), cancer-related stressors, coping styles, and levels of resilience may influence the severity of both dimensions of fatigue.

Objectives: Evaluate for differences in global, cancer-specific, and cumulative life stress, as well as resilience and coping in oncology patients (n=1332) with distinct cognitive fatigue AND evening physical fatigue profiles.

Methods: Latent profile analysis, which combined the two symptom scores, identified three subgroups of patients with distinct cognitive fatigue AND evening physical fatigue profiles (i.e., Low, Moderate, High). Patients completed measures of global, cancer-specific, and cumulative life stress as well measures of resilience and coping. Differences among the latent classes in the various measures were evaluated using parametric and nonparametric tests.

Results: Compared to Low class, the other two classes reported higher global and cancer-specific stress. In addition, they reported higher occurrence rates for sexual harassment and being forced to touch prior to 16 years of age. Compared to the other two classes, High class reported lower resilience scores and higher use of denial, substance use, and behavioral disengagement.

Conclusion: To decrease both cognitive and evening physical fatigue, clinicians need to assess for relevant stressors and initiate interventions to increase resilience and the use of engagement coping strategies. Additional research is warranted on the relative contribution of various social determinants of health to both cognitive and physical fatigue in oncology patients receiving chemotherapy.

Keywords: Cancer; chemotherapy; cognitive impairment; coping; fatigue; resilience; stress.

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Conflict of interest statement

Conflicts of Interest The authors have no conflicts of interest to declare.

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