Distinct Morning and Evening Fatigue Profiles in Patients With Gynecologic Cancers Receiving Chemotherapy.

OBJECTIVES: To identify distinct morning and evening fatigue profiles in patients with gynecologic cancers and evaluate for differences in demographic and clinical characteristics, common symptoms, and quality-of-life outcomes.

SAMPLE & SETTING: Outpatients with gynecologic cancers (N = 233) were recruited before their second or third cycles of chemotherapy at four cancer centers in San Francisco Bay and New York.

METHODS & VARIABLES: The Lee Fatigue Scale was completed six times over two cycles of chemotherapy in the morning and in the evening. Latent profile analysis was used to identify distinct morning and evening fatigue profiles.

RESULTS: Four distinct morning and two distinct evening fatigue classes were identified. Common risk factors for morning and evening fatigue included younger age, higher body mass index, lower functional status, and higher comorbidity burden. Patients in the worst morning and evening fatigue classes reported higher levels of anxiety, depression, and sleep disturbance; lower levels of energy and cognitive function; and poorer quality of life.

IMPLICATIONS FOR NURSING: Clinicians can use this information to identify higher-risk patients and develop individualized interventions for morning and evening fatigue.