Abstract：
OBJECTIVE: Cancer-related fatigue (CRF) is a chronic symptom that can affect the overall functioning of lung cancer patients throughout the course of the disease. However, there is limited research on the trajectory and predictors of CRF specifically in lung cancer patients. Furthermore, few studies have investigated the predictive role of positive psychological and social factors in relation to CRF. This study aimed to explore the trajectory of CRF and its predictors in postoperative chemotherapy patients with lung cancer.
METHODS: A total of 202 lung cancer patients who underwent surgery and received adjuvant chemotherapy were recruited for this study. Baseline questionnaires were completed, covering sociodemographic information, disease details, CRF levels, personality traits, psychological resilience, and social support. CRF was assessed at three time points: first chemotherapy (T1), 3 months after chemotherapy (T2), and 6 months after chemotherapy (T3). Latent class growth modeling (LCGM) was used to identify distinct developmental trajectories of CRF. Logistic regression analysis was employed to examine predictors of CRF within different patient groups.
RESULTS: The LCGM analysis revealed three distinct CRF trajectories: persistent high fatigue group (30.7%), rising fatigue group (30.7%), and no fatigue group (38.6%). Cancer stage (OR = 7.563, 95% CI = 2.468-23.182, P < 0.001), melancholic personality (OR = 6.901, 95% CI = 1.261-37.764, P = 0.026), and high psychological resilience (OR = 0.171, 95% CI = 0.041-0.706, P = 0.015) were associated with the CRF trajectory. On the other hand, sanguine personality (OR = 0.254, 95% CI = 0.071-0.916, P = 0.036) and high social support (OR = 0.168, 95% CI = 0.045-0.627, P = 0.008) were associated with the increasing fatigue trajectory.
CONCLUSIONS: This study demonstrated that 60% of lung cancer patients experienced persistent fatigue throughout the assessment period. Moreover, it confirmed the heterogeneity of CRF trajectories among lung cancer patients. The severity of CRF was found to be higher in patients with advanced clinical stages, depressive personality traits, and lower psychological resilience.
METHODS: A total of 202 lung cancer patients who underwent surgery and received adjuvant chemotherapy were recruited for this study. Baseline questionnaires were completed, covering sociodemographic information, disease details, CRF levels, personality traits, psychological resilience, and social support. CRF was assessed at three time points: first chemotherapy (T1), 3 months after chemotherapy (T2), and 6 months after chemotherapy (T3). Latent class growth modeling (LCGM) was used to identify distinct developmental trajectories of CRF. Logistic regression analysis was employed to examine predictors of CRF within different patient groups.
RESULTS: The LCGM analysis revealed three distinct CRF trajectories: persistent high fatigue group (30.7%), rising fatigue group (30.7%), and no fatigue group (38.6%). Cancer stage (OR = 7.563, 95% CI = 2.468-23.182, P < 0.001), melancholic personality (OR = 6.901, 95% CI = 1.261-37.764, P = 0.026), and high psychological resilience (OR = 0.171, 95% CI = 0.041-0.706, P = 0.015) were associated with the CRF trajectory. On the other hand, sanguine personality (OR = 0.254, 95% CI = 0.071-0.916, P = 0.036) and high social support (OR = 0.168, 95% CI = 0.045-0.627, P = 0.008) were associated with the increasing fatigue trajectory.
CONCLUSIONS: This study demonstrated that 60% of lung cancer patients experienced persistent fatigue throughout the assessment period. Moreover, it confirmed the heterogeneity of CRF trajectories among lung cancer patients. The severity of CRF was found to be higher in patients with advanced clinical stages, depressive personality traits, and lower psychological resilience.
摘要：
目的：癌症相关性疲劳（CRF）是一种慢性症状，可在整个疾病过程中影响肺癌患者的整体功能。然而,关于CRF在肺癌患者中的作用轨迹和预测因素的研究有限.此外，很少有研究调查积极的心理和社会因素对CRF的预测作用。本研究旨在探讨CRF在肺癌术后化疗患者中的作用轨迹及其预测因素。
方法：本研究共招募202名接受手术和辅助化疗的肺癌患者。基线问卷已完成，涵盖社会人口统计信息，疾病详情,CRF级别,人格特质，心理韧性，和社会支持。CRF在三个时间点进行评估：第一次化疗（T1），化疗后3个月（T2），化疗后6个月（T3）。潜在类别生长模型（LCGM）用于识别CRF的不同发育轨迹。采用Logistic回归分析来检查不同患者组中CRF的预测因子。
结果：LCGM分析揭示了三种不同的CRF轨迹：持续高度疲劳组（30.7%），上升疲劳组（30.7%），无疲劳组(38.6%)。癌症分期(OR=7.563,95%CI=2.468-23.182,P<0.001),忧郁人格(OR=6.901,95%CI=1.261-37.764,P=0.026),高心理弹性(OR=0.171,95%CI=0.041~0.706,P=0.015)与CRF轨迹相关。另一方面,乐观人格(OR=0.254,95%CI=0.071-0.916,P=0.036)和高社会支持(OR=0.168,95%CI=0.045-0.627,P=0.008)与疲劳轨迹增加相关。
结论：这项研究表明，60%的肺癌患者在整个评估期间经历了持续性疲劳。此外，这证实了肺癌患者CRF轨迹的异质性.发现CRF的严重程度在晚期临床阶段的患者中更高，抑郁性格特征，和较低的心理弹性。
方法：本研究共招募202名接受手术和辅助化疗的肺癌患者。基线问卷已完成，涵盖社会人口统计信息，疾病详情,CRF级别,人格特质，心理韧性，和社会支持。CRF在三个时间点进行评估：第一次化疗（T1），化疗后3个月（T2），化疗后6个月（T3）。潜在类别生长模型（LCGM）用于识别CRF的不同发育轨迹。采用Logistic回归分析来检查不同患者组中CRF的预测因子。
结果：LCGM分析揭示了三种不同的CRF轨迹：持续高度疲劳组（30.7%），上升疲劳组（30.7%），无疲劳组(38.6%)。癌症分期(OR=7.563,95%CI=2.468-23.182,P<0.001),忧郁人格(OR=6.901,95%CI=1.261-37.764,P=0.026),高心理弹性(OR=0.171,95%CI=0.041~0.706,P=0.015)与CRF轨迹相关。另一方面,乐观人格(OR=0.254,95%CI=0.071-0.916,P=0.036)和高社会支持(OR=0.168,95%CI=0.045-0.627,P=0.008)与疲劳轨迹增加相关。
结论：这项研究表明，60%的肺癌患者在整个评估期间经历了持续性疲劳。此外，这证实了肺癌患者CRF轨迹的异质性.发现CRF的严重程度在晚期临床阶段的患者中更高，抑郁性格特征，和较低的心理弹性。
