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Article

Distinct Trajectories of Fatigue and Sleep Disturbance in Women Receiving Chemotherapy for Breast Cancer

Meagan Whisenant
Bob Wong
Sandra A. Mitchell
Susan L. Beck
Kathi Mooney
ONF 2017, 44(6), 739-750 DOI: 10.1188/17.ONF.739-750

Purpose/Objectives: To examine self-reported severity of fatigue and disturbed sleep experienced daily by women with breast cancer during multiple cycles of chemotherapy, exploring potential classes of women experiencing similar symptom trajectories.


Design: In a secondary analysis, classes of women experiencing similar patterns of fatigue and disturbed sleep were identified.


Setting: Oncology clinics in the United States.


Sample: 166 women with breast cancer receiving chemotherapy. 


Methods: Severity scores were self-reported daily using an automated system. Classes of fatigue and disturbed sleep severity were identified using latent growth mixture modeling.


Main Research Variables: Fatigue, disturbed sleep, age, stage of disease, education, employment, marital status, chemotherapy regimen, hours lying down, and missed work.


Findings: Three fatigue classes were identified: mild decreasing (59% cycle 2, 64% cycle 3), low moderate decreasing (30% cycle 2, 25% cycle 3), and high moderate decreasing (11% both cycles). Two disturbed sleep classes were identified: mild decreasing (89% cycle 2, 81% cycle 3) and increasing (11% cycle 2, 19% cycle 3). Women in the high moderate decreasing fatigue class were more likely to have received doxorubicin (p = 0.02) and spent more hours lying down (p = 0.02).


Conclusions: Patterns of symptom trajectories for fatigue and disturbed sleep were distinguished by baseline symptom severity.


Implications for Nursing: Identification of women at risk for fatigue and disturbed sleep may allow clinicians to intensify symptom management.

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