Determinants of distinct trajectories of fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: 6-month follow-up using Growth Mixture Modeling - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Journal of Pain and Symptom Management Année : 2021

Determinants of distinct trajectories of fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: 6-month follow-up using Growth Mixture Modeling

Louise Baussard
Cecile Proust-Lima
Fabienne Portales
  • Fonction : Auteur
Marc Ychou
  • Fonction : Auteur
Thibault Mazard
Florence Cousson-Gélie

Résumé

OBJECTIVE: This longitudinal prospective and observational study was designed to identify fatigue trajectories during a 6-month period of chemotherapy in patients with metastatic colorectal cancer, and examine the psychosocial factors predicting these trajectories. Associations between fatigue and survival were also investigated. METHODS: A total of 169 patients (M(age)=64.36 years, SD=10.5) reported their fatigue levels every 2 weeks for 6 months. Psychological variables (anxiety, depression, internal control, and coping) were assessed at baseline. A Growth Mixture Model was used to identify latent trajectories of fatigue, and a multinomial logistic regression tested covariate predictors of patients' trajectories. RESULTS: Four clinically distinct fatigue trajectories were identified: intense fatigue (6.51%), moderate fatigue (48.52%), no fatigue (33%), and increasing fatigue (11.83%). Fatigue severity was directly associated with overall survival. High depression levels were associated with fatigue severity over time for intense (OR=1.80 [1.32-2.47]) and for moderate (OR=1.58 [1.25-2.00]) fatigue, compared to patients reporting no fatigue. Patients who did not report fatigue were better adjusted, and had more resources, such as better internal control over the disease and less emotion-focused coping (guilt and avoidance), than those who reported intense (OR(control)=0.77 [0.65-0.92]) or moderate (OR(control)=0.89 [0.79-0.99] and OR(coping)=1.13 [1.02-1.24]) fatigue. CONCLUSIONS: Fatigue trajectories differed considerably across patients with metastatic colorectal cancer. This first longitudinal study on colorectal cancer patients involving transactional variables suggests that psychosocial interventions should target these specific outcomes, in order to help patients manage their fatigue.
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hal-03286850 , version 1 (15-07-2021)

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Louise Baussard, Cecile Proust-Lima, Viviane Philipps, Fabienne Portales, Marc Ychou, et al.. Determinants of distinct trajectories of fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: 6-month follow-up using Growth Mixture Modeling. Journal of Pain and Symptom Management, 2021, ⟨10.1016/j.jpainsymman.2021.06.019⟩. ⟨hal-03286850⟩

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