Identifying risk factors for adverse cancer-related fatigue trajectories after endometrial cancer surgery: A longitudinal study
Abstract
Abstract Objective: To identify distinct longitudinal trajectories of cancer-related fatigue in postoperative endometrial cancer patients and determine the multidimensional predictors of adverse trajectory membership, with the aim of informing person-centered risk-stratified nursing care. Methods: A prospective longitudinal study was conducted in 145 endometrial cancer patients with assessments at 1, 3, and 5 months after surgery. Cancer-related fatigue was measured using the Cancer Fatigue Scale. Latent class growth modeling identified fatigue trajectories, and binary logistic regression examined predictors from physiological, psychological, and environmental domains guided by the Theory of Unpleasant Symptoms. Results: Two distinct trajectories were identified: a fatigue-decreasing group (78.62%) and a fatigue-increasing group (21.38%). Postoperative complications (OR = 8.60, 95% CI: 1.10–67.02), depressive symptoms (OR = 1.31, 95% CI: 1.10–1.55), self-perceived burden (OR = 1.22, 95% CI: 1.05–1.40), and low social support (OR = 1.39, 95% CI: 1.10–1.77) independently predicted membership in the fatigue-increasing group. Conclusions: Postoperative cancer-related fatigue exhibits heterogeneous trajectories. The four identified modifiable biopsychosocial factors can be used by nurses to screen for high-risk patients and to deliver person-centered, targeted interventions (e.g., enhanced recovery for complications, psychological support for depressive symptoms and…
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