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Worse Morning Energy Profiles Are Associated with Significant Levels of Stress and Decrements in Resilience in Patients Receiving Chemotherapy.
Shelley, Alexandra; Mark, Sueann; Block, Astrid; Paul, Steven M; Cooper, Bruce A; Hammer, Marilyn J; Conley, Yvette P; Levine, Jon; Miaskowski, Christine.
Afiliación
  • Shelley A; School of Nursing, University of California, San Francisco, California.
  • Mark S; School of Nursing, University of California, San Francisco, California.
  • Block A; School of Nursing, University of California, San Francisco, California.
  • Paul SM; School of Nursing, University of California, San Francisco, California.
  • Cooper BA; School of Nursing, University of California, San Francisco, California.
  • Hammer MJ; Dana Farber Cancer Institute, Boston, Massachusetts.
  • Conley YP; School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Levine J; School of Medicine, University of California, San Francisco, California.
  • Miaskowski C; School of Nursing, University of California, San Francisco, California; School of Medicine, University of California, San Francisco, California. Electronic address: chris.miaskowski@ucsf.edu.
Semin Oncol Nurs ; 40(5): 151718, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39164158
ABSTRACT

OBJECTIVES:

Evidence suggests that lower levels of morning energy are associated with higher levels of stress and lower levels of resilience in patients receiving chemotherapy. Study purposes were to identify subgroups of patients with distinct morning energy profiles; evaluate for differences among the profiles in demographic and clinical characteristics, as well as measures of stress, resilience, and coping.

METHODS:

A total of 1,343 outpatients receiving chemotherapy completed a demographic questionnaire and measures of global, cancer-related, and cumulative life stress, and resilience at study enrollment. Morning energy was assessed using the Lee Fatigue Scale at six time points over two cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct morning energy profiles. Differences among the subgroups were evaluated using parametric and nonparametric tests.

RESULTS:

Three morning energy profiles were identified (i.e., High (17.3%), Low (60.3%), Very Low (22.4%)). Compared to High class, the other two morning energy classes were less likely to be employed; had a lower functional status and a higher comorbidity burden; and were more likely to self-report depression and back pain. For all three types of stress, significant differences were found among the three classes with scores that demonstrated a dose response effect (i.e., High < Low < Very Low; as decrements in morning energy increased, stress scores increased). Compared to High class, Very Low class reported higher rates of physical and sexual abuse. The resilience scores exhibited a dose response effect as well (i.e., High > Low > Very Low). Patients with the two worst energy profiles reported a higher use of disengagement coping strategies.

CONCLUSIONS:

Findings highlight the complex relationships among decrements in morning energy, various types of stress, resilience, and coping in patients undergoing chemotherapy. IMPLICATIONS FOR NURSING PRACTICE Clinicians need to assess for stress and adverse childhood experiences to develop individualized management plans to increase patients' energy levels.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estrés Psicológico / Fatiga / Resiliencia Psicológica / Neoplasias Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Semin Oncol Nurs Asunto de la revista: ENFERMAGEM / NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estrés Psicológico / Fatiga / Resiliencia Psicológica / Neoplasias Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Semin Oncol Nurs Asunto de la revista: ENFERMAGEM / NEOPLASIAS Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos