Fatigue and associated factors among middle-aged patients with breast cancer undergoing chemotherapy in China: A cross-sectional study

Fatigue is a prevalent and burdensome symptom in patients with breast cancer undergoing chemotherapy, and middle-aged women may be especially vulnerable. To explore fatigue levels and the key factors associated with fatigue in middle-aged patients with breast cancer undergoing chemotherapy. A cross-sectional study. This multicenter, cross-sectional study was conducted between August 2022 and November 2023. Patients completed the Patient-Reported Outcomes Measurement Information System (PROMIS) Short Form 8a to assess fatigue, anxiety, depression, sleep disturbance, and pain interference. Univariate tests, Pearson’s correlation analysis, and hierarchical linear regression were used to identify the influencing factors. A total of 651 patients from two tertiary hospitals in Shanghai and Guangxi were included. The mean fatigue score was 49.4 ± 7.4, with 21.2 % of the patients experiencing mild or more fatigue. The results of hierarchical linear regression analysis showed that absence of medical insurance coverage ( b = 0.073, P = 0.010), the period from 3 months to 1 year in the disease course ( b = 0.073, P = 0.047), undergoing the fourth or higher cycle of chemotherapy ( b = 0.071, P = 0.040), depression ( b = 0.605, P < 0.001), and pain interference ( b = 0.231, P < 0.001) were positively associated with fatigue, while the third chemotherapy cycle ( b = –0.096, P = 0.002) was negatively associated with fatigue. All these variables in the model explained 54.9 % of the variance in fatigue, with depression and pain interference alone accounting for 46.7 % of the variance. Middle-aged patients with breast cancer undergoing chemotherapy in China had a relatively low percentage of and usually mild levels of fatigue. Interventions targeting depression and pain may effectively alleviate fatigue in this population.