Latent Profile Analysis of Multidimensional Fatigue in Adolescent and Young Adult Cancer Patients: Implications for Personalized Fatigue Management

ABSTRACT

Aim(s)

To identify latent fatigue profiles in adolescent and young adult (AYA) cancer patients and explore associated clinical and socioeconomic factors to guide precision nursing.

Design

A cross-sectional observational study.

Methods

A total of 218 AYA cancer patients were recruited from a tertiary cancer center between December 2025 and February 2026. Latent Profile Analysis was used to identify fatigue subgroups based on the Piper Fatigue Scale-Revised. Multinomial logistic regression was applied to examine correlates.

Results

Three distinct profiles emerged: ‘Low-Fatigue Well-Adapted’ (32.6%), ‘High-Fatigue Somatic-Dominant’ (38.1%), and ‘High-Fatigue Emotional-Cognitive Exhaustion’ (29.4%). The Somatic-Dominant group exhibited severe sensory fatigue but mild distress, strongly associated with chemotherapy (OR = 2.42, 95% CI: 1.03–5.68, p = 0.041) and non-working status (OR = 3.02, 95% CI: 1.38–6.58, p = 0.006). Conversely, the Emotional-Cognitive Exhaustion group showed severe affective and cognitive exhaustion. This profile was significantly linked to active chemotherapy (OR = 4.95, 95% CI: 1.98–12.38, p < 0.001), lower income levels (higher income: OR = 0.52, 95% CI: 0.38–0.71, p < 0.001), and gastrointestinal cancer (OR = 3.15, 95% CI: 1.12–8.85, p = 0.029).

Conclusion

Fatigue in AYA patients appears highly heterogeneous, manifesting either as somatic-dominant patterns potentially associated with chemotherapy or multidimensional exhaustion linked to survival and economic pressures.

Implications for the Profession and/or Patient Care

Nursing practice should transition from a uniform approach to phenotype-based precision symptom management. Patients with somatic-dominant fatigue require physical rehabilitation, whereas those experiencing emotional-cognitive exhaustion urgently need integrated nutritional, psychological, and socioeconomic support to mitigate their multidimensional burden.

Impact

What problem did the study address? ○

The study addressed the limitation of treating cancer-related fatigue as a uniform symptom in AYA patients, which masks individual variability and the hidden burden of chronic socioeconomic constraints.

What were the main findings? ○

Three distinct fatigue phenotypes were identified, revealing significant symptom heterogeneity. Severe emotional-cognitive exhaustion was strongly linked not only to chemotherapy but also to chronic economic constraints of maintaining employment while ill.

Where and on whom will the research have an impact? ○

This research will impact oncology nurses, social workers, and clinical policymakers globally by providing an evidence-based framework for precision symptom management and targeted socioeconomic interventions for vulnerable AYA cancer survivors.

Reporting Method

This study adhered to the STROBE reporting guidelines for cross-sectional studies.

Patient or Public Contribution

No patient or public contribution.