Distinct fatigue profiles and psychological mechanisms among breast cancer survivors: A latent profile and mediation analysis
Dusunen Adam - The Journal of Psychiatry and Neurological Sciences, cilt.39, sa.2, ss.90-100, 2026 (ESCI, Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 39 Sayı: 2
- Basım Tarihi: 2026
- Doi Numarası: 10.14744/dajpns.2026.00322
- Dergi Adı: Dusunen Adam - The Journal of Psychiatry and Neurological Sciences
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, CINAHL, EMBASE, Psycinfo, Directory of Open Access Journals, TR DİZİN (ULAKBİM), Academic Search Ultimate (EBSCO), Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Sayfa Sayıları: ss.90-100
- Anahtar Kelimeler: Breast cancer survivors, cancer-related fatigue, fear of recurrence, latent profile analysis, mediation, rumination
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Gazi Üniversitesi Adresli: Evet
Özet
Objective: Cancer-related fatigue (CRF) is highly prevalent among breast cancer survivors. This study aimed to identify CRF subgroups in breast cancer survivors using latent profile analysis (LPA) and to examine the effects of rumination on CRF through anxiety, depression, and fear of cancer recurrence. Method: A total of 201 women diagnosed with early-stage breast cancer completed standardized assessments of fear of cancer recurrence, rumination, anxiety, depression, and cancer-related fatigue. Latent profile analysis was conducted to identify distinct CRF profiles, and differences in psychological variables across groups were examined. Mediation analyses were performed using the PROCESS macro with bootstrapping (5,000 samples) to test indirect effects. Results: LPA identified three distinct profiles: low (50.2%), moderate (37.3%), and high (12.4%). The model demonstrated excellent classification quality (entropy=0.80; average posterior probabilities=0.89–0.93). Participants in the high-CRF group reported significantly higher levels of rumination, anxiety, depression, and fear of recurrence than those in the other two groups (all p<0.001, η2=0.10–0.30). Multinomial regression analysis showed that depression, anxiety, and fear of cancer recurrence significantly predicted membership in the high-CRF group. Mediation analyses indicated that rumination predicted CRF indirectly through depression (b=0.07, 95% confidence interval (CI) [0.01, 0.15]), anxiety (b=0.20, 95% CI [0.05, 0.34]), and fear of recurrence (b=0.17, 95% CI [0.04, 0.30]), jointly accounting for 32.6% of the total effect. Conclusion: The findings suggest that fear of recurrence, anxiety, and depression may increase vulnerability to CRF. The results also underscore the importance of targeting transdiagnostic processes such as rumination in psychological interventions for breast cancer survivors.