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