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Chang L, Wang Y, Zhang J, Zhao W, Li X, Yang L. Effect of music therapy combined with aerobic exercise on sleep quality among breast cancer patients undergoing chemotherapy after a radical mastectomy: a randomized controlled trial. BMC Womens Health 2024; 24:408. [PMID: 39026220 PMCID: PMC11256659 DOI: 10.1186/s12905-024-03241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
PURPOSE We aimed to study the effect of music therapy combined with aerobic exercise on the sleep quality of patients undergoing chemotherapy after a radical mastectomy. METHODS A randomized controlled trial was conducted at the Breast Disease Diagnosis and Treatment Center, Shaanxi Province Tumor Hospital, from July 2017 to June 2019. 110 female breast cancer patients who underwent a radical mastectomy were recruited and randomly allocated into an intervention group or a control group. The intervention group completed music therapy combined with aerobic exercise from the first to the sixth admission to the hospital for chemotherapy, while the control group received only routine nursing care. The sleep quality of these patients was measured using the Pittsburgh Sleep Quality Index (PSQI). A linear mixed model was used to adjust the PSQI of patients after controlling for other confounding factors. RESULTS The mean sleep quality score of the breast cancer patients who received chemotherapy after a radical mastectomy (baseline) was 8.86 ± 2.34. The intervention group had a significantly lower mean global PSQI score than the control group from the first test to the third test, with an adjusted mean difference of -1.05 (95%CI: -1.86, -0.24; P = 0.01), -2.89 (95%CI: -3.70, -2.08; P < 0.001) and - 4.84 (95%CI: -5.65, -4.03; P < 0.001), respectively. A change in the global PSQI score from baseline for the intervention group was from 0.55 (95%CI: -0.24, 1.34; P = 0.171) at the first test to 2.75 (95%CI: 1.96, 3.53; P < 0.001) at the last test, and for the control group was from - 0.51 (95%CI: -1.31, 0.29; P = 0.213 at the first test to -2.10 (95%CI: -2.91, -1.30; P < 0.001) at the last test. CONCLUSIONS An intervention of music therapy combined with aerobic exercise can significantly improve the sleep quality of female breast cancer patients undergoing chemotherapy after a radical mastectomy, and this intervention continuously improves many aspects of sleep reactivity. CLINICAL TRIAL REGISTRATION This study was registered in the Chinese Clinical Trial Registry (ChiCTR2100042975, 02/02/2021).
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Affiliation(s)
- Li Chang
- Shaanxi No. 3 People's Hospital, Shaanxi Provincial Tumor Hospital, Xi'an, 710061, Shaanxi, China
| | - Yan Wang
- Shaanxi No. 3 People's Hospital, Shaanxi Provincial Tumor Hospital, Xi'an, 710061, Shaanxi, China
| | - Jie Zhang
- Shaanxi No. 3 People's Hospital, Shaanxi Provincial Tumor Hospital, Xi'an, 710061, Shaanxi, China
| | - Wenqian Zhao
- School of Nursing, Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
| | - Xiaomei Li
- School of Nursing, Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
| | - Lei Yang
- School of Nursing, Health Science Centre, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China.
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Shen J, Zhou D, Wang M, Li F, Yan HH, Zhou J, Sun WW. Development and validation of a nomogram model of depression and sleep disorders and the risk of disease progression in patients with breast cancer. BMC Womens Health 2024; 24:385. [PMID: 38961427 PMCID: PMC11220980 DOI: 10.1186/s12905-024-03222-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 06/24/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND In this study, we investigated the relationship between the risk of postoperative progressive disease (PD) in breast cancer and depression and sleep disorders in order to develop and validate a suitable risk prevention model. METHODS A total of 750 postoperative patients with breast cancer were selected from the First People's Hospital of LianYunGang, and the indices of two groups (an event group and a non-event group) were compared to develop and validate a risk prediction model. The relationship between depression, sleep disorders, and PD events was investigated using the follow-up data of the 750 patients. RESULTS SAS, SDS, and AIS scores differed in the group of patients who experienced postoperative disease progression versus those who did not; the differences were statistically significant and the ability to differentiate prognosis was high. The area under the receiver operating characteristic (ROC) curves (AUC) were: 0.8049 (0.7685-0.8613), 0.768 (0.727-0.809), and 0.7661 (0.724--0.808), with cut-off values of 43.5, 48.5, and 4.5, respectively. Significant variables were screened by single-factor analysis and multi-factor analysis to create model 1, by lasso regression and cross-lasso regression analysis to create model 2, by random forest calculation method to create model 3, by stepwise regression method (backward method) to create model 4, and by including all variables for Cox regression to include significant variables to create model 5. The AUC of model 2 was 0.883 (0.848-0.918) and 0.937 (0.893-0.981) in the training set and validation set, respectively. The clinical efficacy of the model was evaluated using decision curve analysis and clinical impact curve, and then the model 2 variables were transformed into scores, which were validated in two datasets, the training and validation sets, with AUCs of 0.884 (0.848-0.919) and 0.885 (0.818-0.951), respectively. CONCLUSION We established and verified a model including SAS, SDS and AIS to predict the prognosis of breast cancer patients, and simplified it by scoring, making it convenient for clinical use, providing a theoretical basis for precise intervention in these patients. However, further research is needed to verify the generalization ability of our model.
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Affiliation(s)
- Jun Shen
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Dan Zhou
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Meng Wang
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Fan Li
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Huan-Huan Yan
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Jun Zhou
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China
| | - Wen-Wen Sun
- Department of Breast surgery, The First People's Hospital of LianYunGang, No.6 Zhenhua East Road, High-tech Square, LianYunGang, 222002, Jiangsu Province, China.
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Edmed SL, Huda MM, Smith SS, Seib C, Porter-Steele J, Anderson D, McCarthy AL. Prevalence and predictors of sleep problems in women following a cancer diagnosis: results from the women's wellness after cancer program. J Cancer Surviv 2024; 18:960-971. [PMID: 36823494 PMCID: PMC11082004 DOI: 10.1007/s11764-023-01346-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 02/02/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE Using a discrete dataset from the Women's Wellness after Cancer Program (WWACP), we examine the prevalence and predictors of self-reported sleep problems in women previously treated for cancer. METHODS Participants were 351 women (Mage = 53.2, SD = 8.8) from the WWACP who had completed surgery, chemotherapy and/or radiotherapy for breast, gynaecological or blood cancers within the previous 24 months. Sleep problems were measured using the Pittsburgh Sleep Quality Index (PSQI). Baseline data (i.e. prior to intervention randomisation) were analysed. RESULTS Most women (59%) reported clinically significant sleep disturbance (PSQI > 5), 40% reported insufficient sleep duration (< 7 h), 38% self-reported poor sleep quality and 28% reported poor habitual sleep efficiency (sleep efficiency < 75%). Fewer psychological and vasomotor climacteric symptoms, age < 45 years and having a partner were associated with reduced odds (AOR < 1) of sleep problems. Higher levels of pain-related disability, and an intermediate compared to 'high' level of education, were associated with increased odds (AOR > 1) of sleep problems. CONCLUSIONS These findings confirm previous studies that have found a high prevalence of sleep problems in women previously treated for cancer. A range of sociodemographic, climacteric and pain-related factors were associated with sleep problems in this study. IMPLICATIONS FOR CANCER SURVIVORS Targeted interventions to improve sleep quality after cancer treatment should be explored in this population. Predictors identified in this study could inform intervention targeting and development.
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Affiliation(s)
- Shannon L Edmed
- Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly QLD, Brisbane, 4068, Australia.
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia.
| | - M Mamun Huda
- Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly QLD, Brisbane, 4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia
| | - Simon S Smith
- Institute for Social Science Research, The University of Queensland, 80 Meiers Rd, Indooroopilly QLD, Brisbane, 4068, Australia
- ARC Centre of Excellence for Children and Families Over the Life Course, The University of Queensland, Brisbane, Australia
- ARC Centre of Excellence for the Digital Child, The University of Queensland, Brisbane, Australia
| | - Charrlotte Seib
- School of Nursing and Midwifery, Griffith University, Southport Queensland, 4215, Australia
| | - Janine Porter-Steele
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia
- The Wesley Hospital Choices Cancer Support Centre, Brisbane, Australia
| | - Debra Anderson
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Alexandra L McCarthy
- School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia
- Mater Research Institute, Brisbane, QLD, Australia
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Chang YC, Lin GM, Tseng TA, Vitale E, Yang CH, Yang YL. The Experience of Mindfulness-Based Stress Reduction on Menopausal Symptoms, Sleep Disturbance, and Body Image among Patients with Breast Cancer-A Qualitative Study. Curr Oncol 2023; 30:1255-1266. [PMID: 36661746 PMCID: PMC9857969 DOI: 10.3390/curroncol30010097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND AND AIM The objective was to decrease patient menopausal symptoms, sleep disturbance, and body image using a nonpharmacological therapy for cultivating key healthy lifestyle habits in patients with breast cancer. MATERIALS AND METHODS The participants were 26 women with breast cancer who had recently received structured mindfulness-based stress reduction (MBSR) training in a clinical trial. Focus groups and interviews were conducted, during which the participants were asked semistructured, open-ended questions regarding the experiences of MBSR. RESULTS The participants indicated that MBSR helped them to alleviate hot flashes and night sweats, and improve sleep quality and be more at ease with the external aspect of their body. On the other hand, during MBSR intervention in a group manner, the participants felt more psychological support and an outlet for sharing negative emotional experiences. CONCLUSION This study identified the short-term benefits associated with group-based MBSR for women with breast cancer. In addition, our research identified the difficulties of intervention measures and coping methods. The study described the benefits of MBSR for patients with breast cancer. The findings of this study will help nursing staff identify the main coping menopausal symptoms and control negative mental health.
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Affiliation(s)
- Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung 40604, Taiwan
- Nursing Department, China Medical University Hospital, Taichung 404327, Taiwan
| | - Gen-Min Lin
- Department of Medicine, Hualien-Armed Forces General Hospital, Hualien 97144, Taiwan
- Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tzuhui Angie Tseng
- Department of Environmental and Cultural Resources, National Tsing Hua University, Hsinchu 30063, Taiwan
| | - Elsa Vitale
- Mental Health Center, ASL (Local Health Authority) Bari, 70026 Bari, Italy
| | - Ching-Hsu Yang
- Department of Emergency Medicine, Hsinchu Mackay Memorial Hospital, Hsinchu 30071, Taiwan
| | - Ya-Ling Yang
- School of Nursing, College of Medicine, National Taiwan University, Taipei 10051, Taiwan
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Ştefănuţ AM, Vintilă M, Bădău LM, Grujic D, Oprean CM, Goian C, Sârbescu P. Perception of disease, dyadic coping, and the quality of life of oncology patients in the active treatment phase and their life partners: an approach based on the actor-partner interdependence model. Front Psychol 2023; 14:1069767. [PMID: 37179865 PMCID: PMC10172643 DOI: 10.3389/fpsyg.2023.1069767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 04/11/2023] [Indexed: 05/15/2023] Open
Abstract
Objective The aim of this study based on the Systemic Transactional Model was to examine the relationship between dyadic coping and (1) disease perception and (2) quality of life of a sample of cancer patients and their life partners. Method This cross-sectional study included 138 oncological dyads. The following questionnaires were used: Stress Appraisal Measure, Dyadic Coping Inventory, and European Organisation for Research and Treatment of Cancer QLQ-C30. Data collected was analysed by applying the actor-partner interdependence model. Results The perception of the disease as a threat as well as its centrality significantly negatively influences the positive forms of dyadic coping whilst the perception of the disease as a challenge has a significant positive influence on them. Dyadic coping does not influence symptoms but has significant influences on global health/quality of life. Conclusion This study has highlighted new information regarding how couples cope with cancer. The results encourage the inclusion of the perception of the disease and dyadic coping in interventions that aim to improve the quality of life of cancer patients and their life partners.
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Affiliation(s)
- Adelina Mihaela Ştefănuţ
- Department of Psychology, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
| | - Mona Vintilă
- Department of Psychology, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
- *Correspondence: Mona Vintilă,
| | - Larisa Maria Bădău
- Hygiene Department, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
| | - Daciana Grujic
- Department of Plastic and Reconstructive Surgery, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
| | - Cristina Marinela Oprean
- Morpho-pathology Department, Victor Babeș University of Medicine and Pharmacy, Timișoara, Romania
| | - Cosmin Goian
- Department of Social Assistance, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
| | - Paul Sârbescu
- Department of Psychology, Faculty of Sociology and Psychology, West University of Timişoara, Timişoara, Romania
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Shen J, Wang M, Li F, Li Y, Zhou J, Sun W. Non-Inferiority Study on the Precise Implementation of Multidisciplinary Continuous Nursing Intervention in Patients with Breast Cancer Experiencing Negative Emotions. Cancer Manag Res 2022; 14:1759-1770. [PMID: 35634536 PMCID: PMC9130099 DOI: 10.2147/cmar.s354214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 04/17/2022] [Indexed: 12/09/2022] Open
Affiliation(s)
- Jun Shen
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Meng Wang
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Fan Li
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Yan Li
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Jun Zhou
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
| | - Wenwen Sun
- Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, LianYunGang, People’s Republic of China
- Correspondence: Wenwen Sun, Department of Breast Surgery, The First People’s Hospital of LianYunGang, The First Affiliated Hospital of Kangda College of Nanjing Medical University, No. 6 Zhenhua East Road, High-Tech Square, LianYunGang, 222002, People’s Republic of China, Tel +86-18961325179, Email
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Otte JL, Chernyak Y, Johns SA, Jackson L, Ludwig KK, Dodson J, Manchanda S, Bufink E, Draucker C. Referral process to further evaluate poor sleep in breast cancer survivors. Cancer Med 2022; 11:1891-1901. [PMID: 35128837 PMCID: PMC9041073 DOI: 10.1002/cam4.4578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 01/06/2022] [Accepted: 01/17/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Breast cancer survivors (BCS) are twice as likely to report symptoms of poor sleep as those without cancer. However, sleep disorders are under-assessed and under-treated among BCS. The purpose of this study was to determine the portion of BCS who completed referral visits to a sleep specialist and identify the acceptability, facilitators, and barriers to the screening and referral process. METHODS BCS, who reported having sleep problems, completed questionnaires to screen for symptoms suggestive of sleep disorders. Those with symptoms suggestive of sleep apnea, movement disorders, narcolepsy, insomnia syndrome, or circadian disorders, they were referred to a sleep medicine physician or behavioral sleep medicine psychologist. Two months after the referral, participants were interviewed about their perceptions of the acceptability, barriers, and facilitators to sleep screenings and referrals. RESULTS Of 34 BCS assessed for eligibility, 29 were eligible and had sleep problems. Only eight of 29 participants (27.6%) completed the sleep referral process. Most thought the screening and referral process was acceptable. However, BCS identified barriers to completing the referral visit, including time, not seeing the need for treatment, insurance/sick leave concerns, and distance/transportation. CONCLUSION Adequate evaluation and treatment of sleep disorders in BCS are rare. Creative solutions to address barriers to timely sleep referrals are needed to reduce long-term negative consequences of inadequate sleep.
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Affiliation(s)
- Julie L. Otte
- Indiana University School of NursingIndianapolisINUSA
| | | | - Shelley A. Johns
- Division of General Internal Medicine and GeriatricsIndiana University School of Medicine and Center for Health Services Research, Regenstrief Institute, Inc.IndianapolisIndianaUSA
| | - Lea' Jackson
- Virginia Mason Memorial HospitalYakimaWashingtonUSA
| | | | - Jill Dodson
- Indiana University HealthIndianapolisIndianaUSA
| | - Shalini Manchanda
- Section of Pulmonary, Critical Care, Sleep and Occupational MedicineIndiana University School of MedicineIndianapolisIndianaUSA
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Bean HR, Diggens J, Ftanou M, Weihs KL, Stanton AL, Wiley JF. Insomnia and Fatigue Symptom Trajectories in Breast Cancer: A Longitudinal Cohort Study. Behav Sleep Med 2021; 19:814-827. [PMID: 33470847 DOI: 10.1080/15402002.2020.1869005] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: Insomnia and fatigue are common, although not inevitable, during breast cancer. This study is one of the first aiming to describe distinct trajectory classes of insomnia and fatigue symptoms, and their correlates, from diagnosis through treatment.Methods: This longitudinal cohort study was conducted at a comprehensive cancer center and community oncology practices. Participants (N = 460) were women diagnosed with any stage of breast cancer in the previous 4 months. Primary outcomes for this ancillary study of the existing cohort were self-reported insomnia and fatigue symptoms assessed repeatedly across 12 months.Results: Four distinct classes of insomnia symptoms emerged: persistently very high, clinically elevated symptoms (13.7%); high, clinically elevated symptoms (65.9%); stable low (17.2%) or very low (2.6%) symptoms. Five fatigue symptom classes included high, increasing fatigue (9.6%), two recovery classes starting at high (26.3%), or moderate (18.0%) severity at diagnosis, stable low (33.3%) or very low (12.2%) classes. In multivariate analyses, higher depressive symptoms, anxiety, and chronic life stress were associated with being in the very high insomnia class versus the low symptom class. Oncologic factors were not associated with insomnia class membership. Receiving chemotherapy was linked significantly to high and recovery fatigue symptom classes versus the low class. Higher chronic life stress was associated with more persistent fatigue symptoms.Conclusions: Distinct classes of insomnia and fatigue symptoms were evident; 79.6% of the women had clinically elevated, persistent insomnia symptoms, 53.9% had elevated fatigue. A substantial minority evidenced low symptoms, suggesting targeted or stepped-care approaches to symptom management.
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Affiliation(s)
- Helena R Bean
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University
| | - Justine Diggens
- Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Melbourne
| | - Maria Ftanou
- Psychosocial Oncology Program, Peter MacCallum Cancer Centre, Melbourne.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne
| | - Karen L Weihs
- Department of Psychiatry, University of Arizona.,University of Arizona Cancer Center
| | - Annette L Stanton
- Department of Psychology, University of California Los Angeles.,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University
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Takemura N, Cheung DST, Fong DYT, Lee AWM, Lam TC, Ho JCM, Kam TY, Chik JYK, Lin CC. Relationship of subjective and objective sleep measures with physical performance in advanced-stage lung cancer patients. Sci Rep 2021; 11:17208. [PMID: 34446756 PMCID: PMC8390480 DOI: 10.1038/s41598-021-96481-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/11/2021] [Indexed: 11/25/2022] Open
Abstract
Advanced lung cancer patients suffer from deteriorated physical function, which negatively impacts physical and psychological health. As little is known about sleep and physical function in this population, this study aimed to examine the association between subjective and objective sleep parameters and physical function among them. 164 advanced lung cancer patients were included. Objective sleep was measured by actigraphy (measured on non-dominant wrist for 72 h), and subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Performance-based physical function was measured by Timed Up and Go Test (TUGT), 6-Minute Walk Test (6MWT), Sit-to-Stand Test, and One-leg Standing Test. Univariable and multivariable regression analyses were employed to examine the association between sleep and physical function. Total sleep time (TST) was significantly associated with the 6MWT (β = 0.259; 95% CI 0.120, 0.398; P < 0.001), TUGT (β = - 0.012; 95% CI = - 0.017, - 0.008; P < 0.001) and Sit-to-Stand Test (β = 0.027; 95% CI = 0.018, 0.035; P < 0.001) after adjustment for multiple covariates. PSQI global score was only significantly associated with TUGT (β = 0.140; 95% CI = 0.000, 0.280; P = 0.050) after adjustment for multiple covariates. Shorter sleep duration significantly predicted poorer physical performance in advanced lung cancer patients, and more attention is required for those with less than 4.3 h of sleep on average.Trial registration: ClinicalTrials.gov, NCT03482323. Registered 29 March 2018, https://clinicaltrials.gov/ct2/show/NCT03482323 ; ClinicalTrials.gov, NCT04119778. Registered 8 October 2019, https://clinicaltrials.gov/ct2/show/NCT04119778 .
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Daniel Yee Tak Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Anne Wing Mui Lee
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tai-Chung Lam
- Department of Clinical Oncology, The University of Hong Kong-Shenzhen Hospital, Guangdong, China
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - James Chung-Man Ho
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Tsz Yeung Kam
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong
| | | | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
- Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Kowloon, Hong Kong.
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Ratcliff CG, Zepeda SG, Hall MH, Tullos EA, Fowler S, Chaoul A, Spelman A, Arun B, Cohen L. Patient characteristics associated with sleep disturbance in breast cancer survivors. Support Care Cancer 2020; 29:2601-2611. [PMID: 32964261 DOI: 10.1007/s00520-020-05777-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 09/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Disturbed sleep is common among breast cancer survivors. Identifying patients at risk for disturbed sleep and its sequelae will aid in improving screening and intervention strategies to improve sleep and cancer-related quality of life (QOL). METHODS Women with stages I-III breast cancer undergoing neoadjuvant or adjuvant chemotherapy (N = 415) reported subjectively assessed sleep quality (PSQI) and actigraphy-assessed wake after sleep onset (AAS-WASO), total sleep time (AAS-TST), and sleep efficiency (AAS-SE), sociodemographic, and clinical characteristics and completed questionnaires assessing physical and mental health QOL at study entry and 3, 6, 12, and 15 months later. RESULTS Being from a racially/ethnically underserved population was associated with poorer sleep in all indices (p's < .04). Lower income was associated with poorer subjective sleep and greater AAS-WASO (p's < .02). BMI was associated with lower AAS-SE (p < .001). Baseline subjective sleep complaints were positively associated with depression, fatigue, and health-related QOL and cancer-related symptoms across follow-up (p's < 0.05). Baseline AAS-WASO was positively associated with anxiety and negatively associated with physical health-related QOL at the 3-month follow-up (p's < .001). Baseline AAS-WASO and AAS-SE were associated with mental health-related QOL at the 6-month follow-up (p's < .05). CONCLUSIONS In keeping with previous health disparity research, racially/ethnically underserved populations, lower household income, and higher BMI were associated with increased risk for disturbed sleep. Sleep disturbance may have long-term effects on multiple aspects of QOL for women undergoing treatment for breast cancer. Results may inform strategies to identify patients at greatest risk for disturbed sleep and its sequelae.
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Affiliation(s)
- Chelsea G Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA. .,Department of Psychiatry & Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Stephanie G Zepeda
- Departmnet of Psychology, Our Lady of the Lake University, The Woodlands, TX, USA
| | - Martica H Hall
- Department of Psychology, The University of Pittsburgh, Pittsburgh, PA, USA
| | - Emily A Tullos
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | - Shaelyn Fowler
- Department of Psychology, Sam Houston State University, Huntsville, TX, USA
| | | | - Amy Spelman
- Office of Protocol Research, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Ho RTH, Lo HHM, Fong TCT, Choi CW. Effects of a Mindfulness-based Intervention on diurnal cortisol pattern in disadvantaged families: A randomized controlled trial. Psychoneuroendocrinology 2020; 117:104696. [PMID: 32353816 DOI: 10.1016/j.psyneuen.2020.104696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 03/10/2020] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The present study examined the psychophysiological effects of Family-based Mindfulness Intervention (FBMI) on children and parents from disadvantaged families. METHODS This randomized controlled trial recruited parents and their children from 51 disadvantaged families in Hong Kong and randomized them into FBMI (n = 26) and waitlist control (n = 25) groups. The parent intervention included 6 sessions and the child intervention included 8 sessions with 2 half-hour joint programs. Both interventions lasted 9 hours in total each. All participants completed four salivary cortisol measures after wakeup, before lunchtime, late-afternoon, and before sleep at baseline and end of the intervention. The diurnal cortisol pattern was summarized by the morning cortisol, evening cortisol, mean cortisol, and diurnal cortisol slope. RESULTS Compared to the control group, children in the FBMI group showed significant increases in morning cortisol (d = 0.50, p = 0.03) and significant decreases in diurnal cortisol slopes (d = 0.50, p = 0.04) at the end of intervention. Parents in the FBMI group displayed significant decreases in evening cortisol (d = 0.50, p = 0.04) compared to the control group at the end of intervention. No significant treatment effects were found on the mean cortisol. DISCUSSION The present findings suggest that FBMI could improve the diurnal cortisol slope and cortisol levels of the children and parents from disadvantaged families, respectively. Future studies should elucidate its potential benefits on neuroendocrine functioning.
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Affiliation(s)
- Rainbow T H Ho
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - Herman H M Lo
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong.
| | - Ted C T Fong
- Centre on Behavioral Health, The University of Hong Kong, Hong Kong; Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong
| | - C W Choi
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong
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12
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Evaluation and management of insomnia in women with breast cancer. Breast Cancer Res Treat 2020; 181:269-277. [PMID: 32314110 DOI: 10.1007/s10549-020-05635-0] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/07/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Insomnia is a common issue among patients with breast cancer with a potentially devastating impact on quality of life. It can be caused or exacerbated by multiple disease and treatment-related factors. Despite the prevalence and impact of insomnia, it is rarely addressed systematically in the oncology clinic. We conducted a comprehensive review of insomnia to guide clinical care of patient's with breast cancer and insomnia. METHODS This manuscript reviews the prevalence, etiology, emerging science and both non-pharmacologic and pharmacologic options for treatment of insomnia among patients with breast cancer. RESULTS Multiple factors contribute to insomnia among patients with breast cancer including endocrine therapy and hotflashes, pain and discomfort from local therapy, and fear of recurrence. If we do identify insomnia, there are treatment options and strategies available to help patients. In particular, there is now a considerable body of evidence supporting the use of psychosocial interventions and behavioral treatments, such as cognitive behavioral therapy for insomnia (CBT-I), yoga, and mind-body programs. It is also important for oncology providers to be educated regarding available pharmacologic therapies and emerging data for cannabis-based therapy. CONCLUSION This manuscript provides an up-to-date and comprehensive review of the prevalence, etiology, and treatment approaches available for insomnia for clinicians treating patients with breast cancer. We also address strategies and goals for cancer care delivery and future research.
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Kapoor A, Nambisan P. Personal decision support for survivor engagement: formulation and feasibility evaluation of a conceptual framework for implementing online cancer survivorship care plans. BMC Med Inform Decis Mak 2020; 20:59. [PMID: 32293436 PMCID: PMC7092430 DOI: 10.1186/s12911-020-1073-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 03/16/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Although cancer survivorship care plans have been in use for several years, they have been shown to not be effective in meeting the long-term needs of cancer survivors, in addition being generic and passive in nature. Interactive survivorship care plans in the form of a personal decision support aid could provide an opportunity to not only engage survivors in their health care, but also capture meaningful treatment-related outcomes to use as a rich data source as the basis for making informed decisions. The objective of this research is to formulate an evidence-based model framework for implementing breast cancer survivorship guidelines via an online breast cancer survivorship care plan (SCP). METHODS The study was completed in three steps. In the first step, or the requirements gathering phase, we conducted personal interviews of breast cancer survivors to determine their use of the survivorship care plan (SCP) and related needs to determine core SCP functions and formulate an implementation framework for an online SCP. In the second step, we used the framework as a guide to design and develop the online SCP tool. Finally, in the third step, we conducted preliminary testing to determine the feasibility of the developed tool among online users. RESULTS Fifteen breast cancer survivors were consulted, who reported several issues from their use of the traditional paper-based SCP. Four themes were identified that represent the SCP's core desired functions. Eight features were matched to implement these core functions. Using a personal decision approach, an online SCP tool called ACESO that incorporates these features and functions was developed. Preliminary feasibility testing yielded overall positive responses from breast cancer survivors (n = 51). CONCLUSION Our study demonstrated that survivors face challenges from their use of a traditional paper-based SCP. The online SCP we developed is technically feasible and has the potential to effectively engage breast cancer survivors in self-management and shared decision-making with their clinicians and caregivers. Further testing is required to assess its usability and long-term impact.
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Affiliation(s)
- Akshat Kapoor
- Health Services and Information Management, East Carolina University, 600 Moye Blvd. (Mail Stop 668), Greenville, NC, 27834, USA.
| | - Priya Nambisan
- Department of Health Informatics and Administration, Social Media and Health Research & Training Lab, College of Health Sciences, University of Wisconsin - Milwaukee, Northwest Quadrant Building B, Rm #6410, 2025 East Newport Avenue, Milwaukee, WI, 53201-0413, USA
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Nzwalo I, Aboim MA, Joaquim N, Marreiros A, Nzwalo H. Systematic Review of the Prevalence, Predictors, and Treatment of Insomnia in Palliative Care. Am J Hosp Palliat Care 2020; 37:957-969. [DOI: 10.1177/1049909120907021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction:The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms causing suffering is central to the achievement of this goal. Insomnia reduces quality of life of patients under palliative care. Knowledge about prevalence, associated factors, and treatment of insomnia in palliative care is scarce.Methodology:Literature review about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale.Results:A total of 65 studies were included in the review. Most studies had acceptable /good quality. The prevalence of insomnia in the included studies ranged from 2.1% to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain, and use of specific drugs, including opioids; psychological factors such as anxiety/depression; and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and nonpharmacological), psychological (visualization, relaxation), and spiritual (prayer).Conclusions:The systematic review showed that the prevalence of insomnia is high, with at least one in 3 patients affected in most studies. Insomnia’s risk factors and treatment in palliative care are both associated to physical, psychological, social, and spiritual factors, reflecting its true holistic nature.
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Affiliation(s)
- Isa Nzwalo
- Institute for Health Sciences, Catholic University of Portugal, Lisbon, Portugal
- Unidade de Cuidados de Saúde Personalizados Mar, Tavira, Portugal
| | | | - Natércia Joaquim
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Algarve, Portugal
- Algarve Biomedical Center, Algarve, Portugal
| | - Ana Marreiros
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Algarve, Portugal
- Algarve Biomedical Center, Algarve, Portugal
| | - Hipólito Nzwalo
- Faculty of Medicine and Biomedical Sciences, University of Algarve, Algarve, Portugal
- Algarve Biomedical Center, Algarve, Portugal
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The associations of self-stigma, social constraints, and sleep among Chinese American breast cancer survivors. Support Care Cancer 2019; 28:3935-3944. [DOI: 10.1007/s00520-019-05233-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
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Hong Kong Chinese Medicine Clinical Practice Guideline for Cancer Palliative Care: Pain, Constipation, and Insomnia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1038206. [PMID: 30805017 PMCID: PMC6362507 DOI: 10.1155/2019/1038206] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 01/02/2019] [Indexed: 02/04/2023]
Abstract
It is common for patients with cancers in Hong Kong seeking Chinese Medicine (CM) therapies as supportive care during cancer treatment and to manage treatment-related side effects. This article provides clinical practice guideline (CPG) on the use of CM for specific clinical indications caused by cancer and during cancer treatment, including pain, constipation, and insomnia, and aims to guide local licensed CM practitioners and provide beneficial reference for social medical decision makers and patients. In this manuscript, we summarize the clinical manifestation, CM pattern classification, and CM intervention including herbal treatment, acupuncture treatment, regulating, and nursing based on pattern differentiation.
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Williamson TJ, Love SM, Clague DeHart JN, Jorge-Miller A, Eshraghi L, Cooper Ortner H, Stanton AL. Metastatic Breast Cancer Collateral Damage Project (MBCCD): Scale development and preliminary results of the Survey of Health, Impact, Needs, and Experiences (SHINE). Breast Cancer Res Treat 2018; 171:75-84. [PMID: 29767345 PMCID: PMC6239969 DOI: 10.1007/s10549-018-4823-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/03/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Until recently, people with metastatic breast cancer (MBC) had a very poor prognosis. New treatment approaches have prolonged the time that people with MBC live, but their quality of life has received less attention. Consequently, the needs and concerns across financial, vocational, psychological, social, and physical domains in MBC patients are poorly understood-particularly regarding the collateral damage or longer-term, life-altering impacts of MBC and its treatments. This study's aims were to characterize MBC-related collateral damage, identify groups most likely to experience collateral damage, and examine its associations with psychological health, illness management, and health behaviors. METHODS Participants (N = 515) with MBC were recruited from Dr. Susan Love Research Foundation's Army of Women® and other advocacy organizations. Participants completed questionnaires of MBC-related collateral damage, depressive symptoms, anxiety, self-efficacy for managing oncologic treatments and physical symptoms, sleep, and physical activity. RESULTS Eight domains of MBC-related collateral damage, as well as MBC-related benefit finding, were reliably characterized. Concerns about mortality/uncertainty were most prominent. Participants also endorsed high levels of benefit finding. Participants younger than 50 years, with limited financial resources, or with children under 18 at home reported the most collateral damage. Collateral damage was associated significantly with compromised psychological health, lower illness management efficacy, and poorer health behaviors, beyond sociodemographic and medical characteristics. CONCLUSIONS Subgroups of MBC patients report long-term, life-altering consequences of MBC and its treatments, which relate to important health outcomes. Clinical implications and recommendations are discussed.
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Affiliation(s)
- Timothy J Williamson
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Susan M Love
- Dr. Susan Love Research Foundation, Encino, CA, USA
| | - Jessica N Clague DeHart
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA, USA
| | - Alexandra Jorge-Miller
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | | | | | - Annette L Stanton
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, CA, USA.
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Incidence and Factors Associated With Attentional Fatigue in Working Long-term Breast Cancer Survivors. CLIN NURSE SPEC 2018; 32:177-181. [PMID: 29878928 DOI: 10.1097/nur.0000000000000383] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to examine the incidence of attentional fatigue and the relationship between sleep disturbance and attentional fatigue in working long-term breast cancer survivors (BCS). METHODS A descriptive, correlation design was used. The data for this study were drawn from a larger descriptive study designed to understand the impact of cognitive dysfunction on work-related outcomes. Breast cancer survivors completed questionnaires regarding sleep disturbance, attentional fatigue, and demographic and medical characteristics. Sleep disturbance, a subscale of the Pittsburgh Sleep Quality Index, is measured by asking 9 questions about sleep disturbances. Attentional fatigue was measured by the Attentional Function Index. Descriptive statistics and multiple regression were performed to assess the impact of sleep disturbance on attentional fatigue, controlling for covariates. RESULTS Sixty-eight female BCS, ranging from 29 to 68 years old (mean [SD], 52.1 [8.6] years old) and, on average, 4.97 (SD, 3.36) years posttreatment, participated. Thirty-four percent of BCS had poor to moderate attention function. Sleep disturbance significantly predicted attentional fatigue (P < .05), explaining 16% of the variance, F4,57 = 2.68, P < .04, R = 0.16. CONCLUSIONS Clinicians can assess and intervene to decrease sleep disturbance, which may also improve attentional fatigue in BCS. However, sleep disturbance is only 1 contributing factor. Further investigation into factors contributing to attentional fatigue in BCS is warranted.
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Mosher CE, Secinti E, Li R, Hirsh AT, Bricker J, Miller KD, Schneider B, Storniolo AM, Mina L, Newton EV, Champion VL, Johns SA. Acceptance and commitment therapy for symptom interference in metastatic breast cancer patients: a pilot randomized trial. Support Care Cancer 2018; 26:1993-2004. [PMID: 29327085 DOI: 10.1007/s00520-018-4045-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 01/05/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE Breast cancer is the leading cause of cancer mortality in women worldwide. With medical advances, metastatic breast cancer (MBC) patients often live for years with many symptoms that interfere with activities. However, there is a paucity of efficacious interventions to address symptom-related suffering and functional interference. Thus, this study examined the feasibility and preliminary efficacy of telephone-based acceptance and commitment therapy (ACT) for symptom interference with functioning in MBC patients. METHODS Symptomatic MBC patients (N = 47) were randomly assigned to six telephone sessions of ACT or six telephone sessions of education/support. Patients completed measures of symptom interference and measures assessing the severity of pain, fatigue, sleep disturbance, depressive symptoms, and anxiety. RESULTS The eligibility screening rate (64%) and high retention (83% at 8 weeks post-baseline) demonstrated feasibility. When examining within-group change, ACT participants showed decreases in symptom interference (i.e., fatigue interference and sleep-related impairment; Cohen's d range = - 0.23 to - 0.31) at 8 and 12 weeks post-baseline, whereas education/support participants showed minimal change in these outcomes (d range = - 0.03 to 0.07). Additionally, at 12 weeks post-baseline, ACT participants showed moderate decreases in fatigue and sleep disturbance (both ds = - 0.43), whereas education/support participants showed small decreases in these outcomes (ds = - 0.24 and - 0.18 for fatigue and sleep disturbance, respectively). Both the ACT and education/support groups showed reductions in depressive symptoms (ds = - 0.27 and - 0.28) at 12 weeks post-baseline. Group differences in all outcomes were not statistically significant. CONCLUSIONS ACT shows feasibility and promise in improving fatigue and sleep-related outcomes in MBC patients and warrants further investigation.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA.
| | - Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Ruohong Li
- Department of Biostatistics, Indiana University Fairbanks School of Public Health, Health Sciences Building (RG), 1050 Wishard Blvd. Floors 5 and 6, Indianapolis, IN, 46202, USA
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA
| | - Jonathan Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue North, M3-B232, PO Box 19024, Seattle, WA, 98109, USA
- Department of Psychology, University of Washington, Box 351525, Seattle, WA, 98195, USA
| | - Kathy D Miller
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Bryan Schneider
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Anna Maria Storniolo
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Lida Mina
- Banner MD Anderson Cancer Center, 2946 E Banner Gateway Dr, Gilbert, AZ, 85234, USA
| | - Erin V Newton
- Indiana University School of Medicine, Indiana University Melvin and Bren Simon Cancer Center, 535 Barnhill Drive, Indianapolis, IN, 46202, USA
| | - Victoria L Champion
- School of Nursing, Indiana University, 1111 Middle Drive NU 340G, Indianapolis, IN, 46202, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Center for Health Services Research, Regenstrief Institute, 1101 W. 10th Street, RF-226, Indianapolis, IN, 46202, USA
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Pazarcıkcı F. Kemoterapi Alan Kanser Hastalarında Uyku Kalitesinin Değerlendirilmesi. MEHMET AKIF ERSOY ÜNIVERSITESI SAĞLIK BILIMLERI ENSTITÜSÜ DERGISI 2017. [DOI: 10.24998/maeusabed.292260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sleep-wake difficulties in community-dwelling cancer patients receiving palliative care: subjective and objective assessment. Palliat Support Care 2017; 16:756-766. [PMID: 28933313 DOI: 10.1017/s1478951517000815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Prevalence rates of sleep difficulties in advanced cancer patients have varied widely across studies (12 to 96%), and none of these employed a diagnostic interview to distinguish different types of sleep-wake disorders. Moreover, very limited information is available on subjective and objective sleep parameters in this population. Our study was conducted in palliative cancer patients and aimed to assess rates of sleep-wake disorders and subsyndromal symptoms and to document subjective and objective sleep-wake parameters across various types of sleep-wake difficulties. METHOD The sample was composed of 51 community-dwelling cancer patients receiving palliative care and having an Eastern Cooperative Oncology Group score of 2 or 3. Relevant sections of the Duke Interview for Sleep Disorders were administered over the phone. An actigraphic recording and a daily sleep diary were completed for 7 consecutive days. RESULTS Overall, 68.6% of the sample had at least one type of sleep-wake difficulty (disorder or symptoms): 31.4% had insomnia and 29.4% had hypersomnolence as their main sleep-wake problem. Participants with insomnia as their main sleep difficulty had greater disruptions of subjective sleep parameters, while objectively-assessed sleep was more disrupted in patients with hypersomnolence comorbid with another sleep-wake difficulty.Significance of the Results:The high rates of sleep-wake difficulties found in this study indicate a need to screen more systematically for sleep-wake disorders, including insomnia and hypersomnolence, in both palliative care research and clinical practice, and to develop effective nonpharmacological interventions specifically adapted to this population.
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The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis. Support Care Cancer 2017. [DOI: 10.1007/s00520-017-3777-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Wang Y, Zhu X, Li L, Yi J, He J. What Factors Affect the Insomnia Symptom Trajectories in Women With Nonmetastatic Breast Cancer? J Pain Symptom Manage 2016; 52:850-858. [PMID: 27515406 DOI: 10.1016/j.jpainsymman.2016.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 06/12/2016] [Accepted: 07/29/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study sought to identify the trajectories of insomnia symptoms in Chinese women with nonmetastatic breast cancer and further determine the effects of sociodemographic, disease, and psychological variables on different insomnia symptoms. METHODS A total of 287 female breast cancer patients were recruited to complete measures of cognitive emotion regulation strategies, perceived social support, and insomnia symptoms at six time points from the week after diagnosis to four months after surgery. RESULTS Four distinct classes of insomnia symptom trajectories were identified using growth mixture modeling and were named low sustained class (n = 128, 44.60%), high sustained class (n = 33, 11.50%), moderate sustained class (n = 64, 22.30%), and decreasing class (n = 62, 21.60%). Patients in these trajectory classes differed in demographic characteristics (age, education, employment, and monthly income), pathologic stage, and psychological characteristics (perceived social support and cognitive emotion regulation strategies). Patients with less than nine years of education (adjusted odds ratio = 2.61-4.10) or higher levels of self-blame (adjusted odds ratio = 1.80-2.14) are most likely to belong to the high sustained, moderate sustained, and decreasing classes. CONCLUSION Four latent trajectories may be a reliable and valuable approach in analyzing insomnia symptoms in breast cancer patients. Heterogeneity should be considered to allow more attention to be paid on patients in high and moderate sustained class. Education and cognitive emotion regulation strategies are important factors for the onset and development of insomnia symptoms.
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Affiliation(s)
- Yuping Wang
- School of Humanities & Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China; Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China; Medical Psychological Institute of Central South University, Changsha, Hunan, P.R. China.
| | - Lingyan Li
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
| | - Jinyao Yi
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China
| | - Jincai He
- The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, P.R. China
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The influence of cancer on endocrine, immune, and behavioral stress responses. Physiol Behav 2016; 166:4-13. [DOI: 10.1016/j.physbeh.2015.09.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 09/10/2015] [Accepted: 09/30/2015] [Indexed: 12/21/2022]
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Mosher CE, Tometich DB, Hirsh A, Rand KL, Johns SA, Matthias MS, Outcalt SD, Bricker J, Schneider B, Mina L, Storniolo AM, Newton E, Miller K. Symptom experiences in metastatic breast cancer patients: relationships to activity engagement, value-based living, and psychological inflexibility. Psychooncology 2016; 26:1944-1951. [PMID: 27648927 DOI: 10.1002/pon.4283] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 09/08/2016] [Accepted: 09/15/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study examined symptom-based subgroups of metastatic breast cancer (MBC) patients and the extent to which they differed across key constructs of acceptance and commitment therapy (ACT). METHODS Eighty women with MBC completed self-report surveys assessing 10 common symptoms and several ACT variables (ie, activity engagement, psychological inflexibility, value obstruction, and value progress) during a single time point. RESULTS A cluster analysis yielded 3 patient subgroups: low symptoms, low-moderate symptoms, and moderate-high symptoms. Relative to the subgroup with low symptoms, the other subgroups reported less activity engagement. In addition, compared with patients with low symptoms, the subgroup with moderate-high symptoms reported greater psychological inflexibility (ie, avoidance of unwanted internal experiences) and greater difficulty living consistently with their values. CONCLUSIONS Women with MBC show heterogeneity in their symptom profiles, and those with higher symptom burden are more likely to disengage from valued activities and avoid unwanted experiences (eg, thoughts, feelings, and bodily sensations). Findings are largely consistent with the ACT model and provide strong justification for testing ACT to address symptom interference in MBC patients.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Danielle B Tometich
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Adam Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Shelley A Johns
- Indiana University School of Medicine, Indianapolis, IN, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA
| | - Marianne S Matthias
- Indiana University School of Medicine, Indianapolis, IN, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Samantha D Outcalt
- Indiana University School of Medicine, Indianapolis, IN, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jonathan Bricker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Department of Psychology, University of Washington, Seattle, WA, USA
| | - Bryan Schneider
- Indiana University School of Medicine, Indiana Cancer Pavilion, Indianapolis, IN, USA
| | - Lida Mina
- Indiana University School of Medicine, Indiana Cancer Pavilion, Indianapolis, IN, USA
| | - Anna Maria Storniolo
- Indiana University School of Medicine, Indiana Cancer Pavilion, Indianapolis, IN, USA
| | - Erin Newton
- Indiana University School of Medicine, Indiana Cancer Pavilion, Indianapolis, IN, USA
| | - Kathy Miller
- Indiana University School of Medicine, Indiana Cancer Pavilion, Indianapolis, IN, USA
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26
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Mosher CE, Daily S, Tometich D, Matthias MS, Outcalt SD, Hirsh A, Johns SA, Rand K, Schneider B, Mina L, Storniolo AM, Newton E, Miller K. Factors underlying metastatic breast cancer patients' perceptions of symptom importance: a qualitative analysis. Eur J Cancer Care (Engl) 2016; 27. [PMID: 27464353 DOI: 10.1111/ecc.12540] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2016] [Indexed: 11/29/2022]
Abstract
The symptom literature in cancer has primarily examined symptom severity, frequency and distress. Assessing cancer patients' perceptions of symptom importance-how important it is for them to see improvement in a symptom following an intervention-and factors influencing these judgments would also inform patient-centred care, but this analysis has not been undertaken. This qualitative study aimed to identify factors underlying perceptions of symptom importance among 25 symptomatic metastatic breast cancer (MBC) patients. Participants were recruited from a cancer centre in the Midwestern USA. Semi-structured interviews focused on patients' rationale for considering common symptoms (i.e., anxiety, sadness, sleep problems, pain or fatigue) to be important. Thematic analyses revealed five interrelated factors underlying MBC patients' perceptions of symptom importance: activity restriction, concentration difficulties, exacerbation of other physical symptoms, symptom-related long-term health concerns and negative impact on their relationships with others. Patients most frequently stated that a physical or psychological symptom was important because of the resulting activity restriction. Additionally, some patients considered pain to be important because it signalled potential long-term health concerns, such as worsening metastatic disease. Findings suggest that clinicians should take into account MBC patients' perceptions of symptom importance and factors underlying these judgments when making shared treatment decisions.
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Affiliation(s)
- C E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - S Daily
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - D Tometich
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - M S Matthias
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Communication Studies, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - S D Outcalt
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,Center for Health Information and Communication, Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - S A Johns
- Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Rand
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - B Schneider
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - L Mina
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - A M Storniolo
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - E Newton
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - K Miller
- Indiana University School of Medicine, Indianapolis, IN, USA
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İzci F, İlgün AS, Fındıklı E, Özmen V. Psychiatric Symptoms and Psychosocial Problems in Patients with Breast Cancer. THE JOURNAL OF BREAST HEALTH 2016; 12:94-101. [PMID: 28331743 PMCID: PMC5351486 DOI: 10.5152/tjbh.2016.3041] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 04/18/2016] [Indexed: 01/01/2023]
Abstract
Cancer is a physical disease and also one of the leading clinical manifestations where psychosocial problems are prevalent. Psychosocial problems that these patients may have in the long run include anxiety, uneasiness, mourning, helplessness, fatigue, impairment of concentration, sleep disorders, mental and cognitive reservation, sexual dysfunction, infertility, psychological distress, and psychiatric disorders. Psychosocial problems have a nature of underpinning the emergence of psychological troubles. The prevalence of psychological disorders in patients with cancer range from 29% to 47%. Psychiatric disorders that are likely to be seen are severe stress disorder, adjustment disorder, depressive disorder, and other neurotic disorders. It is considered by the present author that in the event of breast cancer, potential psychiatric disorders may affect prognosis of the disease, adherance to and success of therapy, social and societal functioning, and survival rate. This paper aims to review the psychiatric symptoms and diseases that may develop in patients with breast cancer, which is one of the most frequent types of a globally common disease; i.e., cancer, as well as the impact of psychiatric symptoms on the treatment of disease.
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Affiliation(s)
- Filiz İzci
- Department of Psychiatry, İstanbul Bilim University School of Medicine, İstanbul, Turkey
| | - Ahmet Serkan İlgün
- Clinic of General Surgery, Gaziosmanpaşa Taksim Training and Research Hospital, İstanbul, Turkey
| | - Ebru Fındıklı
- Department of Psychiatry, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Vahit Özmen
- Clinic of General Surgery, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
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28
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Sleep disorders in breast cancer survivors. Support Care Cancer 2016; 24:4197-205. [PMID: 27146391 DOI: 10.1007/s00520-016-3247-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 04/24/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the feasibility, acceptability, and initial results of a structured assessment of sleep disorders in breast cancer survivors (BCS). Our goal was to determine whether the assessment could be easily used and whether it would capture problems suggestive of one or more underlying sleep disorders that require referral to a specialist for diagnostic validation through polysomnography and appropriate specialty treatment. METHODS A cross-sectional, feasibility study using convenience sampling. RESULTS A total of 38 BCS completed the study. Recruitment procedures were adequate in finding eligible BCS, however, procedures used to establish possible patterns of sleep disorders (e.g., interview) were not feasible for screening for sleep disorders in the clinical setting due to the time it took to complete each interview. A total of seven sleep disorder categories were identified in the data with the majority of women having at least one possible sleep disorder. CONCLUSIONS Study findings suggest that population-based screening for sleep disorders in clinical practice should be a priority for BCS reporting chronic sleep problems.
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29
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Wang ML, Liu JE, Su YL, Xue CC. Experiences and insomnia-associated factors in Chinese breast cancer survivors: a qualitative study. J Clin Nurs 2016; 25:1923-30. [PMID: 27080617 DOI: 10.1111/jocn.13208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Mu-Lan Wang
- School of Nursing; Capital Medical University; Beijing China
| | - Jun-E Liu
- School of Nursing; Capital Medical University; Beijing China
| | - Ya-Li Su
- Breast Cancer Center; Beijing Tiantan Hospital Affiliated to Capital Medical University; Beijing China
| | - Cui-Cui Xue
- School of Nursing; Capital Medical University; Beijing China
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30
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Khoramirad A, Mousavi M, Dadkhahtehrani T, Pourmarzi D. Relationship Between Sleep Quality and Spiritual Well-Being/Religious Activities in Muslim Women with Breast Cancer. JOURNAL OF RELIGION AND HEALTH 2015; 54:2276-2285. [PMID: 25487182 DOI: 10.1007/s10943-014-9978-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
For determining relationship between quality of sleep and spiritual well-being/religious activities in Muslim women with breast cancer (WBC), we conducted a cross-sectional study on 80 WBC who presented at all chemotherapy clinics in Qom, Iran, in 2012. We used Pittsburgh Sleep Quality Index (PSQI), spiritual well-being scale (SWBS), and religious activities (RA) questionnaire. Global PSQI score and its seven components score were not significantly correlated with total score of SWBS and its two subscales. Global PSQI score was not significantly correlated with total score of RA questionnaire (P = 0.278), but its "sleep latency" (r = 0.235, P = 0.044) and "use of sleep medications" (r = 0.237, P = 0.040) components were significantly correlated with total score of RA. Global PSQI was significantly correlated with "I don't get much personal strength and support from my God," "I believe there is some real purpose for my life" questions in SWBS, and "Attendance in mosque or religious places" subscale of RA.
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Affiliation(s)
- Ashraf Khoramirad
- Research Center for Medicine and Religion, Qom University of Medical Sciences, Qom, Iran.
| | - Maryam Mousavi
- School of Nursing and Midwifery, Rasht Islamic Azad University, Rasht, Iran.
| | - Tahmineh Dadkhahtehrani
- Department of Midwifery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran.
| | - Davoud Pourmarzi
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Iran.
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31
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Taylor KL, Hadgkiss EJ, Jelinek GA, Weiland TJ, Pereira NG, Marck CH, van der Meer DM. Lifestyle factors, demographics and medications associated with depression risk in an international sample of people with multiple sclerosis. BMC Psychiatry 2014; 14:327. [PMID: 25467385 PMCID: PMC4263016 DOI: 10.1186/s12888-014-0327-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 11/10/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Depression is the most common co-morbidity for people with Multiple Sclerosis (MS); irrespective of disease severity, depression has the greatest impact on quality of life. An emerging paradigm in the treatment of depression is lifestyle medicine. There is significant potential to prevent and treat depression through modification of lifestyle risk factors for people with MS. This study sought to understand the association between lifestyle risk factors, medication and depression risk through the analysis of self-reported data from a large international sample of people with MS. METHODS This cross-sectional analysis recruited a total of 2459 participants via Web 2.0 platforms. Survey data included socio-demographics; a range of lifestyle risk factors; medication; disease variables and depression risk using the Patient Health Questionnaire-2 (PHQ-2). RESULTS In total approximately one fifth (19.3%) of our sample screened positive for depression (PHQ-2 score ≥3). Several demographic factors were significantly associated with this depression risk in bivariate analysis. Regression analyses showed that poor diet, low levels of exercise, obesity, smoking, marked social isolation and taking interferon were associated with greater depression risk. Participants who supplemented with omega 3s, particularly flaxseed oil, had frequent fish consumption, supplemented with vitamin D, meditated, and had moderate alcohol consumption had significantly reduced depression risk. CONCLUSIONS This study demonstrates a significant association between modifiable lifestyle factors and depression risk. Planned longitudinal follow up may clarify causality. Clinicians and people with MS should be aware of the wide range of modifiable lifestyle factors that may reduce depression risk as part of a comprehensive secondary and tertiary preventive medical approach to managing MS.
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Affiliation(s)
- Keryn L Taylor
- Department of Psychiatry, St Vincent's Hospital Melbourne, Victoria, VIC, 3065, Australia. .,Department of Medicine, The University of Melbourne St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Emily J Hadgkiss
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - George A Jelinek
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Tracey J Weiland
- Department of Medicine, The University of Melbourne St Vincent's Hospital, Melbourne, Victoria, Australia. .,Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Naresh G Pereira
- Faculty of Medicine, Notre Dame University, Fremantle, Western Australia, Australia.
| | - Claudia H Marck
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
| | - Dania M van der Meer
- Emergency Practice Innovation Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
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32
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Otte JL, Carpenter JS, Manchanda S, Rand KL, Skaar TC, Weaver M, Chernyak Y, Zhong X, Igega C, Landis C. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med 2014; 4:183-200. [PMID: 25449319 PMCID: PMC4329003 DOI: 10.1002/cam4.356] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/26/2014] [Accepted: 09/07/2014] [Indexed: 11/13/2022] Open
Abstract
Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality.
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Affiliation(s)
- Julie L Otte
- Indiana University School of Nursing, Indianapolis, Indiana
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34
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Krigel S, Myers J, Befort C, Krebill H, Klemp J. ‘Cancer changes everything!’ Exploring the lived experiences of women with metastatic breast cancer. Int J Palliat Nurs 2014; 20:334-42. [DOI: 10.12968/ijpn.2014.20.7.334] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Susan Krigel
- Adjunct Assistant Professor of Psychology, University of Kansas Medical Center, and Behavioral Therapist, Midwest Cancer Alliance, Suite 1100, 4350 Shawnee Mission Parkway, Fairway, Kansas 66205, USA
| | - Jamie Myers
- Adjunct Assistant Professor, University of Kansas School of Nursing, USA
| | - Christie Befort
- Associate Professor, Department of Preventive Medicine and Public Health, University of Kansas Medical Center, USA
| | - Hope Krebill
- Executive Director, Midwest Cancer Alliance, USA
| | - Jennifer Klemp
- Assistant Professor, University of Kansas Medical Center, USA, and Director, Cancer Survivorship, Breast Cancer Survivorship Center, USA
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35
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Influence of sleep disturbances on quality of life of Iranian menopausal women. PSYCHIATRY JOURNAL 2013; 2013:907068. [PMID: 24286070 PMCID: PMC3835748 DOI: 10.1155/2013/907068] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 09/16/2013] [Accepted: 09/17/2013] [Indexed: 11/22/2022]
Abstract
Background. Subjective sleep disturbances increase during menopause. Some problems commonly encountered during menopause, such as hot flushes and sweating at night, can cause women to have difficulty in sleeping. These complaints can influence quality of life of menopausal women. Methods. This cross-sectional study was performed on menopausal women attending health centers in Qazvin for periodic assessments. We measured excessive daytime sleepiness by Epworth sleepiness scale (ESS), obstructive sleep apnea (OSA) by the Berlin questionnaire, and insomnia by the insomnia severity index (ISI). We evaluate quality of life by the Menopause specific quality of life questionnaire (MENQOL). Results. A total of 380 menopausal women entered the study. Mean age of participated women was 57.6 ± 6.02. Mean duration of menopause was 6.3 ± 4.6. The frequency of severe and moderate insomnia was 8.4% (32) and 11.8% (45). Severe daytime sleepiness (ESS ≥ 10) was present in 27.9% (80) of the participants. Multivariate analytic results show that insomnia and daytime sleepiness have independent negative impact on each domain and total score of MENQOL questionnaire. Conclusion. According to our findings, EDS and insomnia are frequent in menopausal women. Both EDS and insomnia have significant quality of life impairment.
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Self-reported sleep disturbance in patients with advanced cancer: Frequency, intensity, and factors associated with response to outpatient supportive care consultation — A preliminary report. Palliat Support Care 2013; 13:135-43. [DOI: 10.1017/s1478951513000850] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractObjectives:Self-reported sleep disturbance (SD) is a distressing symptom in patients with advanced cancer. There are limited data on the treatment of SD and predictors to response of SD to outpatient supportive care clinic (OPC) consultation. The aims of our study was to determine the frequency, intensity, and correlates of SD as assessed with the Edmonton Symptom Assessment System (ESAS) sleep item at the time of initial consultation and identify the predictors of improvement in SD at follow-up.Methods:We reviewed the records of consecutive patients with advanced cancer presenting to the OPC. ESAS scores were obtained at the initial and subsequent visits between January 2008 and February 2010. All patients underwent screening for SD (0–10 scale: 0 = best sleep, presence of SD defined as ≥3) and interdisciplinary assessment and treatment, including drug review, counseling, sleep hygiene review, and drug therapy. A response was defined as a 1-point improvement at the follow-up visit on the Edmonton Symptom Assessment Scale (ESAS) sleep item score. Baseline patient characteristics, medication use, and ESAS scores were analyzed to determine their association with response.Results:The median age was 58 years, and 53% of patients were men. The most common cancer type was head and neck or lung (36%). Of the 442 patients, 330 had baseline SD (score ≥3/10, 75%). Median and mean (standard deviation) baseline SD scores were 5 and 5.1 (2.9). The multivariable regression model found the intensity of baseline ESAS sleep item scores to be associated with baseline sedative use, baseline ESAS pain scores, baseline ESAS fatigue scores, baseline ESAS feeling of well-being scores, and sedative use (R2 = 0.22). Sleep disturbance response at first follow-up was seen in 196 of 330 patients (59%). Moderate to high SD score and anxiety at initial visit with odds ratios (OR) of 2.53 (p = 0.0007) and 1.59 (p = 0.048), respectively, were associated with a response.Significance of results:Both the frequency and severity of SD were high. Response to supportive care consultation was substantial. The severity of SD and anxiety at the initial visit predicted a response at first follow-up. Further research is needed.
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Aldridge-Gerry A, Zeitzer JM, Palesh OG, Jo B, Nouriani B, Neri E, Spiegel D. Psychosocial correlates of sleep quality and architecture in women with metastatic breast cancer. Sleep Med 2013; 14:1178-86. [PMID: 24074694 PMCID: PMC3886805 DOI: 10.1016/j.sleep.2013.07.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/11/2013] [Accepted: 07/12/2013] [Indexed: 12/24/2022]
Abstract
BACKGROUND Sleep disturbance is prevalent among women with metastatic breast cancer (MBC). Our study examined the relationship of depression and marital status to sleep assessed over three nights of polysomnography (PSG). METHODS Women with MBC (N=103) were recruited; they were predominately white (88.2%) and 57.8±7.7 years of age. Linear regression analyses assessed relationships among depression, marital status, and sleep parameters. RESULTS Women with MBC who reported more depressive symptoms had lighter sleep (e.g., stage 1 sleep; P<.05), less slow-wave sleep (SWS) (P<.05), and less rapid eye movement (REM) sleep (P<.05). Single women had less total sleep time (TST) (P<.01), more wake after sleep onset (WASO) (P<.05), worse sleep efficiency (SE) (P<.05), lighter sleep (e.g., stage 1; P<.05), and less REM sleep (P<.05) than married women. Significant interactions indicated that depressed and single women had worse sleep quality than partnered women or those who were not depressed. CONCLUSION Women with MBC and greater symptoms of depression had increased light sleep and reduced SWS and REM sleep, and single women had worse sleep quality and greater light sleep than married counterparts. Marriage was related to improved sleep for women with more depressive symptoms.
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Affiliation(s)
- Arianna Aldridge-Gerry
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd, Stanford, CA 94305-5718, United States.
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Cardoso F, Bese N, Distelhorst SR, Bevilacqua JLB, Ginsburg O, Grunberg SM, Gralla RJ, Steyn A, Pagani O, Partridge AH, Knaul FM, Aapro MS, Andersen BL, Thompson B, Gralow JR, Anderson BO. Supportive care during treatment for breast cancer: resource allocations in low- and middle-income countries. A Breast Health Global Initiative 2013 consensus statement. Breast 2013; 22:593-605. [PMID: 24001709 PMCID: PMC7442957 DOI: 10.1016/j.breast.2013.07.050] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Accepted: 07/23/2013] [Indexed: 12/20/2022] Open
Abstract
Breast cancer patients may have unmet supportive care needs during treatment, including symptom management of treatment-related toxicities, and educational, psychosocial, and spiritual needs. Delivery of supportive care is often a low priority in low- and middle-income settings, and is also dependent on resources available. This consensus statement describes twelve key recommendations for supportive care during treatment in low- and middle-income countries, identified by an expert international panel as part of the 5th Breast Health Global Initiative (BHGI) Global Summit for Supportive Care, which was held in October 2012, in Vienna, Austria. Panel recommendations are presented in a 4-tier resource-stratified table to illustrate how health systems can provide supportive care services during treatment to breast cancer patients, starting at a basic level of resource allocation and incrementally adding program resources as they become available. These recommendations include: health professional and patient and family education; management of treatment related toxicities, management of treatment-related symptoms of fatigue, insomnia and non-specific pain, and management of psychosocial and spiritual issues related to breast cancer treatment. Establishing supportive care during breast cancer treatment will help ensure that breast cancer patients receive comprehensive care that can help 1) improve adherence to treatment recommendations, 2) manage treatment-related toxicities and other treatment related symptoms, and 3) address the psychosocial and spiritual aspects of breast cancer and breast cancer treatments.
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Affiliation(s)
| | - Nuran Bese
- Acibadem Maslak Hospital Breast Health, Istanbul, Turkey
| | | | | | - Ophira Ginsburg
- Women’s College Research Institute, Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Steven M. Grunberg
- Multinational Association of Supportive Care in Cancer, Shelburne, Vermont, USA
| | | | - Ann Steyn
- Reach to Recovery International; Reach to Recovery South Africa, Cape Town. South Africa
| | - Olivia Pagani
- European School of Oncology and Institute of Oncology of Southern Switzerland, Viganello, Switzerland
| | | | - Felicia Marie Knaul
- Harvard Global Equity Initiative, Boston, Massachusetts, USA; Tómatelo a Pecho A.C., Mexico City, Mexico
| | | | | | - Beti Thompson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Julie R. Gralow
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
| | - Benjamin O. Anderson
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Seattle Cancer Care Alliance, University of Washington, Seattle, Washington, USA
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Methodology of an International Study of People with Multiple Sclerosis Recruited through Web 2.0 Platforms: Demographics, Lifestyle, and Disease Characteristics. Neurol Res Int 2013; 2013:580596. [PMID: 23691313 PMCID: PMC3649686 DOI: 10.1155/2013/580596] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 02/27/2013] [Accepted: 03/20/2013] [Indexed: 11/21/2022] Open
Abstract
Background. Despite evidence of the potential importance of the role of health and lifestyle behaviours in multiple sclerosis (MS) outcomes, there has not been a significant focus on this area of research. Aim. We aimed to recruit an international sample of people with MS at baseline and over a five-year timeframe, examine their health and lifestyle behaviours, and determine the relationship of these behaviours to self-reported disability, disease activity, and quality of life. Methods. People with MS were recruited through web 2.0 platforms including interactive websites, social media, blogs, and forums and completed a comprehensive, multifaceted online questionnaire incorporating validated and researcher-derived tools. Results. 2519 participants met inclusion criteria for this study. This paper describes the study methodology in detail and provides an overview of baseline participant demographics, clinical characteristics, summary outcome variables, and health and lifestyle behaviours. The sample described is unique due to the nature of recruitment through online media and due to the engagement of the group, which appears to be well informed and proactive in lifestyle modification. Conclusion. This sample provides a sound platform to undertake novel exploratory analyses of the association between a variety of lifestyle factors and MS outcomes.
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Mosher CE, Johnson C, Dickler M, Norton L, Massie MJ, DuHamel K. Living with metastatic breast cancer: a qualitative analysis of physical, psychological, and social sequelae. Breast J 2013; 19:285-92. [PMID: 23528206 DOI: 10.1111/tbj.12107] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Women with metastatic breast cancer face a wide range of medical, practical, and emotional challenges that impact their quality of life. Research to date, however, has not focused on the quality-of-life concerns of metastatic breast cancer patients with significant distress. The present study examined a range of concerns among distressed metastatic breast cancer patients, including physical and emotional distress, social functioning, and existential issues. Forty-four distressed women with metastatic breast cancer wrote their deepest thoughts and feelings regarding their illness. These essays were thematically analyzed for effects of the illness on quality of life. Three themes were identified in patients' essays. First, metastatic breast cancer and its treatment may result in a number of quality-of-life concerns, including physical symptom burden, emotional distress, body image disturbance, and disrupted daily activities. Second, social constraints on disclosure of cancer-related concerns may exacerbate patients' distress. Third, many women experience a heightened awareness of life's brevity and search for meaning in their cancer experience. Results highlight a range of quality-of-life concerns following a metastatic breast cancer diagnosis and suggest that addressing social constraints on cancer-related disclosure and the search for meaning may improve patients' psychological adjustment.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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Palesh O, Peppone L, Innominato PF, Janelsins M, Jeong M, Sprod L, Savard J, Rotatori M, Kesler S, Telli M, Mustian K. Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nat Sci Sleep 2012; 4:151-162. [PMID: 23486503 PMCID: PMC3593248 DOI: 10.2147/nss.s18895] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Sleep problems are highly prevalent in cancer patients undergoing chemotherapy. This article reviews existing evidence on etiology, associated symptoms, and management of sleep problems associated with chemotherapy treatment during cancer. It also discusses limitations and methodological issues of current research. The existing literature suggests that subjectively and objectively measured sleep problems are the highest during the chemotherapy phase of cancer treatments. A possibly involved mechanism reviewed here includes the rise in the circulating proinflammatory cytokines and the associated disruption in circadian rhythm in the development and maintenance of sleep dysregulation in cancer patients during chemotherapy. Various approaches to the management of sleep problems during chemotherapy are discussed with behavioral intervention showing promise. Exercise, including yoga, also appear to be effective and safe at least for subclinical levels of sleep problems in cancer patients. Numerous challenges are associated with conducting research on sleep in cancer patients during chemotherapy treatments and they are discussed in this review. Dedicated intervention trials, methodologically sound and sufficiently powered, are needed to test current and novel treatments of sleep problems in cancer patients receiving chemotherapy. Optimal management of sleep problems in patients with cancer receiving treatment may improve not only the well-being of patients, but also their prognosis given the emerging experimental and clinical evidence suggesting that sleep disruption might adversely impact treatment and recovery from cancer.
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Affiliation(s)
- Oxana Palesh
- Stanford University School of Medicine, Stanford, CA, USA
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Rafihi-Ferreira RE, Soares MRZ. Insônia em pacientes com câncer de mama. ESTUDOS DE PSICOLOGIA (CAMPINAS) 2012. [DOI: 10.1590/s0103-166x2012000400014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A insônia é uma queixa frequente em pacientes com câncer de mama, e suas consequências podem causar impacto na qualidade de vida e no curso da doença. O objetivo deste estudo foi revisar a literatura especializada sobre a relação entre insônia e câncer de mama, abordando definição, prevalência, fatores etiológicos e as consequências da insônia no contexto da neoplasia mamária, bem como os tratamentos para insônia nessa população. A busca da literatura ocorreu nos bancos de dados Scopus, Web of Science e SciELO, utilizando as palavras chaves: insomnia, sleep, breast cancer, treatment, cognitive-behavioral therapy. Os estudos revisados demonstraram que a etiologia da insônia envolve fatores de predisposição, precipitação e perpetuação. Evidencia-se a importância da melhora na qualidade de sono em pacientes oncológicos, além de se indicar a combinação de terapia farmacológica e cognitivocomportamental no tratamento dos problemas de sono.
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Clevenger L, Schrepf A, Christensen D, DeGeest K, Bender D, Ahmed A, Goodheart MJ, Penedo F, Lubaroff DM, Sood AK, Lutgendorf SK. Sleep disturbance, cytokines, and fatigue in women with ovarian cancer. Brain Behav Immun 2012; 26:1037-44. [PMID: 22543257 PMCID: PMC3434312 DOI: 10.1016/j.bbi.2012.04.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/22/2012] [Accepted: 04/10/2012] [Indexed: 12/13/2022] Open
Abstract
Pro-inflammatory cytokines, such as interleukin-6 (IL-6), have been implicated in the underlying processes contributing to sleep regulation and fatigue. Despite evidence for sleep difficulties, fatigue, and elevations in IL-6 among women with ovarian cancer, the association between these symptoms and IL-6 has not been investigated. To address this knowledge gap, we examined relationships between sleep disturbance, fatigue, and plasma IL-6 in 136 women with ovarian cancer prior to surgery. These relationships were also examined in 63 of these women who were disease-free and not receiving chemotherapy one year post-diagnosis. At both time-points, higher levels of IL-6 were significantly associated with sleep disturbances (p<0.05), controlling for potentially confounding biological and psychosocial covariates. Higher IL-6 was significantly associated with fatigue prior to surgery (p<0.05); however, when sleep disturbance was included in the model, the relationship was no longer significant. IL-6 was not significantly associated with fatigue at one year. Changes in sleep over time were significantly associated with percent change in IL-6 from pre-surgery to one year, adjusting for covariates (p<0.05). These findings support a direct association of IL-6 with sleep disturbances in this population, whereas the relationship between IL-6 and fatigue prior to surgery may be mediated by poor sleep. As this study is the first to examine cytokine contributions to sleep and fatigue in ovarian cancer, further research is warranted to clarify the role of biological correlates of sleep and fatigue in this population.
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Affiliation(s)
| | - Andrew Schrepf
- Department of Psychology, University of Iowa, Iowa City, IA
| | | | - Koen DeGeest
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - David Bender
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Amina Ahmed
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA
| | - Michael J. Goodheart
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA
| | - Frank Penedo
- University of Miami and Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL
| | - David M. Lubaroff
- Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA,Department of Urology, University of Iowa, Iowa City, IA,Department of Microbiology, University of Iowa, Iowa City, IA
| | - Anil K. Sood
- Departments of Gynecologic Oncology and Cancer Biology, University of Texas MD, Anderson Comprehensive Cancer Center, Houston TX
| | - Susan K. Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, IA,Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA,Department of Urology, University of Iowa, Iowa City, IA
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Reed E, Wheeler D, Scanlon K. Spotlight on secondary breast cancer: a policy initiative to influence the care of women with metastatic breast cancer. BREAST CANCER MANAGEMENT 2012. [DOI: 10.2217/bmt.12.40] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
SUMMARY As the treatment of metastatic breast cancer improves, women are living longer with progressive disease. However, the care and support services for this population have not kept pace with the developments in medical management. In 2006, Breast Cancer Care (UK) established the Secondary Breast Cancer Taskforce, which comprised of healthcare professionals, policy makers and women with metastatic breast cancer. It aimed to identify and address the needs of women with metastatic breast cancer. This article reports on the progress to date and future service developments needed to ensure all women with metastatic breast cancer receive the care and support they need to live with progressive breast cancer throughout the illness trajectory from diagnosis until the end of life.
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Affiliation(s)
- Elizabeth Reed
- Breast Cancer Care, 5–13 Great Suffolk Street, London, SE1 0NS, UK
| | - Dora Wheeler
- Breast Cancer Care, 5–13 Great Suffolk Street, London, SE1 0NS, UK
| | - Karen Scanlon
- Breast Cancer Care, 5–13 Great Suffolk Street, London, SE1 0NS, UK
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CHENG K, YEUNG R. Impact of mood disturbance, sleep disturbance, fatigue and pain among patients receiving cancer therapy. Eur J Cancer Care (Engl) 2012; 22:70-8. [DOI: 10.1111/j.1365-2354.2012.01372.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Ritterband LM, Bailey ET, Thorndike FP, Lord HR, Farrell-Carnahan L, Baum LD. Initial evaluation of an Internet intervention to improve the sleep of cancer survivors with insomnia. Psychooncology 2012; 21:695-705. [PMID: 21538678 PMCID: PMC3424270 DOI: 10.1002/pon.1969] [Citation(s) in RCA: 201] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2010] [Revised: 02/24/2011] [Accepted: 02/28/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Insomnia is a common complaint among cancer survivors. Fortunately, cognitive-behavioral therapy for insomnia (CBT-I) has been shown to be an effective treatment in this population. However, it is rarely implemented given its limited availability. To address this barrier, we examined the ability of an easily accessible online CBT-I program to improve insomnia symptoms in cancer survivors. METHODS Twenty-eight cancer survivors with insomnia were randomly assigned to either an Internet insomnia intervention (n = 14) or to a waitlist control group (n = 14). The online program, Sleep Healthy Using The Internet, delivers the primary components of CBT-I (sleep restriction, stimulus control, cognitive restructuring, sleep hygiene, and relapse prevention). Pre- and post-assessment data were collected via online questionnaires and daily sleep diaries. RESULTS Participants in the Internet group showed significant improvements at post-assessment compared with those in the control group in overall insomnia severity (F(1,26) = 22.8; p<0.001), sleep efficiency (F(1,24) = 11.45; P = 0.002), sleep onset latency (F(1,24) = 5.18; P = 0.03), soundness of sleep (F(1,24) = 9.34; P = 0.005), restored feeling upon awakening (F(1,24) = 11.95; P = 0.002), and general fatigue (F(1,26) = 13.88; P = 0.001). Although other group × time interactions were not significant, overall adjusted effect sizes for all sleep variables as well as for fatigue, depression, anxiety, and quality of life ranged from small to large. CONCLUSIONS CBT-I delivered through an interactive, individually tailored Internet intervention may be a viable treatment option for cancer survivors experiencing insomnia.
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Affiliation(s)
- Lee M Ritterband
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, Charlottesville, VA 22908, USA.
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Desai K, Mao JJ, Su I, Demichele A, Li Q, Xie SX, Gehrman PR. Prevalence and risk factors for insomnia among breast cancer patients on aromatase inhibitors. Support Care Cancer 2012; 21:43-51. [PMID: 22584732 DOI: 10.1007/s00520-012-1490-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 04/30/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE Insomnia is increasingly recognized as a major symptom outcome in breast cancer; however, little is known about its prevalence and risk factors among women receiving aromatase inhibitors (AIs), a standard treatment to increase disease-free survival among breast cancer patients. METHODS A cross-sectional survey study was conducted among postmenopausal women with stage 0-III breast cancer receiving adjuvant AI therapy at an outpatient breast oncology clinic of a large university hospital. The insomnia severity index (ISI) was used as the primary outcome. Multivariate logistic regression analyses were performed to evaluate risk factors. RESULTS Among 413 participants, 130 (31.5 %) had subthreshold insomnia on the ISI, and 77 (18.64 %) exceeded the threshold for clinically significant insomnia. In a multivariate logistic regression model, clinically significant insomnia was independently associated with severe joint pain (adjusted odds ratio (AOR) 4.84, 95 % confidence interval (CI) 1.71-13.69, P = 0.003), mild/moderate hot flashes (AOR 2.28, 95 % CI 1.13-4.60, P = 0.02), severe hot flashes (AOR 2.29, 95 % CI 1.23-6.81, P = 0.015), anxiety (AOR 1.99, 95 % CI 1.08-3.65, P = 0.027), and depression (AOR 3.57, 95 % CI 1.48-8.52, P = 0.004). Age (>65 vs. <55 years; AOR 2.31; 95 % CI 1.11-4.81; P = 0.026) and time since breast cancer diagnosis (<2 vs. 2-5 years; AOR 1.94; 95 % CI 1.02-3.69; P = 0.045) were also found to be significant risk factors. Clinical insomnia was more common among those who used medication for treating insomnia and pain. CONCLUSIONS Insomnia complaints exceed 50 % among AI users. Clinically significant insomnia is highly associated with joint pain, hot flashes, anxiety and depression, age, and time since diagnosis.
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Affiliation(s)
- Krupali Desai
- Department of Family Medicine and Community Health, University of Pennsylvania, 3400 Spruce Street, 2 Gates Building, Philadelphia, PA 19104, USA.
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Dedert E, Lush E, Chagpar A, Dhabhar FS, Segerstrom SC, Spiegel D, Dayyat E, Daup M, McMasters K, Sephton SE. Stress, Coping, and Circadian Disruption Among Women Awaiting Breast Cancer Surgery. Ann Behav Med 2012; 44:10-20. [DOI: 10.1007/s12160-012-9352-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hansen MV, Madsen MT, Hageman I, Rasmussen LS, Bokmand S, Rosenberg J, Gögenur I. The effect of MELatOnin on Depression, anxietY, cognitive function and sleep disturbances in patients with breast cancer. The MELODY trial: protocol for a randomised, placebo-controlled, double-blinded trial. BMJ Open 2012; 2:e000647. [PMID: 22240653 PMCID: PMC3278491 DOI: 10.1136/bmjopen-2011-000647] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Introduction Breast cancer represents about one-third of all cancer diagnoses and accounts for about 15% of cancer deaths in women. Many of these patients experience depression, anxiety, sleep disturbances and cognitive dysfunction. This may adversely affect quality of life and also contribute to morbidity and mortality. Melatonin is a regulatory circadian hormone having, among others, a hypnotic and an antidepressive effect. It has very low toxicity and very few adverse effects compared with the more commonly used antidepressants and hypnotics. Methods and analysis The objective of this double-blind, randomised, placebo-controlled trial is to investigate whether treatment with oral melatonin has a prophylactic or ameliorating effect on depressive symptoms, anxiety, sleep disturbances and cognitive dysfunction in women with breast cancer. Furthermore, the authors will examine whether a specific clock-gene, PER3, is correlated with an increased risk of depressive symptoms, sleep disturbances or cognitive dysfunction. The MELODY trial is a prospective double-blinded, randomised, placebo-controlled trial in which the authors intend to include 260 patients. The primary outcome is depressive symptoms measured by the Major Depression Inventory. The secondary outcomes are anxiety measured by a Visual Analogue Scale, total sleep time, sleep efficiency, sleep latency and periods awake measured by actigraphy and changes in cognitive function measured by a neuropsychological test battery. Tertiary outcomes are fatigue, pain, well-being and sleep quality/quantity measured by Visual Analogue Scale and sleep diary and sleepiness measured by the Karolinska Sleepiness Scale. The PER3 genotype is also to be determined in blood samples.
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Affiliation(s)
- Melissa Voigt Hansen
- Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Hageman
- Psychiatric Center Copenhagen, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lars Simon Rasmussen
- Department of Anaesthesia, Centre of Head and Orthopaedics, University of Copenhagen, Copenhagen, Denmark
| | - Susanne Bokmand
- Department of Breast Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Rosenberg
- Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Ismail Gögenur
- Department of Surgery, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
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Comparison of differences and determinants between presence and absence of sleep disturbance in hepatocellular carcinoma patients. Cancer Nurs 2011; 34:354-60. [PMID: 21242769 DOI: 10.1097/ncc.0b013e3182037bf3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hepatocellular carcinoma patients often experience sleep disturbance after undergoing transcatheter arterial chemoembolization (TACE). OBJECTIVE The objectives of this study were to (1) examine and compare symptom distress, depression, and sleep quality in hepatocellular carcinoma patients undergoing TACE with sleep disturbance versus without sleep disturbance and (2) examine the determinants of sleep disturbance in these patients. METHODS Hepatocellular carcinoma patients undergoing TACE were recruited. The patients were evaluated 1 week (T1) and 1 month (T2) after receiving TACE in terms of performance status, symptom distress, depression (T1), and sleep disturbance (T2). Logistic regression was used to determine the predictive factors of sleep disturbance. RESULTS Patients with sleep disturbance reported significantly higher overall symptom distress and depression and lower sleep quality than patients without sleep disturbance. The 5 leading causes of symptom distress in both groups were fatigue, pain, poor appetite, chest tightness, and fever. Older age, greater symptom distress, and higher levels of depression were significantly associated with sleep disturbance. CONCLUSIONS The results of this study show significant associations among symptom distress, depression at baseline, and sleep problems 1 month after undergoing TACE. Clinicians should be aware of the possibility of lasting sleep disturbance in hepatocellular carcinoma patients undergoing TACE. IMPLICATIONS FOR PRACTICE In clinical care, symptom management, psychological consultation, and relaxation training may promote sleep quality.
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