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Song B, Chang Y, Li Y, Zhu J. Effects of Transcutaneous Electrical Acupoint Stimulation on the Postoperative Sleep Quality and Pain of Patients After Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial. Nat Sci Sleep 2020; 12:809-819. [PMID: 33154688 PMCID: PMC7606945 DOI: 10.2147/nss.s270739] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/06/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Postoperative sleep disturbances have serious adverse effects on postoperative outcomes. Our paper aimed to observe the effect of using transcutaneous electrical acupoint stimulation (TEAS) on sleep quality and complications after surgery in patients undergoing selective video-assisted thoracoscopic surgery. PATIENTS AND METHODS Eighty-five patients were divided into the TEAS group or the control group randomly. Thirty minutes of TEAS treatment was performed on TEAS group at the following time points: the first night before surgery, at the end of surgery, and before sleeping on the second and third nights after surgery. The Portable Sleep Monitor (PSM) was performed to determine the sleep quality of the two nights before the operation (Sleep preop 2 and Sleep preop 1) and the first and third night after surgery (Sleep POD 1 and Sleep POD 3). The visual analog scale (VAS) was performed to evaluate pain scores after surgery and the Athens Insomnia Scale (AIS) was used for evaluating subjective sleep quality. RESULTS Participants in the TEAS group had a lower AIS score and higher sleep efficiency at each time point except Sleep preop 2. Participants in the TEAS group showed significantly higher proportion of each sleep stage during Sleep-preop 1, Sleep POD 1, and Sleep POD 3. Patients in the TEAS group had significantly lower VAS scores at 2, 4, and 6 h during the first 24 h after surgery. The incidence of nausea and vomiting and dizziness in the control group was statistically higher than in the TEAS group. CONCLUSION Patients usually have sleep disturbances after video-assisted thoracoscopic surgery, such as decreased distribution of each sleep stage, lower sleep efficiency, and higher AIS score. Undergoing TEAS treatment perioperatively can improve sleep quality, and effectively promote the postoperative analgesic effect and alleviate postoperative complications.
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Affiliation(s)
- Bijia Song
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China.,Department of Anesthesiology, Friendship Hospital of Capital Medical University, Beijing, People's Republic of China
| | - Yuanyuan Chang
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Yang Li
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
| | - Junchao Zhu
- Department of Anesthesiology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, People's Republic of China
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Strollo SE, Fallon EA, Gapstur SM, Smith TG. Cancer-related problems, sleep quality, and sleep disturbance among long-term cancer survivors at 9-years post diagnosis. Sleep Med 2020; 65:177-185. [DOI: 10.1016/j.sleep.2019.10.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 09/19/2019] [Accepted: 10/25/2019] [Indexed: 10/25/2022]
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53
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Rodríguez Torres J, Cabrera Martos I, López López L, Torres Sánchez I, Granados Santiago M, Valenza MC. Psychological distress at hospital admission is related to symptoms severity and health status in malignant pleural effusion patients. Eur J Cancer Care (Engl) 2019; 29:e13212. [PMID: 31880035 DOI: 10.1111/ecc.13212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 11/25/2019] [Accepted: 12/04/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVE The incidence and associated healthcare costs of malignant pleural effusion (MPE) are expected to rise, but there is limited evidence about which factors affect patients' prognosis. So, the aim of this study was to determine whether psychological distress at hospital admission is associated with symptom severity and health status in patients with MPE. METHODS A longitudinal observational prospective cohort study was carried out in the Pulmonology Service of the Granada University Hospital Complex in Granada, Spain. Patients diagnosed with MPE were included and evaluated at hospital admission, at discharge and at one month after discharge. Outcome measures included symptom severity (i.e. dyspnoea, pain and cough) and health status (functionality and self-perceived health status). RESULTS Significant differences were found in symptoms and the health status, with worse results in the group with psychological distress at discharge. One month after discharge, MPE patients with psychological distress exhibited greater symptoms, including more cough and dyspnoea (p < .05). Moreover, these patients showed worse functionality (p < .05) and self-perceived health status (p < .05). CONCLUSION Psychological distress is an important factor to take into account in patients with MPE. The presence of psychological distress appears to increase the symptoms and is associated with worse health status after hospitalisation.
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Affiliation(s)
- Janet Rodríguez Torres
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Cabrera Martos
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Laura López López
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Torres Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - María Granados Santiago
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Marie Carmen Valenza
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
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Hugoy T, Lerdal A, Rustoen T, Oksholm T. Predicting postoperative fatigue in surgically treated lung cancer patients in Norway: a longitudinal 5-month follow-up study. BMJ Open 2019; 9:e028192. [PMID: 31562144 PMCID: PMC6773303 DOI: 10.1136/bmjopen-2018-028192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Despite the negative influence of fatigue on quality of life in patients who undergo lung cancer surgery, little is known about the possible predictors of postoperative fatigue. The aim of this study was to examine demographic and clinical characteristics that might predict postoperative fatigue 5 months after lung cancer surgery. DESIGN A prospective longitudinal follow-up study comprising preoperative and postoperative questionnaires, including Lee Fatigue Scale, and sociodemographic and clinical data. SETTING Three university hospitals in Norway (eg, Oslo University Hospital, St. Olav University Hospital and Haukeland University Hospital). PARTICIPANTS In total, 196 surgically treated patients who answered the questionnaires both preoperatively and at 5-month follow-up with valid fatigue scores. RESULTS Bivariate analyses showed that preoperative fatigue was associated with comorbidities and the symptoms of shortness of breath, cough, depression, anxiety, sleep disturbance and pain. Only cough was directly associated with preoperative fatigue in a regression model. Comorbidities and the symptoms of shortness of breath, cough, depression and sleep disturbance were associated with postoperative fatigue in the bivariate analyses, but only shortness of breath was associated with postoperative fatigue in the regression model. We did not find any significant correlations between fatigue and any treatment variable. CONCLUSION Clinicians should pay special attention to lung symptoms and be aware that these may lead to long-term postoperative fatigue. Further research should examine whether interventions reducing lung symptoms, such as shortness of breath and coughing, may prevent development of fatigue in patients undergoing lung cancer surgery.
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Affiliation(s)
- Therese Hugoy
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Lovisenberg Diakonale Hogskole, Oslo, Norway
| | - Anners Lerdal
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diakonale Hospital, Oslo, Norway
| | - Tone Rustoen
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Research and Development, Division of Emergencies and Critical Care, Oslo universitetssykehus Ulleval, Oslo, Norway
| | - Trine Oksholm
- Faculty of Health Studies, Campus Haraldsplass, VID Vitenskapelige Hogskole, Bergen, Norway
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Lin CY, Cheng ASK, Nejati B, Imani V, Ulander M, Browall M, Griffiths MD, Broström A, Pakpour AH. A thorough psychometric comparison between Athens Insomnia Scale and Insomnia Severity Index among patients with advanced cancer. J Sleep Res 2019; 29:e12891. [PMID: 31328319 DOI: 10.1111/jsr.12891] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
For patients with cancer, sleep disturbance is commonplace. Using classical test theory and Rasch analyses, the present study compared two commonly used psychometric instruments for insomnia - Athens Insomnia Scale and Insomnia Severity Index - among patients with advanced cancer. Through convenience sampling, patients with cancer at stage III or IV (n = 573; 326 males; mean age = 61.3 years; SD = 10.7) from eight oncology units of university hospitals in Iran participated in the study. All the participants completed the Athens Insomnia Scale, Insomnia Severity Index, Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index. Additionally, 433 participants wore an Actigraph device for two continuous weekdays. Classical test theory and Rasch analysis both supported the construct validity for Athens Insomnia Scale (factor loadings from confirmatory factor analysis = 0.61-0.87; test-retest reliability = 0.72-0.82; infit mean square = 0.81-1.17; outfit MnSq = 0.79-1.14) and for Insomnia Severity Index (factor loadings from confirmatory factor analysis = 0.61-0.81; test-retest reliability = 0.72-0.82; infit mean square = 0.72-1.14; outfit mean square = 0.76-1.11). Both Athens Insomnia Scale and Insomnia Severity Index had significant associations with Edmonton Symptom Assessment Scale, Hospital Anxiety and Depression Scale, General Health Questionnaire-12, Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index, as well as having good sensitivity and specificity. Significant differences in the actigraphy measure were found between insomniacs and non-insomniacs based on Athens Insomnia Scale or Insomnia Severity Index score. With promising results, healthcare providers can use either Athens Insomnia Scale or Insomnia Severity Index to understand the insomnia of patients with advanced cancer.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Andy S K Cheng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Babak Nejati
- Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vida Imani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Martin Ulander
- Department of Clinical and Experimental Medicine, Division of Clinical Neurophysiology, Faculty of Health Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Mark D Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, UK
| | - Anders Broström
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.,Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Amir H Pakpour
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.,Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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56
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Guo M, Wang C, Yin X, Nie L, Wang G. Symptom clusters and related factors in oesophageal cancer patients 3 months after surgery. J Clin Nurs 2019; 28:3441-3450. [PMID: 31162849 DOI: 10.1111/jocn.14935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 04/29/2019] [Accepted: 05/26/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Min Guo
- School of Nursing Shandong University Jinan China
| | - Cui Wang
- School of Nursing Shandong University Jinan China
| | - Xiumin Yin
- School of Nursing Shandong University Jinan China
| | - Liting Nie
- School of Nursing Shandong University Jinan China
| | - Gongchao Wang
- School of Nursing Shandong University Jinan China
- Shandong Provincial Hospital Affiliated to Shandong University Jinan China
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57
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Uchida M, Sugie C, Yoshimura M, Suzuki E, Shibamoto Y, Hiraoka M, Akechi T. Factors associated with a preference for disclosure of life expectancy information from physicians: a cross-sectional survey of cancer patients undergoing radiation therapy. Support Care Cancer 2019; 27:4487-4495. [PMID: 30911915 DOI: 10.1007/s00520-019-04716-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/25/2019] [Indexed: 01/29/2023]
Abstract
PURPOSE This study aimed to investigate experiences and preferences for disclosure of life expectancy, agreement between them, and the factors associated with preferences for disclosure of life expectancy with physicians among cancer patients undergoing radiation therapy. METHODS Cancer patients aged 20 years or older were consecutively sampled when they started radiation therapy at two university hospitals. Patients completed self-administered questionnaires concerning their experiences of and preferences for disclosure of life expectancy, treatment decision-making, psychological distress, physical symptoms, sociodemographic and medical factors, physician's communication style, and provision of psychological, physical, and practical support. RESULTS Among the 226 respondents (response rate: 58%) who responded, 54% experienced disclosure of life expectancy, and 45% preferred it. The agreement is 65%. Eighty-five percent recognized their aim of radiation therapy as curative. A univariate analysis indicated that having a full/part-time job and wishing to leave treatment decisions to doctors were significantly associated with preference for disclosure of life expectancy, but psychological distress was not. A multiple regression analysis revealed that having a full-time/part-time job was significantly associated with preference of communication about life expectancy. CONCLUSIONS Fifty-four percent of the patients experienced and 45% of the patients preferred disclosure of life expectancy. The agreement is moderate. Our results show that there was a significant association between employment status and patient's preference for disclosure of life expectancy with physicians. Communication of prognosis is difficult but whether a patient continues to work or not may be an indicator of preference.
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Affiliation(s)
- Megumi Uchida
- Division of Palliative Care and Psycho-Oncology, Nagoya City University Hospital, Nagoya, Japan.
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.
| | - Chikao Sugie
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Michio Yoshimura
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate, School of Medicine, Kyoto, Japan
| | - Eiji Suzuki
- Department of Breast Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yuta Shibamoto
- Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate, School of Medicine, Kyoto, Japan
| | - Tatsuo Akechi
- Division of Palliative Care and Psycho-Oncology, Nagoya City University Hospital, Nagoya, Japan
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University, Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan
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58
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Knoerl R, Chornoby Z, Smith EML. Estimating the Frequency, Severity, and Clustering of SPADE Symptoms in Chronic Painful Chemotherapy-Induced Peripheral Neuropathy. Pain Manag Nurs 2019; 19:354-365. [PMID: 29503217 DOI: 10.1016/j.pmn.2018.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 01/04/2018] [Accepted: 01/06/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND Patients undergoing treatment for cancer commonly experience symptoms such as sleep disturbance, pain, anxiety, depression, and low energy/fatigue (SPADE), subsequently altering physical function and complicating effective symptom management. However, little is known about the frequency, severity, and clustering of SPADE symptoms in individuals with chronic painful chemotherapy-induced peripheral neuropathy (CIPN). Aims/Design: The purpose of this cross-sectional, secondary analysis was to describe the frequency, severity, and clustering of SPADE symptoms and their association with physical function in individuals with chronic painful CIPN. Participants/Subjects: Sixty individuals with chronic painful CIPN were recruited from five academic and community oncology outpatient center to participate in a randomized controlled pilot trial designed to test the efficacy of a cognitive behavioral therapy-based pain management program. METHODS Participants completed the 0-10 Average CIPN Pain Numerical Rating Scale and Patient-Reported Outcome Measurement Information System measures for sleep-related impairment, anxiety, depression, fatigue, and pain interference via tablet before being randomly assigned to a study arm. The frequency, severity, and clustering of SPADE symptoms were calculated via descriptive statistics and Partitioning Around Medoids cluster analysis. Spearman rank correlation was performed to determine the association between number of SPADE symptoms and pain interference severity. RESULTS AND CONCLUSIONS Participants (n = 59) experienced numerous SPADE symptoms. 66.1% of participants experienced at least two SPADE symptoms concurrently. The cluster analysis revealed high (n = 36) and low (n = 23) severity subgroups. There was a moderate correlation (r = 0.48) between the number of SPADE symptoms and pain interference severity. Determining the clustering of SPADE symptoms in individuals with chronic painful CIPN may lead to targeted multifaceted interventions to improve physical function.
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Affiliation(s)
- Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts.
| | - Zach Chornoby
- University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Ellen M L Smith
- University of Michigan School of Nursing, Ann Arbor, Michigan
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59
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Lee K, Oh EG, Kim S, Kim S. Symptom experiences and health‐related quality of life among non‐small cell lung cancer patients participating in clinical trials. J Clin Nurs 2019; 28:2111-2123. [DOI: 10.1111/jocn.14803] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Kyunghwa Lee
- Department of Nursing Yonsei University Graduate School Seoul Korea
| | - Eui Geum Oh
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sanghee Kim
- Mo‐Im Kim Nursing Research Institute Yonsei University College of Nursing Seoul Korea
| | - Sang‐We Kim
- Department of Oncology, Asan Medical Center University of Ulsan College of Medicine Seoul Korea
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Use of Seva Stress Release Acupressure to Reduce Pain, Stress, and Fatigue in Patients Hospitalized for Cancer Treatment. J Hosp Palliat Nurs 2018; 20:521-528. [PMID: 30379796 DOI: 10.1097/njh.0000000000000484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Patients undergoing treatment for cancer often experience stress, fatigue, and pain during their treatment. Medical management of these symptoms can cause additional adverse effects, but it is possible that noninvasive complementary therapies may be able to reduce these symptoms without unwanted adverse effects. The purpose of this study was to assess the feasibility and impact of the Seva Stress Release acupressure protocol on stress, fatigue, pain, and vital signs of patients hospitalized for cancer treatment. Thirty patients receiving cancer treatment and experiencing stress, fatigue, and pain were recruited for the study. After obtaining informed consent, baseline data (survey and vital signs) were obtained, followed by administration of the Seva Stress Release. After the intervention, vital signs were obtained, and patients completed 2 additional surveys. After Seva, patient stress, fatigue, pain, heart rate, and respirations were significantly decreased (P = .000). Sixty-six percent of participants experienced symptom relief for at least 1 to 4 hours. Qualitative findings also indicated that patients reported better sleep and mental clarity after the intervention. The Seva protocol could be taught to nurses and be used as an independent intervention for patients experiencing adverse effects of cancer treatment, to promote comfort and reduce stress and fatigue.
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61
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Trajectory of insomnia symptoms in older adults with lung cancer: using mixed methods. Support Care Cancer 2018; 27:2255-2263. [DOI: 10.1007/s00520-018-4488-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 10/02/2018] [Indexed: 12/19/2022]
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62
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Lai XY, Tang ZM, Zhu XD, Li L, Qin XY, Lan JL, Lu CP, Lyu ZC, Liang LQ, Chen LJ. Sleep Disturbance and Related Factors in Patients with Nasopharyngeal Carcinoma and Their Family Caregivers Prior to the Initiation of Treatment. Sci Rep 2018; 8:14263. [PMID: 30250207 PMCID: PMC6155287 DOI: 10.1038/s41598-018-32587-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 09/07/2018] [Indexed: 11/09/2022] Open
Abstract
Sleep disturbance is a common complaint in cancer patients. However, less is known about the parameters of sleep in patients with nasopharyngeal cancer (NPC) and their family caregivers (FCs) when they are about to begin treatment. We investigated the sleep quality in patients with NPC and their FCs before treatment and determined the related factors that predict sleep disturbance in these patients before therapy. A total of 101 patient-FC dyads were recruited. They completed the Pittsburgh Sleep Quality Index (PSQI) prior to treatment. No differences were found in sleep disturbance between patients (38.6%) and their FCs (31.7%). Patients reported significantly higher rates of short sleep duration than their FCs (P = 0.011). Logistic regression analyses showed that older patients were more prone to suffer from poor sleep quality before treatment (OR = 1.06, 95% CI = 1.01-1.10, P = 0.008), while patients with a higher BMI were less likely to experience sleep disturbance (OR = 0.83, 95% CI = 0.71-0.96, P = 0.012). Sleep disturbance is a significant problem in patients with NPC and their FCs before therapy. Older patients and those with a lower BMI appear to be more inclined to suffer from poor sleep before treatment.
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Affiliation(s)
- Xiao-Ying Lai
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhong-Min Tang
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xiao-Dong Zhu
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Ling Li
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xue-Yan Qin
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jiang-Ling Lan
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Chun-Ping Lu
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Zhi-Chan Lyu
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Li-Qiao Liang
- Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Li-Jun Chen
- Department of Quality Control, Cancer Hospital of Guangxi Medical University, Cancer Institute of Guangxi Zhuang Autonomous Region, Nanning, China.
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Burrell SA, Yeo TP, Smeltzer SC, Leiby BE, Lavu H, Kennedy EP, Yeo CJ. Symptom Clusters in Patients With Pancreatic Cancer Undergoing Surgical Resection: Part II. Oncol Nurs Forum 2018; 45:E53-E66. [PMID: 29947350 DOI: 10.1188/18.onf.e53-e66] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To explore the relationship between 16 symptom clusters (SCs), clinical and demographic influencing factors, and clinical outcomes over time in patients with pancreatic cancer (PC) undergoing surgical resection. SAMPLE & SETTING 143 patients with stage II PC undergoing surgical resection were recruited to participate in this longitudinal, exploratory study conducted at Thomas Jefferson University Hospital, a National Cancer Institute-designated cancer center. METHODS & VARIABLES Quality of life was measured preoperatively and at three, six, and nine months postoperatively. Statistical methods included simple linear and Cox proportional hazard regression. RESULTS Preoperative pain was significantly associated with the pain-gastrointestinal SC, and preoperative worry was significantly associated with the mood SC. The strongest negative association with emotional well-being across all study time points was found with the preoperative mood SC. The insomnia-digestive problems SC and the nutritional problems SC demonstrated a trend toward poor survival. IMPLICATIONS FOR NURSING Findings provide evidence that preoperative worry and pain are associated with SC severity and that SCs may have a detrimental effect on quality of life and survival in patients with PC undergoing surgical resection.
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64
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Nguyen LT, Alexander K, Yates P. Psychoeducational Intervention for Symptom Management of Fatigue, Pain, and Sleep Disturbance Cluster Among Cancer Patients: A Pilot Quasi-Experimental Study. J Pain Symptom Manage 2018; 55:1459-1472. [PMID: 29505795 DOI: 10.1016/j.jpainsymman.2018.02.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 02/22/2018] [Accepted: 02/23/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To assess the feasibility of conducting a trial of a psychoeducational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain, and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context and to undertake a preliminary evaluation of the intervention. METHODS A parallel-group single-blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital. The intervention group received one face-to-face session and two phone sessions delivered by a nurse one week apart, and the comparison group received usual care. Patient outcomes were measured at baseline before the chemotherapy cycle and immediately preceding the next chemotherapy cycle. Separate linear mixed models were used to evaluate the impact of the intervention on total symptom cluster severity, symptom scores, functional status, depressive symptoms, and health-related quality of life. RESULTS The study design was feasible with a recruitment rate of 22.6% and attrition rate of 9.8%. Compared to the control group, the intervention group showed a significant reduction in symptom cluster severity, fatigue severity, fatigue interference, sleep disturbance, depression, and anxiety. Significant differences were not observed for pain severity, pain interference, functional status, and health-related quality of life. The intervention was acceptable to the study population, with a high attendance rate of 78% and adherence rate of 95.7%. CONCLUSION On the basis of the present study findings, future randomized controlled trials are needed to test the effectiveness of a symptom cluster psychoeducational intervention in Vietnam.
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Affiliation(s)
- Ly Thuy Nguyen
- School of Nursing, Queensland University of Technology, Brisbane, Australia; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam.
| | - Kimberly Alexander
- School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Patsy Yates
- School of Nursing, Queensland University of Technology, Brisbane, Australia
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Palliative Care and Physiatry in the Oncology Care Spectrum: An Opportunity for Distinct and Collaborative Approaches. Phys Med Rehabil Clin N Am 2018; 28:35-47. [PMID: 27912999 DOI: 10.1016/j.pmr.2016.08.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
As cancer evolves from a terminal illness to a chronic medical condition, so too does the view of clinical services. Palliative care and physical medicine and rehabilitation (PM&R) will increase in acceptance because they provide a valuable resource. The overarching theme is improving cancer-related symptoms or treatment-related side effects, improving patient health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision making. Managing symptom burden may improve therapy participation/performance. PM&R and palliative care departments are well-equipped to develop patient-centered care protocols, and could play an important role in developing a universal measure of performance status.
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Schell JT, Petermann-Meyer A, Kloss-Brandstätter A, Bartella AK, Kamal M, Hölzle F, Lethaus B, Teichmann J. Distress thermometer for preoperative screening of patients with oral squamous cell carcinoma. J Craniomaxillofac Surg 2018; 46:1111-1116. [PMID: 29789211 DOI: 10.1016/j.jcms.2018.04.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 04/06/2018] [Accepted: 04/23/2018] [Indexed: 12/15/2022] Open
Abstract
In this study, we evaluate the association between distress, various demographic and medical variables, and the prevalence of psychosocial distress in preoperative patients with oral squamous cell carcinoma. A total of 100 consecutive patients were recruited into the study and asked to complete the Distress Thermometer (DT) form with the Problem List questionnaire prior to surgical intervention; the average distress score was 5.7 ± 2.7. The distress score was neither correlated with age (r = -0.025; p = 0.804) nor with tumor size (r = 0.028; p = 0.785). General worries, anxiety, sadness, depression, pain, exhaustion, sleeping disorders, or problems with nutrition resulted in significantly higher distress scores compared to patients without these complaints. Individuals with a DT score of 5 or higher (p = 0.006) were advised to seek out psychological support. There is a strong correlation between a high DT score and emotional disorders, as well as physical problems.
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Affiliation(s)
- Juliana-Theresa Schell
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Andrea Petermann-Meyer
- Department of Hematology, Oncology, Hemostaseology and Stem Cell Transplantation, Section Psychooncology, Euregionales Comprehensive Cancer Center, RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Anita Kloss-Brandstätter
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Alexander K Bartella
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Mohammad Kamal
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Frank Hölzle
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
| | - Bernd Lethaus
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany.
| | - Jan Teichmann
- Department of Oral and Maxillofacial Surgery, (Head: Prof. Dr. Dr. F. W. Hölzle), RWTH Aachen University, Pauwelstr 30, 52054, Aachen, Germany
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Kwekkeboom KL, Tostrud L, Costanzo E, Coe CL, Serlin RC, Ward SE, Zhang Y. The Role of Inflammation in the Pain, Fatigue, and Sleep Disturbance Symptom Cluster in Advanced Cancer. J Pain Symptom Manage 2018; 55:1286-1295. [PMID: 29360570 PMCID: PMC5899940 DOI: 10.1016/j.jpainsymman.2018.01.008] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/04/2018] [Accepted: 01/11/2018] [Indexed: 01/08/2023]
Abstract
CONTEXT Symptom researchers have proposed a model of inflammatory cytokine activity and dysregulation in cancer to explain co-occurring symptoms including pain, fatigue, and sleep disturbance. OBJECTIVES We tested the hypothesis that psychological stress accentuates inflammation and that stress and inflammation contribute to one's experience of the pain, fatigue, and sleep disturbance symptom cluster (symptom cluster severity, symptom cluster distress) and its impact (symptom cluster interference with daily life, quality of life). METHODS We used baseline data from a symptom cluster management trial. Adult participants (N = 158) receiving chemotherapy for advanced cancer reported pain, fatigue, and sleep disturbance on enrollment. Before intervention, participants completed measures of demographics, perceived stress, symptom cluster severity, symptom cluster distress, symptom cluster interference with daily life, and quality of life and provided a blood sample for four inflammatory biomarkers (interleukin-1β, interleukin-6, tumor necrosis factor-α, and C-reactive protein). RESULTS Stress was not directly related to any inflammatory biomarker. Stress and tumor necrosis factor-α were positively related to symptom cluster distress, although not symptom cluster severity. Tumor necrosis factor-α was indirectly related to symptom cluster interference with daily life, through its effect on symptom cluster distress. Stress was positively associated with symptom cluster interference with daily life and inversely with quality of life. Stress also had indirect effects on symptom cluster interference with daily life, through its effect on symptom cluster distress. CONCLUSION The proposed inflammatory model of symptoms was partially supported. Investigators should test interventions that target stress as a contributing factor in co-occurring pain, fatigue, and sleep disturbance and explore other factors that may influence inflammatory biomarker levels within the context of an advanced cancer diagnosis and treatment.
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Affiliation(s)
| | | | | | | | | | | | - Yingzi Zhang
- University of Wisconsin, Madison, Wisconsin, USA
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68
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Hung HY, Wu LM, Chen KP. Determinants of Quality of Life in Lung Cancer Patients. J Nurs Scholarsh 2018; 50:257-264. [DOI: 10.1111/jnu.12376] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Hsiu-Yu Hung
- Registered Nurse, Division of Chest Department; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
| | - Li-Min Wu
- Associate Professor, School of Nursing, Kaohsiung Medical University, and Department of Medical Research; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Kang-Pan Chen
- Supervisor of Nursing Department; Kaohsiung Veterans General Hospital; Kaohsiung Taiwan
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Aksu NT, Erdogan A, Ozgur N. Effects of progressive muscle relaxation training on sleep and quality of life in patients with pulmonary resection. Sleep Breath 2017; 22:695-702. [PMID: 29290053 DOI: 10.1007/s11325-017-1614-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/18/2017] [Accepted: 12/21/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND The inadequate quality and nature of sleep is a commonly reported problem among hospitalized patients. The purpose of this study is to examine the effects of progressive muscle relaxation training program on sleep quality, sleep state, pain, and quality of life in patients who underwent pulmonary resection. METHODS Our study was planned as a single-blind prospective randomized controlled trial. The study was conducted on 26 patients who underwent surgery by using posterolateral thoracotomy method. Progressive muscle relaxation training were given to the training group with a therapist two times a day. Sleep quality, daytime sleeping, pain, and quality of life were respectively evaluated in the morning before the surgery and 1 week after the surgery by using Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, visual analogue scale, and Euro Quality of Life-5D (EQ-5D). RESULTS There is no significant difference between preoperative groups in the total Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Euro Quality of Life-5D, and visual analogue scale scores (p > 0.05). The intra-group change in the study group showed a significant deterioration in the Euro Quality of Life-5D and visual analogue scale scores (p < 0.05). There was a significant deterioration in the total Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, EQ-5D, and visual analogue scale scores in the control group (p < 0.05). The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Euro Quality of Life-5D scores showed significant improvements in the relaxation training group after treatment at 1 week (p < 0.05). CONCLUSIONS Progressive muscle relaxation prevents a decline in patient-reported sleep quality following pulmonary resection.
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Affiliation(s)
- Neriman Temel Aksu
- Department of Physical Therapy and Rehabilitation, Akdeniz University, Antalya, Turkey.
| | - Abdullah Erdogan
- Department of Thoracic Surgery, Akdeniz University Faculty Of Medicine, Antalya, Turkey
| | - Nazmiye Ozgur
- Department of Thoracic Surgery, Akdeniz University Hospital, Antalya, Turkey
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Halle IH, Westgaard TK, Wahba A, Oksholm T, Rustøen T, Gjeilo KH. Trajectory of sleep disturbances in patients undergoing lung cancer surgery: a prospective study. Interact Cardiovasc Thorac Surg 2017; 25:285-291. [PMID: 28486702 DOI: 10.1093/icvts/ivx076] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 02/15/2017] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Patients with lung cancer report sleep difficulties to be frequent and bothersome symptoms. This study describes the trajectory of sleep from before and up to 12 months after surgery for lung cancer. Further, it investigates possible associations between sleep disturbance, demographic and clinical characteristics before surgery. METHODS This study is part of a longitudinal multicentre study. Sleep disturbance was measured by The General Sleep Disturbance Scale (GSDS) that investigates frequencies of sleep difficulties (21 items) and a total sum score ≥43 indicates a clinically meaningful level of sleep disturbance (score range 0-147). Linear mixed models were used to study changes in sleep from baseline to 1, 5, 9 and 12 months after surgery. RESULTS The percentage of patients (n = 264) reporting sleep disturbances was 60.9% at baseline, 68.5% at Month 1, 55.4% at Month 5, 51.3% at Month 9 and 49.7% at Month 12. The increase to and decrease from Month 1 was the only significant alteration in the occurrence of sleep disturbance. The patients reported most problems within the subscales sleep quantity, early awakenings and sleep quality. Factors associated with sleep disturbance were lower age, use of pain medication and psychotropic medication and higher comorbidity score. CONCLUSIONS Lung cancer patients sleep poorly, before as well as after surgery. There is a need to address sleeping disturbance routinely in clinical practice and screening for sleeping problems is indicated. Further studies are warranted concerning factors that contribute to sleep disturbance and how they best can be treated.
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Affiliation(s)
- Ingrid Helene Halle
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Therese Krystad Westgaard
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Alexander Wahba
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trine Oksholm
- VID Specialized University, Haraldsplass, Bergen, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Tone Rustøen
- Department of Nursing Science, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Kari Hanne Gjeilo
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Cardiothoracic Surgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Cardiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,National Competence Centre for Complex Symptom Disorders, St. Olavs Hospital, Trondheim, Norway
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71
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Measurements and status of sleep quality in patients with cancers. Support Care Cancer 2017; 26:405-414. [DOI: 10.1007/s00520-017-3927-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 10/09/2017] [Indexed: 01/04/2023]
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Morrison EJ, Novotny PJ, Sloan JA, Yang P, Patten CA, Ruddy KJ, Clark MM. Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer. Clin Lung Cancer 2017; 18:497-503. [PMID: 28412094 PMCID: PMC9062944 DOI: 10.1016/j.cllc.2017.02.008] [Citation(s) in RCA: 161] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 02/12/2017] [Accepted: 02/21/2017] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Lung cancer is associated with a greater symptom burden than other cancers, yet little is known about the prevalence of emotional problems and how emotional problems may be related to the physical symptom burden and quality of life in newly diagnosed patients with lung cancer. This study aimed to identify the patient and disease characteristics of patients with lung cancer experiencing emotional problems and to examine how emotional problems relate to quality of life and symptom burden. PATIENTS AND METHODS A total of 2205 newly diagnosed patients with lung cancer completed questionnaires on emotional problems, quality of life, and symptom burden. RESULTS Emotional problems at diagnosis were associated with younger age, female gender, current cigarette smoking, current employment, advanced lung cancer disease, surgical or chemotherapy treatment, and a lower Eastern Cooperative Oncology Group performance score. Additionally, strong associations were found between greater severity of emotional problems, lower quality of life, and greater symptom burden. CONCLUSION Certain characteristics place patients with lung cancer at greater risk for emotional problems, which are associated with a reduced quality of life and greater symptom burden. Assessment of the presence of emotional problems at the time of lung cancer diagnosis provides the opportunity to offer tailored strategies for managing negative mood, and for improving the quality of life and symptom burden management of patients with lung cancer.
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Affiliation(s)
| | - Paul J Novotny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Jeff A Sloan
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Ping Yang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Matthew M Clark
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
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Wong ML, Cooper BA, Paul SM, Levine JD, Conley YP, Wright F, Hammer M, Miaskowski C. Differences in Symptom Clusters Identified Using Ratings of Symptom Occurrence vs. Severity in Lung Cancer Patients Receiving Chemotherapy. J Pain Symptom Manage 2017; 54:194-203. [PMID: 28533161 PMCID: PMC5557657 DOI: 10.1016/j.jpainsymman.2017.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 03/13/2017] [Accepted: 04/05/2017] [Indexed: 01/10/2023]
Abstract
CONTEXT An important question in symptom clusters research is whether the number and types of symptom clusters vary based on the specific dimension of the symptom experience used to create the clusters. OBJECTIVES Given that lung cancer patients undergoing chemotherapy (CTX) report an average of 14 co-occurring symptoms and studies of symptom clusters in these patients are limited, the purpose of this study, in lung cancer patients undergoing CTX (n = 145), was to identify whether the number and types of symptom clusters differed based on whether symptom occurrence rates or symptom severity ratings were used to create the clusters. METHODS A modified version of the Memorial Symptom Assessment Scale was used to assess for the occurrence and severity of 38 symptoms, one week after the administration of CTX. Exploratory factor analysis was used to extract the symptom clusters. RESULTS Both the number and types of symptom clusters were relatively similar using symptom occurrence rates or symptom severity ratings. Five symptom clusters were identified using both symptom occurrence rates and severity ratings (i.e., sickness behavior, lung cancer specific, psychological, nutritional, and epithelial). Across these two dimensions, the specific symptoms within each of the symptom clusters were relatively similar. CONCLUSIONS Identification of symptom clusters in patients with lung cancer may assist with the development of more targeted symptom management interventions. Future studies are warranted to determine if symptom clusters change over a cycle of CTX in patients with lung cancer.
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Affiliation(s)
- Melisa L Wong
- School of Medicine, University of California, San Francisco, California, USA
| | - Bruce A Cooper
- School of Nursing, University of California, San Francisco, California, USA
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Fay Wright
- Yale School of Nursing, New Haven, Connecticut, USA
| | - Marilyn Hammer
- Department of Nursing, Mount Sinai Hospital, New York, New York, USA
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Oliveira M, Oliveira G, Souza-Talarico J, Mota D. Surgical Oncology: Evolution of Postoperative Fatigue and Factors Related to Its Severity. Clin J Oncol Nurs 2017; 20:E3-8. [PMID: 26800419 DOI: 10.1188/16.cjon.e3-e8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fatigue has been reported by many patients undergoing surgery and is associated with a negative prognosis. The factors associated with postoperative fatigue and its evolution during the postoperative period are unclear. Adequate fatigue measurement instruments are necessary to obtain reliable evaluations and to direct effective care to control fatigue in this patient population. OBJECTIVES This article describes the evolution of postoperative fatigue in patients with cancer as well as related factors. METHODS A review of the literature using the CINAHL® and PubMed databases was undertaken. FINDINGS The prevalence of moderate and severe fatigue varies during the postoperative period, with a reduction in the 12 months after surgery. Various factors (e.g., stress, anxiety, depression, pain, changes in sleep patterns) seem to influence the severity of fatigue. More evidence is needed to explore the relationship between immediate postoperative fatigue and the evolution of fatigue during the period following surgical treatment for cancer.
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Dreidi MM, Hamdan-Mansour AM. Pain, Sleep Disturbance, and Quality of Life Among Palestinian Patients Diagnosed with Cancer. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2016; 31:796-803. [PMID: 26561425 DOI: 10.1007/s13187-015-0946-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The objective of this descriptive study is to explore the relationships between pain, sleep disturbance, and quality of life among Palestinian patients diagnosed with cancer in the West Bank. A cross-sectional, descriptive-correlational design was used to collect data from 184 patients with cancer. The quality of life questionnaire, visual analogue pain scale, and physical health status were used in data collection. The results showed that the mean score for pain was 5, the best functioning was for cognitive scale (M = 75, SD = 29), the worst symptoms experienced by patients was appetite loss (M = 47, SD = 35), a moderate global health status (M = 53, SD = 27), and the mean for sleep disturbance was 43 (SD = 35). Pain and sleep disturbance showed high negative correlations with functional scales of quality of life and positive with symptom scales. The findings showed that the co-occurrence of pain and sleep disturbance was negatively correlated with quality of life (QoL) and positively with symptom scales. The regression analysis revealed that pain and sleep disturbance accounted for a significant proportion of variance in the QoL (p < 0.001), and the highest proportion was in predicting global health status (41.9 %). The findings of this study give evidence about the importance of assessing pain and sleep quality among Palestinian patients with cancer.
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Affiliation(s)
- Mu'taz M Dreidi
- Faculty of Nursing, Pharmacy and Health Professions, Birzeit University, P. O. Box 14, Birzeit, Palestine.
| | - Ayman M Hamdan-Mansour
- Department of Community Health Nursing, Faculty of Nursing, The University of Jordan, Amman, 11942, Jordan
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Hamada T, Komatsu H, Rosenzweig MQ, Chohnabayashi N, Nishimura N, Oizumi S, Ren D. Impact of Symptom Clusters on Quality of Life Outcomes in Patients from Japan with Advanced Nonsmall Cell Lung Cancers. Asia Pac J Oncol Nurs 2016; 3:370-381. [PMID: 28083555 PMCID: PMC5214871 DOI: 10.4103/2347-5625.196489] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 10/04/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Identify symptom clusters based on symptoms experienced by patients with advanced nonsmall cell lung cancers (NSCLCs), and examine the relationship between the symptom clusters and impairment in everyday life and quality of life (QOL). METHODS Using the M.D. Anderson Symptom Inventory, 9 symptom items and the QOL Questionnaire (QLQ-C-30) evaluation apparatus from the European Organization for Research and Treatment of Cancer, we evaluated symptom severity, interference in daily life, and QOL. Factor analysis and multiple regression analysis techniques were used. RESULTS Sixty patients with advanced NSCLCs seen in pulmonary medicine departments were included in the study. The average age of patients was 64.33 (standard deviation = 11.40). Thirty-six were male and 24 were female. Three symptom clusters were identified as fatigue/anorexia cluster (dry mouth, altered the sense of taste, drowsiness, fatigue/tiredness, and lack of appetite), pain cluster (anxiety, sadness, and pain), numbness cluster (numbness, leg weakness, and distress). The pain cluster had the strongest influence (adjusted R2 = 0.355) on daily life (emotions) while the numbness cluster most strongly affected walking. The fatigue/anorexia cluster explained 22.7% of role function variance. This symptom clustering may be unique among patients with advanced NSCLCs. CONCLUSIONS Each of these clusters affected QOL and everyday life with varying degrees of influence. In clinical screening assessments, focusing on symptom clusters could provide tailored management strategies for patients with advanced NSCLCs. These care strategies may improve outcomes specifically for advanced NSCLCs patients.
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Affiliation(s)
- Tamami Hamada
- Department of Nursing, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Hiroko Komatsu
- Faculty of Nursing and Medical Care, Keio University, Tokyo, Japan
| | - Margaret Quinn Rosenzweig
- Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pennsylvania, USA
| | - Naohiko Chohnabayashi
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Naoki Nishimura
- Division of Pulmonary Medicine, Thoracic Center, St. Luke's International Hospital, Tokyo, Japan
| | - Satoshi Oizumi
- Department of Medicine, School of Medicine, Hokkaido University, Sapporo, Japan
| | - Dianxu Ren
- Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pennsylvania, USA
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Holliday EB, Dieckmann NF, McDonald TL, Hung AY, Thomas CR, Wood LJ. Relationship between fatigue, sleep quality and inflammatory cytokines during external beam radiation therapy for prostate cancer: A prospective study. Radiother Oncol 2015; 118:105-11. [PMID: 26743832 DOI: 10.1016/j.radonc.2015.12.015] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 10/22/2015] [Accepted: 12/18/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND PURPOSE Mechanisms of fatigue reported during radiotherapy are poorly defined but may include inflammatory cytokines and/or sleep disturbances. This prospective, longitudinal, phase II study assessed fatigue, sleep, and serum cytokine levels during radiotherapy for early-stage prostate cancer (PCa). MATERIAL AND METHODS Twenty-eight men undergoing radiotherapy for early-stage PCa wore an Actiwatch Score to record fatigue level, sleep time, onset latency, efficiency and wake after sleep onset. Serum levels of IL-1α, IL-1β, TNF-α, IL-6, IL-8, IL-10 and VEGF were measured weekly during radiotherapy. Patient reported quality of life (QOL) metrics were collected before and after treatment. Linear mixed effects models examined trajectories across treatment weeks. RESULTS Fatigue increased across treatment weeks (P<.01), and fatigue was associated with decreased patient-reported QOL. Sleep efficiency increased across treatment weeks (rate of change over time=.29, P=.03), and sleep onset latency decreased (rate of change over time=.86, P=.06). IL-6 tended to increase during treatment (P=0.09), but none of the cytokine levels or sleep variables were significantly related to fatigue trajectories. CONCLUSIONS Despite increased sleep efficiency across treatment weeks, fatigue significantly increased. Although IL-6 increased during the course of radiotherapy, cytokines levels were not associated with fatigue scores or sleep disturbance. Further studies are needed to define the mechanisms for fatigue during radiotherapy.
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Affiliation(s)
- Emma B Holliday
- The University of Texas MD Anderson Cancer Center Division of Radiation Oncology, Houston, United States
| | - Nathan F Dieckmann
- Oregon Health & Science University School of Nursing, Department of Public Health and Preventative Medicine & Department of Psychiatry, Portland, United States
| | - Tasha L McDonald
- Oregon Health & Science University Department of Radiation Medicine, Portland, United States
| | - Arthur Y Hung
- Oregon Health & Science University Department of Radiation Medicine, Portland, United States
| | - Charles R Thomas
- Oregon Health & Science University Department of Radiation Medicine, Portland, United States
| | - Lisa J Wood
- The University of Texas MD Anderson Cancer Center Division of Radiation Oncology, Houston, United States; Massachussettes General Hospital Institute of Health Professions, Boston, United States.
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Fu JB, Lee J, Tran KB, Siangco CM, Ng AH, Smith DW, Bruera E. Symptom Burden and Functional Gains in a Cancer Rehabilitation Unit. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2015; 22:517-523. [PMID: 26929772 DOI: 10.12968/ijtr.2015.22.11.517] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND/AIMS To determine if there is a relationship between patient symptoms and functional improvement on inpatient rehabilitation. METHODS Retrospective review of medical records at an American tertiary referral-based cancer center of all patients admitted to an inpatient rehabilitation unit between 3/1/2013-5/20/2013. Main outcome measures included the Edmonton Symptom and Assessment Scale (ESAS) and Functional Independence Measure (FIM). FINDINGS The medical records for 71 unique cancer rehabilitation inpatients were analyzed. Statistical analysis of total admission ESAS on total FIM change found no significant relationships. The symptom burden of the patients was mild. Patients demonstrated statistically significant improvements in function and symptoms during inpatient rehabilitation. The mean change in total FIM and total ESAS were an increase of 19.20 and decrease of 7.41 respectively. Statistically significant changes occurred in fatigue, sleep, pain, and anxiety. CONCLUSION Both symptom and functional scores improved significantly during inpatient rehabilitation. However, no significant relationships were found between symptoms at admission and improvement in FIM.
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Affiliation(s)
- Jack B Fu
- Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center
| | - Jay Lee
- Department of Educational Psychology, University of Houston
| | - Kenny B Tran
- Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center
| | - Christian M Siangco
- Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center
| | - Amy H Ng
- Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center
| | - Dennis W Smith
- Department of Educational Psychology, University of Houston
| | - Eduardo Bruera
- Department of Palliative Care and Rehabilitation Medicine, University of Texas MD Anderson Cancer Center
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Avelino CUR, Cardoso RM, Aguiar SSD, Silva MJSD. Assessment of quality of life in patients with advanced non-small cell lung carcinoma treated with a combination of carboplatin and paclitaxel. J Bras Pneumol 2015; 41:133-42. [PMID: 25972967 PMCID: PMC4428850 DOI: 10.1590/s1806-37132015000004367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/12/2014] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE: Non-small cell lung carcinoma (NSCLC) is the most common type of lung cancer. Most patients are diagnosed at an advanced stage, palliative chemotherapy therefore being the only treatment option. This study was aimed at evaluating the health-related quality of life (HRQoL) of advanced-stage NSCLC patients receiving palliative chemotherapy with carboplatin and paclitaxel. METHODS: This was a multiple case study of advanced-stage NSCLC outpatients receiving chemotherapy at a public hospital in Rio de Janeiro, Brazil. The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire was used in conjunction with its supplemental lung cancer-specific module in order to assess HRQoL. RESULTS: Physical and cognitive functioning scale scores differed significantly among chemotherapy cycles, indicating improved and worsened HRQoL, respectively. The differences regarding the scores for pain, loss of appetite, chest pain, and arm/shoulder pain indicated improved HRQoL. CONCLUSIONS: Chemotherapy was found to improve certain aspects of HRQoL in patients with advanced-stage NSCLC.
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Affiliation(s)
- Camila Uanne Resende Avelino
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Multiprofessional Residence Program in Oncology, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Rafael Marques Cardoso
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Chemotherapy Center, Cancer Hospital I, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Suzana Sales de Aguiar
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. Department of Clinical Epidemiology, José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
| | - Mário Jorge Sobreira da Silva
- José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil. José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro, Brazil
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Chambers SK, Morris BA, Clutton S, Foley E, Giles L, Schofield P, O'Connell D, Dunn J. Psychological wellness and health-related stigma: a pilot study of an acceptance-focused cognitive behavioural intervention for people with lung cancer. Eur J Cancer Care (Engl) 2014; 24:60-70. [PMID: 25053458 PMCID: PMC4309461 DOI: 10.1111/ecc.12221] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2014] [Indexed: 12/01/2022]
Abstract
People with lung cancer experience health-related stigma that is related to poorer psychosocial and quality of life outcomes. The present Phase 1 study applied mixed methods to test the acceptability of an acceptance-focused cognitive behavioural intervention targeting stigma for this patient group. Fourteen lung cancer patients completed a 6-week Psychological Wellness intervention with pre- and post-test outcome measures of psychological and cancer-specific distress, depression, health-related stigma and quality of life. In-depth interviews applying interpretative phenomenological analysis assessed participants' experiences of the intervention. Moderate to large improvements were observed in psychological (ηp (2) = 0.182) and cancer-specific distress (ηp (2) = 0.056); depression (ηp (2) = 0.621); health-related stigma (ηp (2) = 0.139). In contrast, quality of life declined (ηp (2) = 0.023). The therapeutic relationship; self-management of distress; and relationship support were highly valued aspects of the intervention. Barriers to intervention included avoidance and practical issues. The lung cancer patients who completed the Psychological Wellness intervention reported improvements in psychological outcomes and decreases in stigma in the face of declining quality of life with patients reporting personal benefit from their own perspectives. A randomised controlled trial is warranted to establish the effectiveness of this approach.
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Affiliation(s)
- S K Chambers
- Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia; Cancer Council Queensland, Brisbane, Queensland, Australia; Health & Wellness Institute, Edith Cowan University, Perth, Western Australia, Australia
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The influence of symptom clusters and the most distressing concerns regarding quality of life among patients with inoperable lung cancer. Eur J Oncol Nurs 2014; 18:236-41. [DOI: 10.1016/j.ejon.2013.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 11/29/2013] [Accepted: 12/04/2013] [Indexed: 01/22/2023]
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Maneeton B, Maneeton N, Reungyos J, Intaprasert S, Leelarphat S, Thongprasert S. Prevalence and relationship between major depressive disorder and lung cancer: a cross-sectional study. Onco Targets Ther 2014; 7:815-21. [PMID: 24920922 PMCID: PMC4043796 DOI: 10.2147/ott.s60000] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective The aims of this study were to estimate the prevalence and examine the factors associated with major depressive disorder (MDD) in lung cancer patients. Materials and methods This cross-sectional study was carried out in the oncology clinic of the University Hospital, Chiang Mai University, Thailand. Patients with all stages of lung cancer were included in this study. Demographic data of eligible patients were gathered. The Mini-International Neuropsychiatric Interview, Thai version 5.0.0 was used to identify MDD. The Thai version of the Personal Health Questionnaire Depression Scale was used to assess depression severity. Results A total of 146 lung cancer patients from the outpatient clinic from July to December 2012 were approached. The 104 patients were included and analyzed in this study. Based on the Mini-International Neuropsychiatric Interview, 14.4% of them were defined as having MDD. Multiple linear regression analysis revealed that Chalder Fatigue Scale, Functional Assessment of Cancer Therapy – Lung, and Pittsburgh Sleep Quality Index scores were significantly correlated with MDD in lung cancer patients. Conclusion The results suggest that MDD is more prevalent in lung cancer patients. In addition, fatigue, poor quality of life, and sleep disturbance may increase associated MDD. Because of the small sample size, further studies should be conducted to confirm these results.
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Affiliation(s)
| | - Narong Maneeton
- Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Jirayu Reungyos
- Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | - Suthi Intaprasert
- Department of Psychiatry, Chiang Mai University, Chiang Mai, Thailand
| | | | - Sumitra Thongprasert
- Department of Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Akyuz RG, Ugur O, Elcigil A. Sleep Quality in Lung Cancer Patients. Asian Pac J Cancer Prev 2013; 14:2909-13. [DOI: 10.7314/apjcp.2013.14.5.2909] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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