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Tao Y, Liu Q, Ye X, Feng J, Liu H, Wu J, Zhang J, Lin Q, Lu J, Liu R. Uncovering the symptom relationship among sleep quality, anxiety, and depression in Chinese patients with breast cancer: multidimensional data validation using PSQI versus actigraphy. J Cancer Surviv 2024:10.1007/s11764-024-01649-5. [PMID: 39141310 DOI: 10.1007/s11764-024-01649-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 07/16/2024] [Indexed: 08/15/2024]
Abstract
PURPOSE The interplay between sleep quality, anxiety, and depression among breast cancer patients remains poorly understood. This study aimed to investigate and compare the symptoms relationships among these three factors in Chinese breast cancer patients, utilizing two sleep assessments. METHODS Our study encompassed 288 participants diagnosed with breast cancer, from whom we collected demographic information through questionnaires. Sleep quality symptoms were assessed using the Pittsburgh Sleep Quality Index (PSQI) and wrist actigraphy, while anxiety and depression symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). Network analyses were conducted using R to calculate the centrality (strength) and further identify central symptoms and bridge symptoms in two networks that differed by sleep assessments. Central symptoms are closely related to other symptoms, whereas bridge symptoms indicate that symptoms may increase spread risk between different conditions. RESULTS In the network using PSQI data, "I have lost interest in my appearance" had the highest strength centrality (rs = 2.417), followed by "sleep duration" (rs = 1.068) and "sleep efficiency" (rs = 0.955). In the network using wrist actigraphy data, "wake after sleep onset" had the highest strength value (rs = 2.437), followed by "sleep efficiency" (rs = 2.397) and "sleep latency" (rs = 1.506). Two bridge symptoms were identified: "I feel cheerful" and "I look forward with enjoyment to things" in both networks. CONCLUSIONS Depressive symptoms played a leading role in the sleep-anxiety-depression network, underscoring the need for targeted intervention tailored to survivors' specific needs. IMPLICATIONS FOR CANCER SURVIVORS Health workers can give priority to symptom-specific screening and therapies, incorporating psychological support into standard cancer care.
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Affiliation(s)
- Yining Tao
- Clinical Research Center, Ningbo No. 2 Hospital, Ningbo, Zhejiang, China
| | - Qixi Liu
- Department of Nursing, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
| | - Xinxin Ye
- Department of Sports Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jie Feng
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Department of Hospital Infection-Control, Tongde Hospital of Zhejiang Province, Hangzhou, China
| | - Huanju Liu
- Women's Hospital and Institute of Genetics, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinqing Wu
- Department of Joint Surgery, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
| | - Jing Zhang
- Department of Breast Surgery, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
| | - Qian Lin
- Department of Breast Surgery, Mindong Hospital Affiliated to Fujian Medical University, Ningde, Fujian, China
| | - Jingzhan Lu
- Institute of Health Informatics, University College London, London, UK
| | - Renyang Liu
- Emergency and Critical Care Center, Intensive Care Unit, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China.
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Al-Mhanna SB, Batrakoulis A, Norhayati MN, Mohamed M, Drenowatz C, Irekeola AA, Afolabi HA, Gülü M, Alkhamees NH, Wan Ghazali WS. Combined Aerobic and Resistance Training Improves Body Composition, Alters Cardiometabolic Risk, and Ameliorates Cancer-Related Indicators in Breast Cancer Patients and Survivors with Overweight/Obesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Sports Sci Med 2024; 23:366-395. [PMID: 38841642 PMCID: PMC11149074 DOI: 10.52082/jssm.2024.366] [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: 01/09/2024] [Accepted: 04/11/2024] [Indexed: 06/07/2024]
Abstract
Breast cancer survivors with obesity are at a high risk of cancer recurrence, comorbidity, and mortality. This review aims to systematically evaluate the effects of combined aerobic and resistance training (CART) on body composition, lipid homeostasis, inflammation, adipokines, cancer-related fatigue, sleep, and quality of life in breast cancer patients and survivors with overweight/obesity. An electronic search was conducted in PubMed, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases from inception up to January 8, 2024. Randomized controlled trials (RCTs) meeting the inclusion criteria were selected for the analysis. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the quality of evidence. A random-effects model was used, and data were analyzed using mean (MD) and standardized mean differences (SMD) for continuous variables with 95% confidence intervals (CI). We assessed the data for risk of bias, heterogeneity, sensitivity, reporting bias, and quality of evidence. A total of 17 randomized controlled trials were included in the systematic review involving 1,148 female patients and survivors (mean age: 54.0 ± 3.4 years). The primary outcomes showed significant improvements in body mass index (SMD -0.57 kg/m2, p = 0.04), body fat (SMD -0.50%, p = 0.02), fat mass (SMD -0.63 kg, p = 0.04), hip circumference (MD -3.14 cm, p = 0.02), and fat-free mass (SMD 1.03 kg, p < 0.001). The secondary outcomes indicated significant increases in high-density lipoprotein cholesterol (MD -0.05 mmol/L, p = 0.008), natural killer cells (SMD 0.42%, p = 0.04), reductions in triglycerides (MD -81.90 mg/dL, p < 0.01), total cholesterol (SMD -0.95 mmol/L, p < 0.01), tumor necrosis factor α (SMD -0.89 pg/mL, p = 0.03), and leptin (SMD -0.63 ng/mL, p = 0.03). Also, beneficial alterations were found in cancer-related fatigue (SMD -0.98, p = 0.03), sleep (SMD -1.17, p < 0.001), and quality of life (SMD 2.94, p = 0.02) scores. There was very low to low confidence in the estimated effect of most of the outcomes. The present findings reveal that CART could be considered an adjunct therapy in supporting the conventional clinical approach observed following exercise. However, further high-quality research is needed to evaluate whether CART would be a valuable intervention to lower aggressive pharmacologic use in breast cancer patients with overweight/obesity.
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Affiliation(s)
- Sameer Badri Al-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Karies, Trikala, Greece
- Department of Physical Education and Sport Science, School of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece
| | - Mohd Noor Norhayati
- Department of Family Medicine, School of Medical Sciences, Kubang Keria, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Teacher Education Upper Austria, Linz, Austria
| | - Ahmad Adebayo Irekeola
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Hospital University Sains Malaysia, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Nouf H Alkhamees
- Department of Rehabilitation, College of Health and Rehabilitation Sciences Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
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Elamin N, Althebity N, Alkhamisi TA, Al-Foheidi M. Sleep quality and psychological disorders in breast cancer female patients receiving radiotherapy at a tertiary oncology center in West Saudi Arabia. Support Care Cancer 2024; 32:163. [PMID: 38367029 DOI: 10.1007/s00520-024-08368-8] [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: 01/18/2023] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE Breast cancer is the most prevalent type of cancer among women worldwide. Many recently diagnosed and treated breast cancer patients complain about sleep disorders, depression, anxiety, stress, and fatigue. This study aimed to evaluate sleep quality among breast cancer patients and to assess its association with psychological disorders, and socio-demographic and clinical characteristics of patients. METHODS This cross-sectional study was conducted among women who received radiotherapy for breast cancer (stage 1-3) at King Abdul-Aziz Medical City-Jeddah from January to August 2021. Each participant completed a personal information form, the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire (IPAQ). Clinical data were collected from the medical records to evaluate certain risk factors. Descriptive statistics were used for participant characteristics, and analyses of variance were used to assess associations between the qualitative variables. RESULTS Fifty-six women with a mean age of 50.1 years and an average of 10 months after cancer diagnosis were included. Poor sleep quality was present in 58% of respondents. Symptomatic depression, anxiety, and stress were found in 34%, 32%, and 30% of women, respectively. Poor sleep quality was associated with depression (p = 0.031), anxiety (p = 0.03), and stress (p = 0.024) and was independently associated with hot flashes. In multivariate analysis, patients with depression or with cancer for more than 6 months were less likely to have good sleep after controlling other variables (21.74 and 14.71 times, respectively). CONCLUSION Poor sleep quality was present in 58% of women with breast cancer receiving radiotherapy and was significantly associated with depression, anxiety, stress, and hot flashes. Depression level and cancer duration were significant predictors of sleep quality. Early identification and proper management of psychological and sleep disorders are necessary to improve the quality of life and survival of breast cancer patients.
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Affiliation(s)
- Nadia Elamin
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia.
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - Nisreen Althebity
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Taif A Alkhamisi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Meteb Al-Foheidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- Oncology Center of Princess Norah, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
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Park JY, Kim MS, Ryu JM. Predictors of sleep quality components in patients undergoing transarterial chemoembolisation: a cross-sectional study. Support Care Cancer 2024; 32:149. [PMID: 38329591 DOI: 10.1007/s00520-024-08338-0] [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: 07/12/2023] [Accepted: 01/20/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Patients undergoing transarterial chemoembolisation experience postembolisation symptoms and interferences affecting sleep quality, which require intervention. The study aimed to identify the predictors of sleep quality components in patients undergoing transarterial chemoembolisation. METHODS This study included two groups of participants: 50 patients undergoing transarterial chemoembolisation and 45 nurses caring for them. Data were collected from September to November 2022 using a structured questionnaire, and analysed using descriptive statistics, the t-test, analysis of variance, Spearman's rank correlation, and multiple regression analysis using the SPSS 27.0 program (IBM Corp., Armonk, NY, USA). RESULTS The mean sleep quality score was 40.28±14.10. Heat sensation (t=-2.08, p=.043) and fatigue (t=-4.47, p<.001) predicted sleep fragmentation in 38.6% of the patients. Abdominal pain (t=-2.54, p=.014), vomiting (t=-2.21, p=.032), and the expected fatigue by the nurses (t=2.68, p=.014) predicted sleep length in 41.7% of patients. Abdominal pain (t=-2.05, p=.046) explained 42.9% of sleep depth. CONCLUSION Based on the predictors of sleep quality components obtained in this study, strategies to improve sleep quality tailored to patients undergoing transarterial chemoembolisation should be developed. This study highlighted the need to bridge the gap between patients' and nurses' expected fatigue and its contribution to sleep fragmentation and sleep length. It also highlighted the importance of noncontact temperature measurement, controlling vomiting, and pain relief for improving sleep length in patients undergoing transarterial chemoembolisation.
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Affiliation(s)
- Ji Young Park
- Gastrointestinal Surgery Ward, Pusan National University Hospital, Busan, South Korea
| | - Myoung Soo Kim
- Department of Nursing, Pukyong National University, 599-1, Daeyeon 3 dong, Namgu, Busan, 48513, South Korea.
| | - Jung Mi Ryu
- Department of Nursing, Busan Institute of Science and Technology, Busan, South Korea
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Li S, Jiang Y, Yuan B, Wang M, Zeng Y, Knobf MT, Wu J, Ye Z. The interplay between stigma and sleep quality in breast cancer: A cross-sectional network analysis. Eur J Oncol Nurs 2024; 68:102502. [PMID: 38194900 DOI: 10.1016/j.ejon.2023.102502] [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: 11/16/2023] [Revised: 12/16/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE Stigma, a subjective internal shame, arises from the association of cancer with death. Sleep quality can be considered a product of stigma. However, the extent of overlap or difference between the two remains unclear. METHODS In total, 512 survivors with breast cancer were recruited from the "Be Resilient to Breast Cancer" project between May and August 2023. This study estimated the stigma, sleep quality, and their relationship by conducting a cross-sectional network analysis. The social impact scale and Pittsburgh Sleep Quality Index scale were employed in this study. RESULTS The core symptom for stigma from the network analysis was alienation by people (Strength = 1.213, Betweenness = 13, Closeness = 0.00211). The core symptom for sleep quality were the sleep quality (Str = 1.114, Bet = 17, Clo = 0.01586). Regarding the combination network, results showed that self-isolation and daytime dysfunction were the bridge nodes and that daytime dysfunction was positively associated with feeling less capable than before (according to self) (r = 0.15). CONCLUSION Our study demonstrates the core symptoms in different symptomatic networks, which can be targeted for treatment personalization and aid in the improvement of sleep quality and stigma in breast cancer patients.
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Affiliation(s)
- Shuhan Li
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yingting Jiang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Bixia Yuan
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Minyi Wang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Yihao Zeng
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - M Tish Knobf
- School of Nursing, Yale University, Orange, CT, United States
| | - Jiahua Wu
- Department of Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
| | - Zengjie Ye
- School of Nursing, Guangzhou Medical University, Guangzhou, Guangdong Province, China.
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He C, He Y, Yang T, Wu C, Lin Y, Yan J, Chang W, Chang F, Wang Y, Wu S, Cao B. Relationship of sleep-quality and social-anxiety in patients with breast cancer: a network analysis. BMC Psychiatry 2023; 23:887. [PMID: 38017507 PMCID: PMC10683122 DOI: 10.1186/s12888-023-05262-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND There is a complex relationship between social anxiety and sleep quality. However, network analysis studies of associations between social anxiety and sleep quality are lacking, particularly among patients with breast cancer. The current study aimed to extend this research to a sample of patients with breast cancer and to examine symptom-level associations between social anxiety and sleep quality using network analysis. METHODS Network analysis was conducted to explore their associations and identify bridge items of social anxiety and sleep quality. RESULTS The network structure revealed 9 important edges between social anxiety and sleep quality. "Subjective sleep quality" had the highest EI value in the network. "Working difficulty under watching" and "Sleep disorders" had the highest BEI values in their own communities. CONCLUSION There are complex pathological correlation pathways between social anxiety and sleep quality in breast cancer patients. "Subjective sleep quality", "Working difficulty under watching" and "Sleep disorders" have the potential to be intervention targets for sleep disorder-social anxiety comorbidity. Medical staff can take corresponding interventions according to the the centrality indices and bridge centrality indicators identified in this study, which is likely to effectively reduce the comorbidity of sleep disorders and social anxiety.
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Affiliation(s)
- Chunyan He
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yang He
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Tianqi Yang
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Chao Wu
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yawei Lin
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Jiaran Yan
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Wei Chang
- Center for Aerospace Clinical Medicine, Department of Aerospace Medicine, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Fenxia Chang
- Department of Obstetrics and Gynecology, Xi 'an Daxing Hospital, Xi'an, 710000, Shaanxi, China
| | - Yameng Wang
- School of Clinical Medicine, Anhui Medical University, Hefei, 230000, Anhui, China
| | - Shengjun Wu
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
| | - Baohua Cao
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
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Zhu W, Gao J, Guo J, Wang L, Li W. Anxiety, depression, and sleep quality among breast cancer patients in North China: Mediating roles of hope and medical social support. Support Care Cancer 2023; 31:514. [PMID: 37552286 PMCID: PMC10409667 DOI: 10.1007/s00520-023-07972-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND Sleep disorders are highly prevalent among breast cancer patients and have a detrimental impact on their quality of life. This study aims to investigate the serial multiple mediating roles of social support and hope in the relationship between anxiety, depression, and sleep quality in breast cancer patients. METHODS A cross-sectional study was conducted in China from October 2021 to February 2022. A total of 315 breast cancer patients were assessed using self-reported questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Social Support Survey (MOS-SSS), Herth Hope Index (HHI), and Hospital Anxiety and Depression Scale (HADS). Mediation analysis was performed using the R Statistical Software. RESULTS Sleep quality exhibited a negative correlation with hope and medical social support (P < 0.01), and a positive correlation with anxiety and depression (P < 0.01). Anxiety and depression accounted for 18.8% and 12.8% of the variance in sleep quality, respectively. Bootstrap analyses of the anxiety-medical social support-hope-sleep quality pathway indicated the presence of direct effects [B = 0.331, 95%CI (0.215, 0.493)] and indirect effects of anxiety on sleep quality mediated solely by medical social support [B = 0.054, 95%CI (0.015, 0.108)] and hope [B = 0.041, 95%CI (0.018, 0.073)], as well as combined effects [B = 0.012, 95%CI (0.004, 0.025)]. Similarly, the depression-medical social support-hope-sleep quality pathway revealed direct effects [B = 0.235, 95%CI (0.104, 0.372)] and indirect effects of depression on sleep quality mediated solely by medical social support [B = 0.078, 95%CI (0.016, 0.150)] and hope [B = 0.049, 95%CI (0.018, 0.086)], as well as combined effects [B = 0.017, 95%CI (0.004, 0.034)]. CONCLUSIONS This research validates the hypothesis that medical social support and hope serve as mediators between anxiety, depression, and sleep quality in breast cancer patients. Interventions targeting anxiety, depression, medical social support, and hope have the potential to effectively enhance sleep quality.
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Affiliation(s)
- Wenjuan Zhu
- Breast Surgery Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Shanxi Province, Taiyuan, 030032, China
| | - Jinnan Gao
- Breast Surgery Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Shanxi Province, Taiyuan, 030032, China
| | - Jun Guo
- Breast Surgery Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Shanxi Province, Taiyuan, 030032, China
| | - Linying Wang
- Comprehensive Medical Department, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, Wuhan, 430030, China
| | - Wanling Li
- Nursing Department, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Shanxi Province, Taiyuan, 030032, China.
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, Wuhan, 430030, People's Republic of China.
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Lee S, Ma C, Shi Q, Meyers J, Kumar P, Couture F, Kuebler P, Krishnamurthi S, Lewis D, Tan B, O'Reilly EM, Shields AF, Meyerhardt JA. Sleep and cancer recurrence and survival in patients with resected Stage III colon cancer: findings from CALGB/SWOG 80702 (Alliance). Br J Cancer 2023; 129:283-290. [PMID: 37179438 PMCID: PMC10338523 DOI: 10.1038/s41416-023-02290-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND We sought to assess the influences of sleep duration, sleep adequacy, and daytime sleepiness on survival outcomes among Stage III colon cancer patients. METHODS We conducted a prospective observational study of 1175 Stage III colon cancer patients enrolled in the CALGB/SWOG 80702 randomised adjuvant chemotherapy trial who completed a self-reported questionnaire on dietary and lifestyle habits 14-16 months post-randomisation. The primary endpoint was disease-free survival (DFS), and secondary was overall survival (OS). Multivariate analyses were adjusted for baseline sociodemographic, clinical, dietary and lifestyle factors. RESULTS Patients sleeping ≥9 h-relative to 7 h-experienced a worse hazard ratio (HR) of 1.62 (95% confidence interval (CI), 1.01-2.58) for DFS. In addition, those sleeping the least (≤5 h) or the most (≥ 9 h) experienced worse HRs for OS of 2.14 (95% CI, 1.14-4.03) and 2.34 (95% CI, 1.26-4.33), respectively. Self-reported sleep adequacy and daytime sleepiness showed no significant correlations with outcomes. CONCLUSIONS Among resected Stage III colon cancer patients who received uniform treatment and follow-up within a nationwide randomised clinical trial, very long and very short sleep durations were significantly associated with increased mortality. Interventions targeting optimising sleep health among indicated colon cancer patients may be an important method by which more comprehensive care can be delivered. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01150045.
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Affiliation(s)
| | - Chao Ma
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA
| | - Qian Shi
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey Meyers
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN, USA
| | | | | | - Philip Kuebler
- Columbus NCI Community Oncology Research Program, Columbus, OH, USA
| | | | | | - Benjamin Tan
- Siteman Cancer Center, Washington University School of Medicine, Saint Louis, MO, USA
| | - Eileen M O'Reilly
- Memorial Sloan Kettering Cancer Center, Weill Cornell Medical Center, New York, NY, USA
| | | | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber/Partners CancerCare, Boston, MA, USA.
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Alhuzaim WM, Alajlan RM, Alshehri RA, Alanazi RM, Alsarhan LK, Alamri HK. Post-gastric Sleeve Surgery Chronic Symptoms From a Sample of Patients in Saudi Community. Cureus 2023; 15:e42000. [PMID: 37593300 PMCID: PMC10428182 DOI: 10.7759/cureus.42000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND A common bariatric procedure known as gastric sleeve surgery can cause significant weight loss and co-morbid condition alleviation. However, patients could experience persistent problems such as gastrointestinal, musculoskeletal/neural, and psychiatric disorders after surgery. This study aims to identify the most prevalent chronic symptoms following sleeve gastrectomy among a sample of Saudi patients and the impact these symptoms have on patients' lives. METHODOLOGY Patients who underwent gastric sleeve surgery at the Ensan Clinic, a facility specializing in gastroenterology, were the subjects of this retrospective cohort analysis. The study population consisted of patients who underwent gastric sleeve surgery, showed up for follow-up after the procedure, and met the inclusion and exclusion criteria. The data collection sheet is divided into seven sections. Sociodemographic information was required in the first section, gastric sleeve surgery information in the second, vital signs in the third, lab results in the fourth, past medical history in the fifth, current treatments in the sixth, and postoperative complications and chronic symptoms in the seventh and final sections. RESULTS In 117 patients, the study evaluated the effects of gastric sleeve surgery. Participants had an average age of 40.21 years, and 61.5% were female. Regarding persistent symptoms after surgery, a sizable percentage of patients mentioned digestive issues such as GERD (44.4%), dyspepsia (60.7%), vomiting (23.1%), nausea (39.3%), and abdominal distention (45.3%). A total of 34.2% of patients reported experiencing anxiety, compared to 11.1% who said they had depression or 2.6% who said they had social issues. A few patients reported experiencing neurological or musculoskeletal issues, including exhaustion (7.7%), faintness (5.1%), back or joint discomfort (7.7%), and shortness of breath (8.5%). CONCLUSION After undergoing gastric sleeve surgery, a sizable proportion of patients complained of various chronic symptoms and nutritional inadequacies, primarily gastrointestinal problems and musculoskeletal/neurological issues. The study's findings show a connection between these symptoms and surgery.
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Affiliation(s)
- Waleed M Alhuzaim
- Gastroenterology, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Raghad M Alajlan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Rahaf A Alshehri
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Razan M Alanazi
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Leen K Alsarhan
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
| | - Hala K Alamri
- Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, SAU
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El Kherchi O, Aquil A, Elkhoudri N, Guerroumi M, El Azmaoui N, Mouallif M, Aitbouighoulidine S, Chokri A, Benider A, Elgot A. Relationship between Sleep Quality and Anxiety-Depressive Disorders in Moroccan Women with Breast Cancer: A Cross-Sectional Study. IRANIAN JOURNAL OF PUBLIC HEALTH 2023; 52:1457-1465. [PMID: 37593511 PMCID: PMC10430391 DOI: 10.18502/ijph.v52i7.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/14/2022] [Indexed: 08/19/2023]
Abstract
Background Breast cancer is the most common female cancer in the world. Sleep disruption is one of the major problems of breast cancer patients. This study aimed to evaluate the quality of sleep in a group of Moroccan women with breast cancer and analyze the association between sleep quality, depression, and anxiety. Methods This cross-sectional study was carried out among 337 Moroccan women treated for breast cancer at the Mohammed VI Cancer Treatment Center in Casablanca in 2019. A questionnaire was designed for this purpose based on two scales: Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety Depression Scale (HADS). Results 71.5% of the participants had significant sleep disturbances; the subjective quality of patients' sleep was considered to be quite poor (20.8%) and 43.9% of participants need more than 60 minutes to fall asleep. The average sleep duration was 6.16 h/night and 84.3% of patients had not taken sleep medicines in the last month. The most common reasons for sleep disturbances were getting up to use the bathroom (67.4%) and waking up in the middle of the night or early morning (54%). Anxiety and depression were positively correlated with PSQI scores. Conclusion The present study highlights how much breast cancer patients are vulnerable to psychological disorders and then incites the decision makers in oncology departments to implement rigorous psychological health care strategies in order to ameliorate mental health and sleep quality of breast cancer patients.
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Affiliation(s)
- Ouassil El Kherchi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Amina Aquil
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Noureddine Elkhoudri
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Maroua Guerroumi
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Naoual El Azmaoui
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Mustapha Mouallif
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Salma Aitbouighoulidine
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
| | - Aziz Chokri
- Hassan First University of Settat, Institut des Sciences du Sport, 26000, Settat, Morocco
| | - Abdellatif Benider
- Ibn Rochd University Hospital Center, Mohammed VI Center for the Treatment of Cancers, Casablanca, Morocco
| | - Abdeljalil Elgot
- Hassan First University of Settat, Higher Institute of Health Sciences, Laboratory of Sciences and Health Technologies, Epidemiology and Biomedical Unit, 26000, Settat, Morocco
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Zhu W, Li W, Gao J, Wang L, Guo J, Yang H. Factors associated with the sleep disturbances of people with breast cancer during chemotherapy in China: A cross-sectional study. Nurs Open 2023. [PMID: 37099665 DOI: 10.1002/nop2.1784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/10/2023] [Accepted: 04/16/2023] [Indexed: 04/28/2023] Open
Abstract
AIM The aim of the study was to investigate the incidence of sleep disturbance and its relationship with anxiety and depression symptoms, social support and hope in breast cancer patients in China during chemotherapy. DESIGN A single-centre cross-sectional study. METHODS A total of 329 breast cancer patients were selected via convenience sampling method before they began chemotherapy (n = 115), before the 5th week of chemotherapy (n = 117) or 1 month after chemotherapy ended (n = 97) and administered paper-and-pencil questionnaires to evaluate sleep quality, depression and anxiety symptoms, social support and hope. Risk factors significantly associated with sleep disturbance during bivariate were incorporated in the multivariate analysis. Bivariate analyses showed that age, menopausal status, depression and anxiety symptoms, emotional/informational support, tangible support, affectionate support, positive social interaction and total support were predictors of sleep disturbance. RESULTS Sleep disturbance was prevalent in breast cancer patients before (27.0%), during (32.5%) and after (39.2%) chemotherapy, with 37.4%, 41.9% and 52.6% of participants, respectively, reporting sleeping below the recommended 7 h. Only 8.6%-15.5% of patients reported taking sedative-hypnotic drugs during the chemotherapy. Multivariate analyses found that participants reporting clinically significant anxiety (HADS > 8) were 3.5 times more likely to report sleep disturbance (PSQI > 8) than participants without clinically significant anxiety, and each increment in emotional/informational support was associated with a 9.04% reduced risk of sleep disturbance. Moreover, age was an independent predictor of sleep disturbance during multivariate modelling.
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Affiliation(s)
- Wenjuan Zhu
- Shanxi Medical University, Taiyuan, China
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Wanling Li
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei, China
| | - Jinnan Gao
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Linying Wang
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Jun Guo
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Hui Yang
- Shanxi Medical University, Taiyuan, China
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Longpré SM, Rader NC, Dougherty KJ, Motai Y, Leinhauser KC. Factors That Influence Occupational Engagement of Young Adults Who Are Cancer Survivors: A Pilot Study. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023; 43:218-227. [PMID: 36245400 DOI: 10.1177/15394492221128779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Cancer and its treatment can impact occupational engagement. However, occupational therapy-specific research studying young adult cancer survivors remains limited. The objective of this study to identify the type of occupations that young adult cancer survivors choose to engage in and to understand their decision-making process when choosing these occupations. A mixed-methods explanatory sequential design was used. Eleven participants, nine females and two males, between the ages of 18 and 35, were included. Several occupations were identified for engagement such as activities of daily living, leisure, work, sleep and rest, and health management. The predominant factor that influenced why occupations were chosen was that individuals purposefully selected occupations that allowed them to choose a path toward a more meaningful life. Information gained from this pilot study can be used to inform occupational therapy practitioners regarding services and interventions that promote occupational engagement for young adult cancer survivors.
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Affiliation(s)
| | - Nadeya C Rader
- Blanchfield Army Community Hospital, Fort Campbell, KY, USA
| | | | - Yael Motai
- Wellness Beyond Rehab, LLC, Oldsmar, FL, USA
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Wong BW, Chan YH, Kramer MS, Sundström-Poromaa I, Logan S, Cauley JA, Yong EL. Factors associated with poor sleep quality in midlife Singaporean women: The Integrated Women's Health program (IWHP). Sleep Med X 2022; 5:100060. [PMID: 36568060 PMCID: PMC9772553 DOI: 10.1016/j.sleepx.2022.100060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 10/18/2022] [Accepted: 12/03/2022] [Indexed: 12/13/2022] Open
Abstract
Objective To examine factors associated with poor sleep quality in community-dwelling midlife women. Methods Healthy women (aged 45-69 years) of Chinese, Malay and Indian ethnicities attending well-women clinics at the National University Hospital, Singapore, completed the Pittsburgh Sleep Quality Index (PSQI). A PQSI score >5 denoted poor sleep quality. The women filled out validated questionnaires covering menopausal and genito-urinary symptoms, and mental health. Physical performance was measured. Bone mineral density and visceral adiposity were assessed by dual energy X-ray absorptiometry. Binary logistic regression analyses assessed independent factors for poor sleep. Results Poor sleep quality was reported in 38.2% of women (n = 1094, mean age: 56.4 ± 6.2 years). Indian women had higher sleep disturbance scores than Chinese women (mean ± SD: 1.33 ± 0.58 vs 1.17 ± 0.49). Malays experienced more daytime dysfunction (0.54 ± 0.60 vs 0.33 ± 0.55) and had a higher overall PSQI score (6.00 ± 3.31 vs 5.02 ± 2.97) than the Chinese. A low education level (aOR: 1.76, 95% CI: 1.01-3.05), feelings of irritability (2.67, 1.56-4.60) and vaginal dryness (1.62, 1.03-2.54) were associated with poor sleep quality in the adjusted multivariable model. Women with moderate to severe disability were ∼3 times (2.99, 1.20-7.44) more likely to experience less than ideal sleep quality, while urinary incontinence (1.53, 1.08-2.17) and breast cancer history (2.77, 1.36-5.64) were also associates of poor sleep quality. Conclusion Self-reports of education level, irritability, vaginal dryness, disability, urinary incontinence, and breast cancer history were independently related to poor sleep. Ethnic differences suggest the need for targeted interventions among the ethnic groups.
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Affiliation(s)
- Beverly W.X. Wong
- Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, 119228, Singapore
| | - Yiong Huak Chan
- Yong Loo Lin School of Medicine, Biostatistics Unit, National University of Singapore, 117597, Singapore
| | - Michael S. Kramer
- Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, 119228, Singapore,Departments of Epidemiology and Biostatistics and of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | | | - Susan Logan
- Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, 119228, Singapore
| | - Jane A. Cauley
- Department of Epidemiology, University of Pittsburgh, School of Public Health, Pittsburgh, PA, 15261, United States
| | - Eu-Leong Yong
- Department of Obstetrics and Gynecology, National University Hospital, National University of Singapore, 119228, Singapore,Corresponding author. Department of Obstetrics & Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System Tower Block, 1E Kent Ridge Road, 119288, Singapore.
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Kim J, Hong Y, Baek S, Lee KP, Ahn S. The synergistic effect of physical activity and nutrition to improve the quality of life in breast cancer patients: a systemic review. Phys Act Nutr 2022; 26:22-31. [PMID: 36775648 PMCID: PMC9925113 DOI: 10.20463/pan.2022.0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/02/2022] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Medical recommendations for balanced control of exercise, physical activity, and nutritional intake after breast cancer diagnosis remain unclear. Therefore, this review aims to summarize effective exercise methods and dietary opinions by reviewing clinical trial results. METHODS We systematically reviewed studies that evaluated 1) the relationship between exercise methods and quality of life improvement in patients with breast cancer and 2) the recommendations for physical activity, exercise, nutrition, and potential ways to improve life after breast cancer. To conduct this literature review, we searched the PubMed database for articles published until October 1, 2022, using the terms "physical activity OR exercise," "breast cancer," and "nutrition." After a primary review of the retrieved articles, we included clinical trials in this systematic review. RESULTS We hypothesized that physical activity improves the quality of life after the onset of breast cancer, suggesting that a balanced approach to aerobic exercise and resistance exercise increases the efficacy of anticancer treatment. From a nutritional point of view, it is recommended that both physical activity and diet management are necessary for patients with breast cancer. CONCLUSION Customized exercise and diet can help with weight loss, the reduction of cancer-induced fatigue, the regulation of hormonal changes, the reduction of inflammatory factors, and the improvement of mental health and vitality. Understanding the integrated mechanisms of physical activity and nutritional balance will improve the quality of life of patients with breast cancer. Therefore, it is necessary to continuously advance exercise programs and develop an alimentary balance control program.
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Affiliation(s)
- Jisu Kim
- Department of Sports Medicine and Science Graduate School of Konkuk University, Republic of Korea,Physical Activity & Performance Institute, Konkuk University, Republic of Korea
| | - Yoogyung Hong
- Research and Development Center, UMUST R&D Corporation, Seoul 05029, Republic of Korea
| | - Suji Baek
- Research and Development Center, UMUST R&D Corporation, Seoul 05029, Republic of Korea
| | - Kang Pa Lee
- Research and Development Center, UMUST R&D Corporation, Seoul 05029, Republic of Korea,Corresponding author : Kang Pa Lee Research and Development Center, UMUST R&D Corporation, Seoul 05029, Republic of Korea. Tel: +82-10-9288-2744 E-mail:
| | - Sanghyun Ahn
- Department of Anatomy, College of Korean Medicine, Semyung University, Chungbuk, Republic of Korea,Corresponding author : Kang Pa Lee Research and Development Center, UMUST R&D Corporation, Seoul 05029, Republic of Korea. Tel: +82-10-9288-2744 E-mail:
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Imani V, Ahorsu DK, Taghizadeh N, Parsapour Z, Nejati B, Chen HP, Pakpour AH. The Mediating Roles of Anxiety, Depression, Sleepiness, Insomnia, and Sleep Quality in the Association between Problematic Social Media Use and Quality of Life among Patients with Cancer. Healthcare (Basel) 2022; 10:1745. [PMID: 36141357 PMCID: PMC9498660 DOI: 10.3390/healthcare10091745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/03/2022] [Accepted: 09/06/2022] [Indexed: 02/05/2023] Open
Abstract
The present study examined the mediating role of anxiety, depression, sleepiness, insomnia, and sleep quality in the association between problematic social media use and quality of life (QoL) among patients with cancer. This cross-sectional survey study recruited 288 patients with cancer to respond to measures on anxiety, depression, sleepiness, insomnia, sleep quality, problematic social media use, and QoL. Structural Equation Modeling was used for the mediation analysis. There were significant relationships between all of the variables used in the study. It was revealed that problematic social media use did not directly influence the QoL of patients with cancer except via anxiety, depression, sleepiness, and insomnia. Sleep quality did not mediate the association between problematic social media use and QoL. Healthcare workers managing cancer should pay attention to the mental health needs of their patients even as they treat their cancer so as to improve their quality of life. Future studies may examine other variables that affect the QoL of patients with cancer as well as other mediating and moderating variables.
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Affiliation(s)
- Vida Imani
- Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran
- Sleep Disorders Unit, Department of Neurology, Acibadem University, Istanbul 34752, Turkey
| | - Daniel Kwasi Ahorsu
- Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Nasrin Taghizadeh
- Medical Eye Care, Applied Sciences and Medical University, 20457 Hamburg, Germany
| | - Zahra Parsapour
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan 8174/673461, Iran
| | - Babak Nejati
- Hematology and Medical Oncology Research Center, Tabriz University of Medical Sciences, Tabriz 5166/15731, Iran
| | - Hsin-Pao Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, Kaohsiung 824, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin 3419/759811, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, SE-551 11 Jönköping, Sweden
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Kim SY, Lee Y, Koh SB. Factors Affecting the Occurrence of Mental Health Problems in Female Cancer Survivors: A Nationwide Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148615. [PMID: 35886467 PMCID: PMC9323619 DOI: 10.3390/ijerph19148615] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/13/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Abstract
The purpose of this study is to determine the effect of cancer survivorship stage and health-related behaviors on the risk of developing mental health problems (depressive and anxiety disorders) in women who have experienced cancers that affect women (breast cancer, cervical cancer, ovarian cancer, endometrial cancer). Using the healthcare utilization and medical checkup data from 2010 to 2020 provided by the National Health Insurance Service, the occurrence of mental health problems since 2020 was tracked for 36,801 women diagnosed with cancer. The occurrence of mental health problems was defined as the cases in which the disease code was assigned to anxiety disorders (F40~F44, F48) and depressive disorders (F32~34, F41.2, F92) as presented in ICD-10. To evaluate the effect of cancer survivorship stage and health-related behaviors on the development of mental health problems, the hazard ratio (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. During the follow-up period of 5.6 years, anxiety disorder occurred in 14,698 (39.9%), and by cancer type, breast cancer survivors accounted for the most at 1.02 per 1000 person-years. The risk of anxiety disorders increased in those who experienced cervical cancer (AHR, 1.08, 95% CI, 1.03-1.13) and those in the acute survivorship stage (AHR, 1.38, 95% CI, 1.22-1.55). In terms of health-related behaviors, the risk of developing anxiety disorder was shown to be reduced in drinkers (AHR, 0.91, 95% CI, 0.87-0.96), former smokers (AHR, 0.86, 95% CI, 0.77-0.97), and current smokers (AHR, 0.80, 95% CI, 0.71-0.90). During the follow-up period of 5.6 years, depressive disorder occurred in 6168(16.8%), and by cancer type, ovarian cancer survivors accounted for the most at 1.30 per 1000 person-years. The risk of developing depressive disorders was highest in those who experienced ovarian cancer (AHR, 1.40, 95% CI, 1.27-1.53) and those in the acute survivorship stage (AHR, 2.99, 95% CI, 2.60-3.42). For health-related behaviors, the risk of developing depressive disorders was increased in former smokers (AHR, 1.32, 95% CI, 1.14-1.54), current smokers (AHR, 1.21, 95% CI, 1.04-1.41), and those with insufficient physical activity (AHR, 1.09, 95% CI, 1.02-1.15). It has been confirmed that cancer type, cancer survivorship stage, and health-related behaviors, such as smoking, drinking, and physical activity, are significantly related to the risk of mental health problems. Thus, it is necessary to develop strategies to cope with mental health problems at the individual and national levels and to develop interventions to promote a more active lifestyle.
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Affiliation(s)
- So Young Kim
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26464, Korea;
| | - Yeonju Lee
- Health Insurance Research Institute, National Health Insurance Service, Wonju 26464, Korea;
| | - Sang Baek Koh
- Department of Preventive Medicine, Yonsei University Wonju College of Medicine, Wonju 26426, Korea;
- Correspondence: ; Tel.: +82-33-736-2893
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Sleep health in young women with breast cancer: a narrative review. Support Care Cancer 2022; 30:6419-6428. [PMID: 35288784 DOI: 10.1007/s00520-022-06953-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/03/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this narrative review was to synthesize the evidence on sleep health in young women with breast cancer and provide recommendations for clinical practice and research. METHODS Multiple databases were searched (OVID Medline, OVID PsycINFO, OVID Embase, and Scopus) using the search terms "breast neoplasm", "young women", "sleep", "sleep disturbance", "sleep problems", "sleep deficiency", and "insomnia". There were 467 titles and abstracts screened, and 82 full-text papers were reviewed, yielding 11 research publications for inclusion. RESULTS Sleep problems are prevalent among young women with breast cancer and are associated with vasomotor symptoms of menopause and psychological symptom distress. The evidence, however, is weak due to methodological and design aspects of the studies. CONCLUSIONS Poor sleep health in women with breast cancer is a clinically relevant problem that persists after treatment. As sleep is multidimensional and multifactorial, future research should evaluate sleep with objective sleep measures as well as self-reports; consider longitudinal designs; include factors that potentially contribute to poor sleep quality, such as physical and psychological symptom distress, family stressors, and competing life demands for this age group; and explore the perspective of this younger population of survivors on sleep. For clinical practice, survivorship visits should incorporate sleep assessment for all breast cancer survivors, especially younger women.
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