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Brossoit RM, Stark HP, Crain TL, Bodner TE, Hammer LB, Mohr CD, Shea SA. Multidimensionality of the PROMIS sleep disturbance 8b short form in working adult populations. Sleep Health 2023; 9:925-932. [PMID: 37770251 PMCID: PMC10888491 DOI: 10.1016/j.sleh.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 07/25/2023] [Accepted: 08/04/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVES The Patient-Reported Outcomes Measurement Information System sleep disturbance measures were developed using item response theory assumptions of unidimensionality and local independence. Given that sleep health is multidimensional, we evaluate the factor structure of the Patient-Reported Outcomes Measurement Information System sleep disturbance 8b short form to examine whether it reflects a unidimensional or multidimensional construct. METHODS Six full-time working adult samples were collected from civilian and military populations. Exploratory and confirmatory factor analyses were conducted. Single-factor and two-factor models were performed to evaluate the dimensionality of sleep disturbance using the 8b short form. Sleep duration and subjective health were examined as correlates of the sleep disturbance dimensions. RESULTS Across six working adult samples, single-factor models consistently demonstrated poor fit, whereas the two-factor models, with insomnia symptoms (ie, trouble sleeping) and dissatisfaction with sleep (ie, subjective quality of sleep) dimensions demonstrated sufficient fit that was significantly better than the single-factor models. Across each sample, dissatisfaction with sleep was more strongly correlated with sleep duration and subjective health than insomnia symptoms, providing additional evidence for distinguishability between the two sleep disturbance factors. CONCLUSIONS In working adult populations, the Patient-Reported Outcomes Measurement Information System sleep disturbance 8b short form is best modeled as two distinguishable factors capturing insomnia symptoms and dissatisfaction with sleep, rather than as a unidimensional sleep disturbance construct.
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Affiliation(s)
- Rebecca M Brossoit
- Louisiana State University, Department of Psychology, Baton Rouge, Louisiana, USA.
| | - Hannah P Stark
- Louisiana State University, Department of Psychology, Baton Rouge, Louisiana, USA
| | - Tori L Crain
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Todd E Bodner
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Leslie B Hammer
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
| | - Cynthia D Mohr
- Portland State University, Department of Psychology, Portland, Oregon, USA
| | - Steven A Shea
- Oregon Health & Science University, Oregon Institute of Occupational Health Sciences, Portland, Oregon, USA
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An Update on Prevalence, Assessment, and Risk Factors for Sleep Disturbances in Patients with Advanced Cancer—Implications for Health Care Providers and Clinical Research. Cancers (Basel) 2022; 14:cancers14163933. [PMID: 36010925 PMCID: PMC9406296 DOI: 10.3390/cancers14163933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Simple Summary This review focuses on sleep in patients with advanced cancer. Cancer patients experience multiple symptoms and they receive concomitant medications. These are all factors that may affect sleep. In this paper, we present recommendations on sleep assessment in patients with advanced cancer and highlight cancer-related factors that may contribute to insomnia. Sleep is an essential aspect of health-related quality of life; therefore, it is important for health care providers to focus on sleep to improve patient care. Abstract Patients with advanced cancer experience multiple symptoms, with fluctuating intensity and severity during the disease. They use several medications, including opioids, which may affect sleep. Sleep disturbance is common in cancer patients, decreases the tolerability of other symptoms, and impairs quality of life. Despite its high prevalence and negative impact, poor sleep quality often remains unrecognized and undertreated. Given that sleep is an essential aspect of health-related quality of life, it is important to extend both the knowledge base and awareness among health care providers in this field to improve patient care. In this narrative review, we provide recommendations on sleep assessment in patients with advanced cancer and highlight cancer-related factors that contribute to insomnia. We also present direct implications for health care providers working in palliative care and for future research.
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Robbins R, Cole R, Ejikeme C, Orstad SL, Porten S, Salter CA, Sanchez Nolasco T, Vieira D, Loeb S. Systematic review of sleep and sleep disorders among prostate cancer patients and caregivers: a call to action for using validated sleep assessments during prostate cancer care. Sleep Med 2022; 94:38-53. [PMID: 35489117 PMCID: PMC9277625 DOI: 10.1016/j.sleep.2022.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE/BACKGROUND To examine the impact of prostate cancer (PCa) on sleep health for patients and caregivers. We hypothesized that sleep disturbances and poor sleep quality would be prevalent among patients with PCa and their caregivers. PATIENTS/METHODS A systematic literature search was conducted according to the Preferred Reporting Items for a Systematic Review and Meta-analysis guidelines. To be eligible for this systematic review, studies had to include: (1) patients diagnosed with PCa and/or their caregivers; and (2) objective or subjective data on sleep. 2431 articles were identified from the search. After duplicates were removed, 1577 abstracts were screened for eligibility, and 315 underwent full-text review. RESULTS AND CONCLUSIONS Overall, 83 articles met inclusion criteria and were included in the qualitative synthesis. The majority of papers included patients with PCa (98%), who varied widely in their treatment stage. Only 3 studies reported on sleep among caregivers of patients with PCa. Most studies were designed to address a different issue and examined sleep as a secondary endpoint. Commonly used instruments included the Insomnia Severity Index and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaires (EORTC-QLQ). Overall, patients with PCa reported a variety of sleep issues, including insomnia and general sleep difficulties. Both physical and psychological barriers to sleep are reported in this population. There was common use of hypnotic medications, yet few studies of behavioral interventions to improve sleep for patients with PCa or their caregivers. Many different sleep issues are reported by patients with PCa and caregivers with diverse sleep measurement methods and surveys. Future research may develop consensus on validated sleep assessment tools for use in PCa clinical care and research to promote facilitate comparison of sleep across PCa treatment stages. Also, future research is needed on behavioral interventions to improve sleep among this population.
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Affiliation(s)
- Rebecca Robbins
- Harvard Medical School, Boston, MA, USA; Brigham & Women's Hospital, Boston, MA, USA.
| | - Renee Cole
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | | | - Stephanie L Orstad
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Sima Porten
- Department of Urology, University of California, San Francisco, USA
| | | | | | - Dorice Vieira
- NYU Grossman School of Medicine, New York, NY, USA; Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Stacy Loeb
- Departments of Urology and Population Health, NYU School of Medicine and Manhattan Veterans Affairs, New York, NY, USA
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NIH's Helping to End Addiction Long-term SM Initiative (NIH HEAL Initiative) Clinical Pain Management Common Data Element Program. THE JOURNAL OF PAIN 2021; 23:370-378. [PMID: 34508905 DOI: 10.1016/j.jpain.2021.08.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 07/22/2021] [Accepted: 08/11/2021] [Indexed: 12/20/2022]
Abstract
The Helping to End Addiction Long-term Initiative (NIH HEAL Initiative) is an aggressive trans-NIH effort to speed solutions to stem the national opioid public health crisis, including through improved pain management. Toward this end, the NIH HEAL Initiative launched a common data element (CDE) program to ensure that NIH-funded clinical pain research studies would collect data in a standardized way. NIH HEAL Initiative staff launched a process to determine which pain-related core domains should be assessed by every clinical pain study and what questionnaires are required to ensure that the data is collected uniformly. The process involved multiple literature reviews, and consultation with experts inside and outside of NIH and the investigators conducting studies funded by the initiative. Ultimately, 9 core pain domains, and questionnaires to measure them, were chosen for studies examining acute pain and chronic pain in adults and pediatric populations. These were augmented with dozens of study-specific supplemental questionnaires to enable uniform data collection methods of outcomes outside of the core domains. The selection of core domains will ensure that valuable clinical pain data generated by the initiative is standardized, useable for secondary data analysis, and useful for guiding future research, clinical practice decisions, and policymaking. PERSPECTIVE: The NIH HEAL Initiative launched a common data element program to ensure that NIH-funded clinical pain research studies would collect data in a standardized way. Nine core pain domains and questionnaires to measure them were chosen for studies examining acute pain and chronic pain in adults and pediatric populations.
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Colorectal Cancer Anatomical Site and Sleep Quality. Cancers (Basel) 2021; 13:cancers13112578. [PMID: 34070246 PMCID: PMC8197388 DOI: 10.3390/cancers13112578] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/16/2021] [Accepted: 05/20/2021] [Indexed: 01/05/2023] Open
Abstract
Simple Summary Around 70% of colorectal cancer patients report having sleeping issues, and identifying whether anatomic site plays a significant factor in sleep quality is important. The aim of our population-based study was to assess differences in sleep between rectal and colon cancer patients. We identified that rectal cancer patients were more likely to have sleep complications, such as changes in sleep patterns after diagnosis, getting up to use the bathroom, and pain, compared to colon cancer patients. Identifying whether anatomic colorectal cancer site affects sleep quality and sleep-related issues suggests that sleep-focused survivorship care may be suggested for rectal cancer patients to ensure patients receive appropriate support. Abstract Purpose: Sleep quality in relation to anatomic site among colorectal cancer (CRC) patients is not well understood, though discerning the relationship could contribute to improved survivorship care. Methods: We ascertained sleep quality (Pittsburgh Sleep Quality Index) and other personal characteristics within an ongoing population-based study of CRC patients identified through a cancer registry (N = 1453). Differences in sleep quality by CRC site were analyzed using chi-square and ANOVA tests. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of tumor site with sleep quality concerns, adjusting for patient attributes and time since diagnosis. Results: Sleeping problems were reported by 70% of CRC patients. Overall, participants with rectal (vs. colon) cancer were more likely (OR (95% CI)) to report general trouble sleeping (1.58 (1.19, 2.10)). Rectal cancer patients were also more likely than colon cancer patients to report changes in sleep patterns after cancer diagnosis (1.38 (1.05, 1.80)), and trouble sleeping specifically due to getting up to use the bathroom (1.53 (1.20, 1.96)) or pain (1.58 (1.15, 2.17)), but were less likely to report trouble sleeping specifically due to issues with breathing/coughing/snoring (0.51 (0.27, 0.99)). Conclusion: Overall, rectal cancer patients were more likely to have sleep complications compared to colon cancer patients. This suggests sleep-focused survivorship care may be adapted according to CRC site to ensure patients receive appropriate support.
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Khater W, Masha'al D, Al-Sayaheen A. Sleep assessment and interventions for patients living with cancer from the patients' and nurses' perspective. Int J Palliat Nurs 2020; 25:316-324. [PMID: 31339821 DOI: 10.12968/ijpn.2019.25.7.316] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Difficulty sleeping is a common symptom for patients living with cancer that significantly affects their lives. However, although sleep disorders are common, it is an overlooked problem in cancer care. PURPOSE This study assessed the prevalence of sleep disturbances among patients living with cancer, and assessed the adequacy of sleep assessment and intervention for patients from both nurses' and patients' perspectives. METHOD Descriptive, cross-sectional and correlational design was used in this study. A convenience sample of 129 patients with cancer and 113 registered nurses working with cancer patients was recruited. A structured face-to-face interview was used to complete the patients' questionnaires and a self-administered questionnaire was given to nurses. FINDINGS The majority of patients with cancer reported having poor sleep quality (69.8%). About 86.7% (n=98) of nurses reported that they have never screened patients with cancer for any sleep problems, and 76.7% (n=99) of the patients reported that they have never been assessed for sleep problems by the nursing staff during hospitalisation. Only 8% of patients with cancer who reported having problems sleeping to a nurse received interventions to promote better sleep. CONCLUSION Assessment of sleep disturbances in patients with cancer should be unified using a comprehensive reliable valid instrument, as well as providing evidence-based interventions according to patient's need. A written policy should be introduced to encourage sleep documentation and to make sleep care for patients part of routine nursing care.
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Affiliation(s)
- Wejdan Khater
- Associate Professor, Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology
| | - Dina Masha'al
- Associate Professor, Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology
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Shady K, Nair J, Crannell C. Lavender Aromatherapy: Examining the Effects of Lavender Oil Patches on Patients in the Hematology-Oncology Setting. Clin J Oncol Nurs 2019; 23:502-508. [DOI: 10.1188/19.cjon.502-508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Gressel GM, Dioun SM, Richley M, Lounsbury DW, Rapkin BD, Isani S, Nevadunsky NS, Kuo DYS, Novetsky AP. Utilizing the Patient Reported Outcomes Measurement Information System (PROMIS®) to increase referral to ancillary support services for severely symptomatic patients with gynecologic cancer. Gynecol Oncol 2019; 152:509-513. [PMID: 30876496 DOI: 10.1016/j.ygyno.2018.10.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The Patient-Reported Outcomes Measurement Information System (PROMIS®) Network has developed a comprehensive repository of electronic patient reported outcomes measures (ePROs) of major symptom domains that have been validated in cancer patients. Their use for patients with gynecologic cancer has been understudied. Our objective was to establish feasibility and acceptability of PROMIS ePRO integration in a gynecologic oncology outpatient clinic and assess if it can help identify severely symptomatic patients and increase referral to supportive services. METHODS English-speaking patients with a confirmed history of gynecologic cancer completed PROMIS ePROs on iPads in the waiting area of an outpatient gynecologic oncology clinic. Symptom scores were calculated for each respondent and grouped using documented severity thresholds. Response data was compared with clinicopathologic characteristics across symptom domains. Severely symptomatic patients were offered referral to ancillary services and asked to complete post-exposure surveys assessing acceptability of the ePRO. RESULTS Of the 336 patients who completed ePROs, 35% had active disease and 19% had experienced at least one disease recurrence. Sixty-nine percent of the cohort demonstrated moderate to severe physical dysfunction (60%), pain (36%), fatigue (28%), anxiety (9%), depression (8%), and sexual dysfunction (32%). Thirty-nine (12%) severely symptomatic patients were referred to services such as psychiatry, palliative care, pain management, social work or integrative oncology care. Most survey respondents identified the ePROs as helpful (78%) and easy to complete (92%). CONCLUSIONS Outpatient PROMIS ePRO administration is feasible and acceptable to gynecologic oncology patients and can help identify severely symptomatic patients for referral to ancillary support services.
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Affiliation(s)
- Gregory M Gressel
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America.
| | - Shayan M Dioun
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America
| | - Michael Richley
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America
| | - David W Lounsbury
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Bruce D Rapkin
- Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America; Albert Einstein College of Medicine, Department of Epidemiology and Population Health, Bronx, NY, United States of America
| | - Sara Isani
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Nicole S Nevadunsky
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - D Y S Kuo
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
| | - Akiva P Novetsky
- Montefiore Medical Center, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States of America; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States of America
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Grooming a CAT: customizing CAT administration rules to increase response efficiency in specific research and clinical settings. Qual Life Res 2018; 27:2403-2413. [DOI: 10.1007/s11136-018-1870-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2018] [Indexed: 12/13/2022]
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10
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Coles T, Tan X, Bennett AV, Sanoff HK, Basch E, Jensen RE, Reeve BB. Sleep quality in individuals diagnosed with colorectal cancer: Factors associated with sleep disturbance as patients transition off treatment. Psychooncology 2017; 27:1050-1056. [PMID: 29265709 DOI: 10.1002/pon.4595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 10/21/2017] [Accepted: 11/14/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To identify patient characteristics associated with sleep disturbance and worsening of sleep in individuals diagnosed with localized colorectal cancer and assess heterogeneity in these relationships. METHODS Data were from the MY-Health study, a community-based observational study of adults diagnosed with cancer. Patient-Reported Outcomes Measurement Information System® Sleep Disturbance, Anxiety, Depression, Fatigue, and Pain Interference measures were administered. Participants self-reported demographics, comorbidities, and treatment information. Regression mixture and multiple regression models were used to evaluate the relationship between sleep disturbance and patient characteristics cross-sectionally at an average of 10 months after diagnosis (n = 613) as well as change in sleep disturbance over a 6-month period (n = 361). RESULTS Pain, anxiety, fatigue, and the existence of multiple comorbid conditions had statistically significant relationships with sleep disturbance (B = 0.09, 0.22, 0.29, and 1.53, respectively; P < 0.05). Retirement (B = -2.49) was associated with sleep quality in the cross-sectional model. Worsening anxiety (B = 0.14) and fatigue (B = 0.20) were associated with worsening sleep disturbance, and more severe sleep disturbance 10 months after diagnosis (B = -0.21) was associated with improvement in sleep quality after diagnosis (P < 0.05). No evidence of latent subgroups of patients (heterogeneity) was present. CONCLUSIONS Pain, anxiety, fatigue, employment, and comorbid conditions were associated with sleep disturbance, but regression coefficients were small (< |2.5|). Results suggest that screening for anxiety, depression, fatigue, or pain is not sufficient for identifying sleep disturbance. Given the negative consequences of sleep disturbance, sleep disturbance screening may be warranted.
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Affiliation(s)
- Theresa Coles
- RTI Health Solutions, Research Triangle Park, Durham, NC, USA
| | - Xianming Tan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Antonia V Bennett
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hanna K Sanoff
- Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ethan Basch
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Roxanne E Jensen
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Washington, DC, USA.,Department of Oncology, Georgetown University, Washington, DC, USA
| | - Bryce B Reeve
- Department of Population Health Sciences, Duke School of Medicine, Durham, NC, USA
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Hyphantis T, Goulia P, Zerdes I, Solomou S, Andreoulakis E, Carvalho AF, Pavlidis N. Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer. Dig Dis Sci 2016; 61:273-82. [PMID: 26289259 DOI: 10.1007/s10620-015-3843-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/02/2015] [Indexed: 12/09/2022]
Abstract
BACKGROUND Sleep disturbances are common in cancer patients, but little is known about the complex interplay between the background psychological profile, coping with health stressors capacities and psychological distress in the formation of sleep difficulties in colorectal cancer. AIMS To study the course and to identify psychological predictors of sleep difficulties in early non-metastatic colorectal cancer patients over a one-year period. METHODS In this 1-year prospective study, we assessed in 84 early non-metastatic colorectal cancer patients the association of psychological distress (SCL-90-R), sense of coherence (SOC-29), and defense styles (Defense Style Questionnaire) with sleep difficulties (SCL-90-R) in multiple regression models. Eighty-two patients with breast cancer and 50 patients with cancer of unknown primary site served as disease controls, and 84 matched for age and sex alleged healthy individuals served as healthy controls. RESULTS Colorectal cancer patients presented more sleep difficulties compared to healthy participants but fewer than patients with breast cancer and cancer of unknown primary site. Colorectal cancer patients' trouble falling asleep (p = 0.033) and wakening up early in the morning (p < 0.001) deteriorated over time. Sleep that was restless or disturbed was independently associated with low SOC (p = 0.046) and maladaptive defenses (p = 0.008). Anxiety symptoms (p < 0.001) predicted deterioration in trouble falling asleep, while depressive symptoms (p = 0.022) and self-sacrificing defense style (p = 0.049) predicted deterioration in wakening up early in the morning. CONCLUSIONS Psychological parameters and coping with health stressors capacities are independently associated with sleep difficulties in colorectal cancer patients, indicating the need for psychological interventions aiming at improving adjustment to the disease.
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Affiliation(s)
- Thomas Hyphantis
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece.
| | - Panagiota Goulia
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Ioannis Zerdes
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Solomis Solomou
- Department of Psychiatry, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
| | - Elias Andreoulakis
- 3rd Department of Psychiatry, Aristotle University of Thessaloniki, University Campus, Thessaloniki, 54124, Greece
| | - André F Carvalho
- Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Nicholas Pavlidis
- Department of Medical Oncology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
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Dyer J, Cleary L, McNeill S, Ragsdale-Lowe M, Osland C. The use of aromasticks to help with sleep problems: A patient experience survey. Complement Ther Clin Pract 2015; 22:51-8. [PMID: 26850806 DOI: 10.1016/j.ctcp.2015.12.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 12/01/2015] [Accepted: 12/03/2015] [Indexed: 01/07/2023]
Abstract
To document the use of aromasticks to facilitate sleep in a cancer centre in the UK. Sleep disturbance is a common problem amongst patients diagnosed with cancer. Essential oils may be inhaled by means of an aromastick (a personal inhaler device containing essential oils) as a means of improving sleep. A prospective audit of aromasticks given to help facilitate sleep. Sixty-five aromasticks were given out over a 13 week period. 94% of patients reported that they did use their aromastick to help them sleep and 92% reported that they would continue to do so. An improvement of at least one point on a Likert scale measuring sleep quality was shown by 64% of patients following the use of an aromastick. Bergamot (Citrus bergamia) and sandalwood (Santalum austrocaladonicum); and frankincense (Boswellia carterii), mandarin (Citrus reticulata) and lavender (Lavandula angustifolia) were the essential oils used in the two blends chosen by patients.
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Affiliation(s)
- Jeannie Dyer
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK.
| | - Lise Cleary
- Therapies Department, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Sara McNeill
- Therapies Department, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Maxine Ragsdale-Lowe
- Therapies Department, The Royal Marsden NHS Foundation Trust, Sutton, Surrey, SM2 5PT, UK
| | - Caroline Osland
- Therapies Department, The Royal Marsden NHS Foundation Trust, London, SW3 6JJ, UK
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Akman T, Yavuzsen T, Sevgen Z, Ellidokuz H, Yilmaz AU. Evaluation of sleep disorders in cancer patients based on Pittsburgh Sleep Quality Index. Eur J Cancer Care (Engl) 2015; 24:553-9. [PMID: 25727241 DOI: 10.1111/ecc.12296] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2015] [Indexed: 11/28/2022]
Abstract
Insomnia, poor sleep quality and short sleep durations are the most common problems seen in cancer patients. More studies are needed about sleep disorders in cancer patients. In our study, we aimed to investigate the prevalence of sleep disorders and the impact of these problems on the quality of life in cancer patients. Pittsburgh Sleep Quality Index (PSQI) was given to a total of 314 patients. The psychometric evaluation of the Turkish version of PSQI in cancer patients revealed that 127 (40.4%) patients had global PSQI scores >5, indicating poor sleep quality. There was no statistically significant relationship between PSQI scores and sexuality, marital status, cancer stage and chemotherapy type (P > 0.05); while the patients with bone and visceral metastasis had much lower PSQI scores (P = 0.006). Patients with Eastern Cooperative Oncology Group performance scores of 3 or more had also significantly lower PSQI scores (P = 0.02). In conclusion, PSQI questionnaire may be used to evaluate the sleep disorders in cancer patients. Consistent use of multi-item measures such as PSQI with established reliability and validity would improve our understanding of difficulties experienced by cancer patients with chronic insomnia.
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Affiliation(s)
- Tulay Akman
- Tepecik Education and Research Hospital, Division of Medical Oncology, Izmir, Turkey
| | - Tugba Yavuzsen
- Dokuz Eylul University Medical School, Division of Medical Oncology, Izmir, Turkey
| | - Zeynep Sevgen
- Dokuz Eylul University Medical School, Department of Internal Medicine, Izmir, Turkey
| | - Hulya Ellidokuz
- Dokuz Eylul University Medical School, Department of Preventive Oncology, Izmir, Turkey
| | - Ahmet Ugur Yilmaz
- Medical Park, Izmir University, Division of Medical Oncology, Izmir, Turkey
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Otte JL, Carpenter JS, Manchanda S, Rand KL, Skaar TC, Weaver M, Chernyak Y, Zhong X, Igega C, Landis C. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med 2014; 4:183-200. [PMID: 25449319 PMCID: PMC4329003 DOI: 10.1002/cam4.356] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 08/26/2014] [Accepted: 09/07/2014] [Indexed: 11/13/2022] Open
Abstract
Although sleep is vital to all human functioning and poor sleep is a known problem in cancer, it is unclear whether the overall prevalence of the various types of sleep disorders in cancer is known. The purpose of this systematic literature review was to evaluate if the prevalence of sleep disorders could be ascertained from the current body of literature regarding sleep in cancer. This was a critical and systematic review of peer-reviewed, English-language, original articles published from 1980 through 15 October 2013, identified using electronic search engines, a set of key words, and prespecified inclusion and exclusion criteria. Information from 254 full-text, English-language articles was abstracted onto a paper checklist by one reviewer, with a second reviewer randomly verifying 50% (k = 99%). All abstracted data were entered into an electronic database, verified for accuracy, and analyzed using descriptive statistics and frequencies in SPSS (v.20) (North Castle, NY). Studies of sleep and cancer focus on specific types of symptoms of poor sleep, and there are no published prevalence studies that focus on underlying sleep disorders. Challenging the current paradigm of the way sleep is studied in cancer could produce better clinical screening tools for use in oncology clinics leading to better triaging of patients with sleep complaints to sleep specialists, and overall improvement in sleep quality.
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Affiliation(s)
- Julie L Otte
- Indiana University School of Nursing, Indianapolis, Indiana
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Nelson AM, Coe CL, Juckett MB, Rumble ME, Rathouz PJ, Hematti P, Costanzo ES. Sleep quality following hematopoietic stem cell transplantation: longitudinal trajectories and biobehavioral correlates. Bone Marrow Transplant 2014; 49:1405-11. [PMID: 25133898 PMCID: PMC4221490 DOI: 10.1038/bmt.2014.179] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 06/04/2014] [Accepted: 06/25/2014] [Indexed: 12/24/2022]
Abstract
The present study examined changes in sleep quality following hematopoietic stem cell transplantation (HSCT) and investigated associations with biobehavioral factors. Individuals undergoing HSCT for hematologic malignancies (N=228) completed measures of sleep quality and psychological symptoms pre-transplant and 1, 3, 6, and 12 months post-transplant. Circulating inflammatory cytokines (IL-6, TNF-α) were also assessed. Sleep quality was poorest at one month post-transplant, improving and remaining relatively stable after 3 months post-transplant. However, approximately half of participants continued to experience significant sleep disturbance at 6 and 12 months post-transplant. Mixed-effects linear regression models indicated that depression and anxiety were associated with poorer sleep quality, while psychological well-being was associated with better sleep. Higher circulating levels of IL-6 were also linked with poorer sleep. Subject-level fixed effects models demonstrated that among individual participants, changes in depression, anxiety, and psychological well-being were associated with corresponding changes in sleep after covarying for the effects of time since transplant. Sleep disturbance was most severe when depression and anxiety were greatest, and psychological well-being was lowest. Findings indicate that sleep disturbance is a persistent problem during the year following HSCT. Patients experiencing depression or anxiety and those with elevated inflammation may be at particular risk for poor sleep.
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Affiliation(s)
- A M Nelson
- Department of Health Outcomes & Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - C L Coe
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - M B Juckett
- 1] Hematology/Oncology Division, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA [2] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - M E Rumble
- 1] Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA [2] Center for Sleep Medicine and Research, University of Wisconsin-Madison, Madison, WI, USA
| | - P J Rathouz
- Department of Biostatistics & Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA
| | - P Hematti
- 1] Hematology/Oncology Division, Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA [2] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - E S Costanzo
- 1] Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA [2] Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
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Romito F, Cormio C, De Padova S, Lorusso V, Berio MA, Fimiani F, Piattelli A, Palazzo S, Abram G, Dudine L, Guglielmi A, Galise I, Romito S, Mattioli V. Patients attitudes towards sleep disturbances during chemotherapy. Eur J Cancer Care (Engl) 2013; 23:385-93. [PMID: 23947497 DOI: 10.1111/ecc.12106] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2013] [Indexed: 11/27/2022]
Abstract
Sleep disturbances are among the most distressing symptoms in cancer: they often co-occur with fatigue, pain and psychological distress. Despite the negative impact on quality of life, patients rarely seek help for managing their sleep disturbances. This paper presents the results of a multicentre observational study on patients' attitudes towards their sleep problems. The study also investigates symptom correlates. Patients responded to a semi-structured interview and completed the following questionnaires: Pittsburgh Sleep Quality Index; Brief Fatigue Inventory; Hospital Anxiety and Depression Scale; and European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life QLQ-C30 Questionnaire (QLQ-C30). Four hundred and three cancer patients were enrolled in the study. Bad sleepers constituted 66% of the sample. Thirty-eight per cent of them had not turned to any professional to solve their sleep disturbances because they had various beliefs about the importance of the problem and the possibility to be treated. The main correlates of sleep disturbances were psychological distress, reduced physical functioning and reduced overall quality of life. In conclusion, there is a need to sensitise patients to actively search for a solution to their sleep disturbances so they can be solved along with other co-occurring symptoms. Doctors could also be encouraged to dedicate more attention to routinely asking cancer patients about eventual sleep disturbances.
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Affiliation(s)
- F Romito
- Experimental Unit of Psycho-Oncology, Department of Critical Area and Surgery, National Cancer Research Center, Istituto Tumori 'Giovanni Paolo II', Bari, Italy
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Cook KF, Bamer AM, Amtmann D, Molton IR, Jensen MP. Six patient-reported outcome measurement information system short form measures have negligible age- or diagnosis-related differential item functioning in individuals with disabilities. Arch Phys Med Rehabil 2012; 93:1289-91. [PMID: 22386213 DOI: 10.1016/j.apmr.2011.11.022] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2011] [Revised: 11/09/2011] [Accepted: 11/15/2011] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate the measurement invariance of 6 self-report measures selected for an ongoing longitudinal study of individuals with spinal cord injury, muscular dystrophy, postpolio syndrome, and multiple sclerosis. DESIGN Participants completed and returned by mail surveys that included the targeted self-report measures. Ordinal logistic regressions methods were applied to evaluate items for differential item functioning (DIF) by diagnosis and age range. SETTING Community. PARTICIPANTS Participants (N=2479) who had 1 of the 4 target diagnoses. INTERVENTIONS None. MAIN OUTCOME MEASURES Six short-form measures from the Patient-Reported Outcome Measurement Information System (PROMIS) were administered to participants to measure fatigue, pain interference, satisfaction with social roles, sleep disturbance, sleep-related impairment, and depression. RESULTS One item of 1 measure (fatigue) exhibited DIF by diagnosis based on a published standard for meaningful DIF. However, scores corrected for this DIF were highly correlated with uncorrected scores (r>.999). No DIF by age range was found for any of the measures. CONCLUSIONS Study findings support the use of the selected PROMIS short forms for comparing symptoms and quality of life indicators across different diagnoses and age ranges.
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Affiliation(s)
- Karon F Cook
- Department of Medical Social Sciences, Northwestern University, Chicago, IL.
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McChargue DE, Sankaranarayanan J, Visovsky CG, Matthews EE, Highland KB, Berger AM. Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy. Support Care Cancer 2010; 20:245-52. [PMID: 21174129 DOI: 10.1007/s00520-010-1060-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2010] [Accepted: 12/06/2010] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. METHODS A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. RESULTS Total adherence rates to the BT plan were 51-52% at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). CONCLUSIONS Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.
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Affiliation(s)
- Dennis E McChargue
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA.
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