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Galin M, de Girolamo L, Clarisse B, Segura-Djezzar C, Glöckner F, Elia C, Réhel S, Clochon P, Doidy F, Chavant J, Etard O, Viader F, Grellard JM, Lequesne J, Joly F, Eustache F, Martin T, Giffard B, Quarck G, Perrier J. Exploration of effects of galvanic vestibular stimulation on circadian rhythms and its associations with sleep and spatial memory in patients with breast cancer: The ICANSLEEP-2 protocol. PLoS One 2024; 19:e0306462. [PMID: 39083526 PMCID: PMC11290633 DOI: 10.1371/journal.pone.0306462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 05/29/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Patients with breast cancer (BC) exhibit circadian rhythm disruptions, mainly of rest-activity rhythm (RAR), of which sleep is an essential component, and cortisol rhythm. Sleep complaints such as insomnia and cognitive impairments are prevalent in BC. In general population, sleep is known to contribute greatly to cognition. Thus, improving RAR (and particularly sleep) could help limiting cognitive impairments in BC patients. It has recently been suggested that, in addition to its essential role in spatial memory, the vestibular system contributes to RAR synchronization. Its stimulation could therefore limit both sleep disturbances and spatial memory deficits in BC. OBJECTIVES The main aim of the ICANSLEEP-2 study is to assess the effects of galvanic vestibular stimulation (GVS) on circadian rhythms. The secondary aim is to assess whether GVS improves sleep and spatial memory in BC patients. METHODS Two groups with insomnia complaints (Insomnia Severity Index > 7) will be included: a patients' group with BC (n = 50) and a healthy control group without history of cancer (n = 25). There will be two assessment sessions, before and after 2 weeks of GVS. Patients will be randomly assigned to either a GVS group or a sham group (noneffective stimulation). Controls will receive GVS. GVS effects will be quantified and compared between groups. Assessments will include actigraphy, salivary cortisol, polysomnography, a cognitive test battery (including a computer-based task for spatial memory) and validated questionnaires (for psychological functioning and sleep complaints). DISCUSSION Current methods for improving sleep in BC have had controversial outcomes regarding sleep structure. We expect GVS to offer a new mean of directly targeting RAR disruptions in BC patients, with beneficial effects on sleep structure. Given the crucial impact of sleep on cognitive functioning, notably spatial memory, improving sleep of BC patients should enhance their cognitive functioning. ETHICS AND DISSEMINATION This study received ethical approval from the Ile de France IV institutional review board on 19 April 2022 (no. ID-RCB: 2022-A00437-36). The findings yielded by this protocol will be presented at various conferences and in peer-reviewed journals. CLINICALTRIALS.GOV REGISTRATION NUMBER NCT05414357.
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Affiliation(s)
- Melvin Galin
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Laura de Girolamo
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | | | - Franka Glöckner
- Faculty of Psychology, Chair of Lifespan Developmental Neuroscience, TU Dresden, Dresden, Germany
| | - Clara Elia
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Stéphane Réhel
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Patrice Clochon
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Franck Doidy
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Julien Chavant
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Olivier Etard
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Fausto Viader
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | | | - Justine Lequesne
- Clinical Research Department, François Baclesse Center, Caen, France
| | - Florence Joly
- Clinical Research Department, François Baclesse Center, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
- Cancer Prevention and Treatment (ANTICIPE) Research Unit, INSERM, Normandy University, Caen, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Tristan Martin
- Movement – Interactions, Performance (MIP) Team, Faculty of Sciences and Technologies, Le Mans University, Le Mans, France
| | - Bénédicte Giffard
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
- Cancer and Cognition Platform, French League Against Cancer, Caen, France
| | - Gaëlle Quarck
- COMETE Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
| | - Joy Perrier
- Neuropsychology and Imaging of Human Memory Research Unit, GIP Cyceron-Normandy University-PSL-EPHE-INSERM-Caen University Hospital, Caen, France
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Hwang Y, Conley S, Redeker NS, Sanft T, Knobf MT. A qualitative study of sleep in young breast cancer survivors: "No longer able to sleep through the night". J Cancer Surviv 2024; 18:828-835. [PMID: 36680672 DOI: 10.1007/s11764-023-01330-3] [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: 10/05/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023]
Abstract
Sleep disturbance is common among women with breast cancer and is associated with greater symptom distress and poorer outcomes. Yet, for the unique subgroup of young women with breast cancer (YWBC), there is limited information on sleep. To address the gap in our understanding of sleep health in YWBC, we explored their perspective on sleep quality, sleep changes over time, contributing factors, and any strategies used to promote sleep. As part of an explanatory sequential mixed method study, we recruited a sub-sample of 35 YWBC (≤ 50 years of age at the time of diagnosis) from the larger quantitative study phase. These participants were within the first 5 years since diagnosis and completed primary and systemic adjuvant therapy. We conducted virtual semi-structured interviews, transcribed them verbatim, and analyzed data with an interpretive description approach. YWBC experience difficulty falling asleep, waking up at night, and not feeling refreshed in the morning. They attributed interrupted sleep to vasomotor symptoms, anxiety/worry, ruminating thoughts, everyday life stressors, and discomfort. The sleep disturbance was most severe during and immediately after treatment but persisted across the 5 years of survivorship. The participants reported trying pharmacologic and non-pharmacologic strategies to improve the quantity and quality of their sleep. Future research would benefit from longitudinal designs to capture temporal changes in sleep and develop interventions to improve sleep health. Clinically, assessment of sleep health is indicated for YWBC related to the prevalence of disturbed sleep. IMPLICATIONS FOR CANCER SURVIVORS: Early access to sleep assessment and management, ideally before cancer treatment, would be beneficial for young breast cancer survivors. In addition, cancer treatment plans should include physical and psychological symptoms, especially those reported by women in this study: vasomotor symptoms, anxiety and worry, discomfort, and pain.
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Affiliation(s)
- Youri Hwang
- School of Nursing, Yale University, New Haven, USA.
| | | | - Nancy S Redeker
- School of Nursing, University of Connecticut, New Haven, USA
| | - Tara Sanft
- School of Medicine, Yale University, New Haven, USA
| | - M Tish Knobf
- School of Nursing, Yale University, New Haven, USA
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Carson EK, Dhillon HM, Vardy JL, Brown C, Nunes-Zlotkowski KF, Della-Fiorentina S, Khan S, Parsonson A, Roncoloato F, Pearson A, Barnes T, Kiely BE. Telehealth cognitive behaviour therapy for the management of sleep disturbance in women with early breast cancer receiving chemotherapy: a feasibility study. Support Care Cancer 2024; 32:375. [PMID: 38780707 PMCID: PMC11116244 DOI: 10.1007/s00520-024-08554-8] [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: 01/15/2024] [Accepted: 05/07/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Sleep quality commonly deteriorates in people receiving chemotherapy for breast cancer (BC). We aimed to determine feasibility and acceptability of telehealth-delivered cognitive behaviour therapy for insomnia (CBT-I) in people with early BC receiving (neo)adjuvant chemotherapy. METHODS Multi-centre, single arm, phase 2 feasibility trial. People with stage I-III BC received 4 sessions of telehealth CBT-I over 8 weeks, during chemotherapy. Participants completed Pittsburgh Sleep Quality Index (PSQI) and other Patient Reported Outcome Measures (PROMs) at baseline, post-program (week 9) and post-chemotherapy (week 24); and an Acceptability Questionnaire at week 9. Primary endpoint was proportion completing 4 sessions of telehealth CBT-I. RESULTS In total, 41 participants were recruited: mean age 51 years (range 31-73). All 4 CBT-I sessions were completed by 35 (85%) participants. Acceptability of the program was high and 71% reported 'the program was useful'. There was no significant difference in the number of poor sleepers (PSQI score ≥ 5) at baseline 29/40 (73%) and week 24 17/25 (68%); or in the mean PSQI score at baseline (7.43, SD 4.06) and week 24 (7.48, SD 4.41). From baseline to week 24, 7/25 (28%) participants had a ≥ 3 point improvement in sleep quality on PSQI, and 5/25 (20%) had a ≥ 3 point deterioration. There was no significant difference in mean PROM scores. CONCLUSION It is feasible to deliver telehealth CBT-I to people with early BC receiving chemotherapy. Contrary to literature predictions, sleep quality did not deteriorate. Telehealth CBT-I has a potential role in preventing and managing sleep disturbance during chemotherapy. Australian New Zealand Clinical Trials Registry (ANZCTR) registration number: ACTRN12620001379909 and date 22/12/2020.
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Affiliation(s)
- Emma-Kate Carson
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia.
| | - Haryana M Dhillon
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
| | - Janette L Vardy
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Chris Brown
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
| | - Kelly Ferrao Nunes-Zlotkowski
- Centre for Medical Psychology & Evidence-Based Decision-Making, University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, Psycho-Oncology Cooperative Research Group, University of Sydney, Sydney, NSW, Australia
| | - Stephen Della-Fiorentina
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Southern Highlands Cancer Centre, Southern Highlands Private Hospital, Bowral, NSW, Australia
- Cancer Services, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Sarah Khan
- Southern Highlands Cancer Centre, Southern Highlands Private Hospital, Bowral, NSW, Australia
| | - Andrew Parsonson
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Felicia Roncoloato
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia
| | - Antonia Pearson
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Northern Beaches Hospital, Frenchs Forest, NSW, Australia
| | - Tristan Barnes
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
- Northern Beaches Hospital, Frenchs Forest, NSW, Australia
| | - Belinda E Kiely
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- School of Medicine, Western Sydney University, Campbelltown, NSW, Australia
- Macarthur Cancer Therapy Centre, Campbelltown Hospital, Campbelltown, NSW, Australia
- Concord Cancer Centre, Concord Repatriation General Hospital, Concord, NSW, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
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Cui C, Wang L. Role of social support in the relationship between resilience and sleep quality among cancer patients. Front Psychiatry 2024; 15:1310118. [PMID: 38690201 PMCID: PMC11058993 DOI: 10.3389/fpsyt.2024.1310118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 04/04/2024] [Indexed: 05/02/2024] Open
Abstract
Introduction The present study aimed to investigate the effect of resilience on sleep quality and explore the role of social support between resilience and sleep quality in cancer patients. Methods A multicenter and cross-sectional study was conducted in China from May to November 2021. A total of 202 cancer patients were recruited to complete the questionnaires composed of demographic information, Pittsburg Sleep Quality Index (PSQI), Resilience Scale-14 (RS-14), and Multidimensions Scale of Perceived Social Support (MSPSS). The associations between resilience, social support, and sleep quality were explored through hierarchical regression analysis. Results The prevalence of poor sleep quality was 50% among cancer patients. Resilience, social support, and the interaction between resilience and social support were all found to be significantly associated with sleep quality. Results of simple slope analysis indicated that the association between resilience and sleep quality were gradually decreased with the increasing social support levels (1 SD below the mean, B=-0.225, β=-0.551, P<0.001), mean social support (B=-0.147, β=-0.353, P<0.001) and high social support (1 SD above the mean, B=-0.065, β=-0.156, P<0.001). Additionally, social support mediated the effect of resilience on sleep quality among cancer patients. Discussion Poor sleep quality has been common in cancer patients. Social support could mediate and alleviate the relationship between resilience and sleep quality among cancer patients. Besides providing sufficient social support, interventions based on resilience should be applied to address sleep problems in cancer patients.
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Affiliation(s)
- ChunYing Cui
- School of Humanities and Management, Wannan Medical College, Wuhu, Anhui, China
| | - Lie Wang
- School of Public Health, China Medical University, Shenyang North New Area, Shenyang, Liaoning, China
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Lee RM, Rash JA, Seal M, McCarthy J, Garland SN. Early change in fatigue, insomnia, and cognitive impairment and symptom severity 3 years post-treatment in breast cancer survivors. Support Care Cancer 2024; 32:232. [PMID: 38499790 DOI: 10.1007/s00520-024-08418-1] [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: 11/08/2023] [Accepted: 03/01/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Breast cancer is the most common form of cancer among Canadian women. Survivorship challenges include fatigue, sleep disturbance, and cognitive impairment. This study examined (1) symptom trajectory from diagnosis to 3 years; (2) whether symptom change in the first 4 months was associated with prolonged difficulties after 3 years; and (3) which factors were associated with deterioration in symptoms during the first 4 months. METHODS This prospective observational cohort study examined 53 women (Mage = 58.6, 96.2% White, 67.9% stage I) with newly diagnosed breast cancer over 3 years. Women completed assessments before starting treatment, 4 months, and 3 years after diagnosis. Three-way repeated-measures ANOVAs evaluated symptom trajectories. A repeated-measures mediation analysis was performed to determine if change from pre-treatment to 4 months accounted for change from pre-treatment to 3 years. A series of between-subjects ANOVAs were used to determine what variables significantly differed by deterioration status. RESULTS Perceived cognitive impairment and fatigue increased linearly from diagnosis to 3 years. Change in fatigue in the first 4 months fully accounted for its change over 3 years. Insomnia severity and sleep quality deteriorated from diagnosis to 4 months, but returned to pre-treatment levels at 3 years. Those whose fatigue and cognitive ability deteriorated during the first 4 months were younger. CONCLUSION Efforts to identify those who are at risk of experiencing fatigue, sleep disturbance, and cognitive impairment; monitor patients early after receiving a diagnosis; and provide targeted interventions may prevent long-term deterioration and improve well-being.
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Affiliation(s)
- Rachel M Lee
- Department of Psychology, Faculty of Science, Memorial University, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada
- Beatrice Hunter Cancer Research Institute, Suite 2L-A2, Tupper Link, 5850 College Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada
| | - Joshua A Rash
- Department of Psychology, Faculty of Science, Memorial University, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada
| | - Melanie Seal
- Discipline of Oncology, Faculty of Medicine, Memorial University, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada
| | | | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada.
- Beatrice Hunter Cancer Research Institute, Suite 2L-A2, Tupper Link, 5850 College Street, PO Box 15000, Halifax, NS, B3H 4R2, Canada.
- Discipline of Oncology, Faculty of Medicine, Memorial University, 230 Elizabeth Avenue, St. John's, NL, A1C 5S7, Canada.
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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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Al-Sharman A, Al-Sarhan A, Aburub A, Shorman R, Bani-Ahmad A, Siengsukon C, Bani Issa W, Abdelrahim DN, Hijazi H, Khalil H. Quality-of-life among women with breast cancer: application of the international classification of functioning, disability and health model. Front Psychol 2024; 15:1318584. [PMID: 38362250 PMCID: PMC10867976 DOI: 10.3389/fpsyg.2024.1318584] [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: 10/21/2023] [Accepted: 01/04/2024] [Indexed: 02/17/2024] Open
Abstract
Background This study aimed to identify the factors that influence Breast Cancer (BC) women's quality of life (QoL) based on the International Classification of Functioning, Disability and Health (ICF) framework. Method A cross-sectional study was conducted among 188 women with BC. The dependent variable, QoL, was measured using the Quality of Life Index (QLI-c). The independent variables were measured using the following Arabic-validated questionnaires: Pittsburgh Sleep Quality Index (PSQI), Female Sexual Function Index (FSFI), Modified Fatigue Impact Scale (MFIS), Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ). Results There was a significant positive correlation between monthly income (r = 0.17, p = 0.016) and QoL, and significant negative correlation between the stage of disease (r = -0.221, p = 0.002) and duration of first diagnosis (r = -0.280, p = 0.004) with QoL. Poor sleep quality, sexual dysfunction, fatigue, depression, and anxiety had significant negative correlations with QoL (p < 0.01). Multiple regression analysis revealed that among the various factors that might affect QoL, sexual dysfunction, poor sleep quality, depression, and anxiety were significant predictors of QoL (p ≤ 0.05). Conclusion The ICF provided an excellent framework to explore the factors influencing QoL among women with BC. This study has given evidence for the relationship of demographic, clinical, and body functional factors with QoL among women with BC. Interestingly, sexual dysfunction, poor sleep quality, depression, and anxiety factors are predictors of QoL. Awareness of these factors that predict QoL will guide healthcare professionals to improve the health and QoL of BC women.
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Affiliation(s)
- Alham Al-Sharman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Areen Al-Sarhan
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ala Aburub
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Raid Shorman
- Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Ali Bani-Ahmad
- Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Catherine Siengsukon
- Department of Physical Therapy, Rehabilitation Science, & Athletic Training, University of Kansas Medical Center, Kansas City, KS, United States
| | - Wegdan Bani Issa
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Dana N. Abdelrahim
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Heba Hijazi
- Department of Health Care Management, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Hanan Khalil
- Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Doha, Qatar
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Bi L, Gao W, Zhang X, Li N, Han J, Shi M. Efficacy of traditional Chinese medicine external therapy on sleep quality in patients with cancer: A systematic review and network meta-analysis. Asia Pac J Oncol Nurs 2023; 10:100308. [PMID: 37928412 PMCID: PMC10622624 DOI: 10.1016/j.apjon.2023.100308] [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: 06/19/2023] [Accepted: 09/11/2023] [Indexed: 11/07/2023] Open
Abstract
Objective This network meta-analysis aims to assess and compare the effectiveness of various external therapies from traditional Chinese medicine (TCM) in enhancing sleep quality among patients with cancer. Methods We systematically searched nine electronic databases, encompassing five English and four Chinese databases, for randomized controlled trials (RCTs) from their inception up to August 10, 2023. The random effects model was utilized for effect size analysis, and the standardized mean difference (SMD) along with its corresponding 95% confidence interval (CI) were computed. Network meta-analysis and comparative effects ranking were executed utilizing STATA 14.0. Results We included thirty-four RCTs involving seven distinct external TCM therapies. Among these, Chinese medicine pillow (SMD = -3.27; 95% CI: -6.03 to -0.51), auricular acupressure (SMD = -2.33; 95% CI: -3.36 to -1.29), moxibustion (SMD = -2.28; 95% CI: -3.63 to -0.94), acupressure (SMD = -1.67; 95% CI: -2.64 to -0.70), and acupuncture (SMD = -1.43; 95% CI: -2.65 to -0.21) demonstrated significant effects in improving sleep quality when compared to usual care or waitlist. The cumulative ranking curve values revealed that the Chinese medicine pillow exhibited the highest potential for effectively enhancing sleep quality in patients with cancer, followed by auricular acupressure, moxibustion, acupressure, acupuncture, Tuina, and electroacupuncture. Conclusions Our study highlights the Chinese medicine pillow as an optimal external TCM therapy for ameliorating sleep quality in cancer patients, but more RCTs are needed to validate this conclusion. These findings serve as valuable support for future clinical trials and research endeavors. Systematic review registration CRD42022381370.
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Affiliation(s)
- Liuna Bi
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Wenjuan Gao
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Xian Zhang
- Department of Radiotherapy, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Na Li
- Department of Traditional Chinese Medicine, Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jing Han
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Ming Shi
- National and Local Joint Engineering Laboratory of Tumor Biotherapy, The First Clinical College of Xuzhou Medical University, Xuzhou, China
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Calvo-Schimmel A, Paul SM, Cooper BA, Shin J, Harris C, Oppegaard K, Hammer MJ, Cartwright F, Conley YP, Kober KM, Levine JD, Miaskowski C. Oncology Outpatients With Worse Anxiety and Sleep Disturbance Profiles Are at Increased Risk for a Higher Symptom Burden and Poorer Quality of Life. Cancer Nurs 2023; 46:417-431. [PMID: 35688433 PMCID: PMC9729413 DOI: 10.1097/ncc.0000000000001139] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Anxiety and sleep disturbance are frequent symptoms during chemotherapy. OBJECTIVES Purposes were to identify subgroups of oncology outpatients with distinct joint anxiety and sleep disturbance profiles, as well as evaluate for differences in demographic and clinical characteristics, sleep disturbance characteristics, severity of common symptoms, and quality-of-life outcomes among these subgroups. METHODS Oncology outpatients (n = 1331) completed self-report measures of anxiety and sleep disturbance 6 times over 2 chemotherapy cycles. Latent profile analysis was done to identify subgroups of patients with distinct joint anxiety and sleep disturbance profiles. RESULTS Three profiles were identified (ie, no anxiety and low sleep disturbance (59.7%), moderate anxiety and high sleep disturbance (32.5%), high anxiety and very high sleep disturbance (7.8%)). Compared with the no anxiety and low sleep disturbance class, the other 2 classes were younger; less likely to be married; had a lower annual household income; and had childcare responsibilities. Patients in the 2 worse profiles had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and evening fatigue, as well as lower levels of morning and evening energy, cognitive function, and poorer quality of life. CONCLUSIONS More than 40% of patients had moderate or high levels of anxiety and high or very high levels of sleep disturbance. Modifiable risk factors associated with these profiles may be used to develop targeted interventions for 1 or both symptoms. IMPLICATIONS FOR PRACTICE Clinicians need to assess for the co-occurrence of anxiety and sleep disturbance.
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Affiliation(s)
- Alejandra Calvo-Schimmel
- Author affiliations: School of Nursing, University of California, San Francisco (Drs Calvo-Schimmel, Paul, Cooper, Kober, and Miaskowski and Mss Shin, Harris, and Oppegaard); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); Department of Nursing, Mount Sinai Medical Center, New York (Dr Cartwright); School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Conley); and School of Medicine, University of California, San Francisco (Drs Levine and Miaskowski)
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Cheng WH, Teo RH, Cheng LJ, Lau Y, Lau ST. Global prevalence of sleep disturbances among breast cancer survivors: A systematic review with meta-analysis. Sleep Health 2023; 9:704-716. [PMID: 37453906 DOI: 10.1016/j.sleh.2023.04.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 04/21/2023] [Accepted: 04/25/2023] [Indexed: 07/18/2023]
Abstract
Breast cancer is a common cancer in which patients are highly susceptible to different sleep disturbances. However, current evidence lacked consistency in methodologies in investigating the prevalence of sleep disturbances among breast cancer survivors. The review aims to (1) investigate the global prevalence of sleep disturbances among breast cancer survivors; and (2) investigate the factors influencing the prevalence estimates. A comprehensive search was conducted in 8 databases using a 3-step approach, up to January 2022. The Newcastle-Ottawa Scale and Cochrane risk of bias tool were used to evaluate the quality of individual studies. Meta-analysis, meta-regression, and subgroup analysis were performed using R software. Certainty of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations criteria. A total of 51 studies were selected involving 28,036 breast cancer survivors across 17 countries. The global prevalence of poor sleep quality was 62%, different severities of insomnia were 3%-32%, and excessive daytime sleepiness was 24%. Subgroup analyses showed that a significantly higher prevalence of poor sleep quality was found in breast cancer survivors during treatment compared with pre- or post-treatment. No significant covariates were found in a series of meta-regression analyses. The majority (73.5%) of individual studies were high quality but the certainty of the evidence was low or very low according to Grading of Recommendations, Assessment, Development, and Evaluations criteria. More than half of breast cancer survivors have sleep disturbances, so developing a strategic intervention is warranted. Given the low or very low certainty of the evidence, a robust design for large-scale research is crucial in the future.
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Affiliation(s)
- Wen Hui Cheng
- Nursing Division, Singapore General Hospital, Singapore Health Services, Singapore
| | - Rui Hong Teo
- Nursing Division, Singapore General Hospital, Singapore Health Services, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Siew Tiang Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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11
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Wu HS, Gao F, Given C. Living as a Survivor: Sleep Disturbance, Fatigue, Depressive Mood, and Cognitive Dysfunction After Breast Cancer Treatment. Cancer Nurs 2023; 47:00002820-990000000-00096. [PMID: 36728181 PMCID: PMC10349906 DOI: 10.1097/ncc.0000000000001200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Many cancer survivors endure multiple symptoms while striving to return to a normal life. Those symptoms often co-occur and exacerbate one another; however, their interplay is not fully understood. OBJECTIVE This study aimed to examine the occurrence and concurrence of sleep disturbance, fatigue, depressive mood, and cognitive dysfunction in posttreatment breast cancer survivors. METHODS The data for this descriptive analysis were collected as part of the screening for a clinical trial. The occurrences of sleep disturbance, depressive mood, and cognitive dysfunction were each determined by the cutoff scores of the Pittsburgh Sleep Quality Index, Center for Epidemiological Studies Depression Scale, and Montreal Cognitive Assessment, respectively; fatigue was determined by meeting the International Classification of Diseases cancer-related fatigue criteria. RESULTS A convenience sample of 81 women completed chemotherapy or/and radiation for stage I-III breast cancer an average of 23.1 (±SD = 9.0) months ago. Sleep disturbance (85%) was most prevalent, followed by fatigue (67%), depressive mood (46%), and cognitive dysfunction (29%). Of the survivors, 80% reported 2 or more co-occurring symptoms. Worsened subjective sleep quality, sleep disturbance, and daytime dysfunction significantly increased the risk of fatigue by 5.3, 4.3, and 4.3 times (all P < .001) and depression by 2.0, 2.7, and 3.0 times (all P < .05), respectively. CONCLUSION Sleep disturbance significantly increased the risk of survivors' fatigue and/or depressive mood after cancer treatment completion. IMPLICATION FOR PRACTICE Effectively managing sleep disturbance and improving the individual's sleep perception may subsequently reduce fatigue and/or depressive mood among breast cancer survivors. Nonpharmacological strategies for managing multiple posttreatment symptoms are needed.
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Affiliation(s)
- Horng-Shiuann Wu
- Author Affiliations: College of Nursing, Michigan State University (Drs Wu and Given), East Lansing; and Division of Public Health Sciences, Washington University School of Medicine (Dr Gao), St Louis, Missouri
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12
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Calvo-Schimmel A, Kober KM, Paul SM, Cooper BA, Harris C, Shin J, Hammer MJ, Conley YP, Dokiparthi V, Olshen A, Levine JD, Miaskowski C. Sleep disturbance is associated with perturbations in immune-inflammatory pathways in oncology outpatients undergoing chemotherapy. Sleep Med 2023; 101:305-315. [PMID: 36470166 PMCID: PMC11200329 DOI: 10.1016/j.sleep.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/14/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE/BACKGROUND Sleep disturbance is a common problem in patients receiving chemotherapy. Purpose was to evaluate for perturbations in immune-inflammatory pathways between oncology patients with low versus very high levels of sleep disturbance. PATIENTS/METHODS Sleep disturbance was evaluated using the General Sleep Disturbance Scale six times over two cycles of chemotherapy. Latent profile analysis was used to identify subgroups of patients with distinct sleep disturbance profiles. Pathway impact analyses were performed in two independent samples using gene expression data obtained from RNA sequencing (n = 198) and microarray (n = 162) technologies. Fisher's combined probability test was used to identify significantly perturbed pathways between Low versus Very High sleep disturbance classes. RESULTS In the RNA sequencing and microarray samples, 59.1% and 51.9% of patients were in the Very High sleep disturbance class, respectively. Thirteen perturbed pathways were related to immune-inflammatory mechanisms (i.e., endocytosis, phagosome, antigen processing and presentation, natural killer cell mediated cytotoxicity, cytokine-cytokine receptor interaction, apoptosis, neutrophil extracellular trap formation, nucleotide-binding and oligomerization domain-like receptor signaling, Th17 cell differentiation, intestinal immune network for immunoglobulin A production, T-cell receptor signaling, complement and coagulation cascades, and tumor necrosis factor signaling). CONCLUSIONS First study to identify perturbations in immune-inflammatory pathways associated with very high levels of sleep disturbance in oncology outpatients. Findings suggest that complex immune-inflammatory interactions underlie sleep disturbance.
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Affiliation(s)
- Alejandra Calvo-Schimmel
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Kord M Kober
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Steven M Paul
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Bruce A Cooper
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Carolyn Harris
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Joosun Shin
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | | | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Vasuda Dokiparthi
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
| | - Adam Olshen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
| | - Jon D Levine
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
| | - Christine Miaskowski
- Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA, USA.
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Cogan JC, Raghunathan RR, Beauchemin MP, Accordino MK, Huang Y, Elkin EB, Melamed A, Wright JD, Hershman DL. New and Persistent Sedative-Hypnotic Use After Adjuvant Chemotherapy for Breast Cancer. J Natl Cancer Inst 2022; 114:1698-1705. [PMID: 36130058 PMCID: PMC9745429 DOI: 10.1093/jnci/djac170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/19/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Sedative-hypnotic medications are used to treat chemotherapy-related nausea, anxiety, and insomnia. However, prolonged sedative-hypnotic use can lead to dependence, misuse, and increased health-care use. We aimed to estimate the rates at which patients who receive adjuvant chemotherapy for breast cancer become new persistent users of sedative-hypnotic medications, specifically benzodiazepines and nonbenzodiazepine sedative-hypnotics (Z-drugs). METHODS Using the MarketScan health-care claims database, we identified sedative-hypnotic-naïve patients who received adjuvant chemotherapy for breast cancer. Patients who filled 1 and more prescriptions during chemotherapy and 2 and more prescriptions up to 1 year after chemotherapy were classified as new persistent users. Univariate and multivariable logistic regression analyses were used to estimate odds of new persistent use and associated characteristics. RESULTS We identified 22 039 benzodiazepine-naïve patients and 23 816 Z-drug-naïve patients who received adjuvant chemotherapy from 2008 to 2017. Among benzodiazepine-naïve patients, 6159 (27.9%) filled 1 and more benzodiazepine prescriptions during chemotherapy, and 963 of those (15.6%) went on to become new persistent users. Among Z-drug-naïve patients, 1769 (7.4%) filled 1 and more prescriptions during chemotherapy, and 483 (27.3%) became new persistent users. In both groups, shorter durations of chemotherapy and receipt of opioid prescriptions were associated with new persistent use. Medicaid insurance was associated with new persistent benzodiazepine use (odds ratio = 1.88, 95% confidence interval = 1.43 to 2.47) compared with commercial or Medicare insurance. CONCLUSIONS Patients who receive sedative-hypnotic medications during adjuvant chemotherapy for breast cancer are at risk of becoming new persistent users of these medications after chemotherapy. Providers should ensure appropriate sedative-hypnotic use through tapering dosages and encouraging nonpharmacologic strategies when appropriate.
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Affiliation(s)
- Jacob C Cogan
- Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, USA
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Rohit R Raghunathan
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melissa P Beauchemin
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Melissa K Accordino
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Yongmei Huang
- Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Elena B Elkin
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Alexander Melamed
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Jason D Wright
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
| | - Dawn L Hershman
- Columbia University College of Physicians and Surgeons, New York, NY, USA
- Herbert Irving Comprehensive Cancer Center, New York, NY, USA
- New York Presbyterian Hospital, New York, NY, USA
- Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
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14
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Di Nardo P, Lisanti C, Garutti M, Buriolla S, Alberti M, Mazzeo R, Puglisi F. Chemotherapy in patients with early breast cancer: clinical overview and management of long-term side effects. Expert Opin Drug Saf 2022; 21:1341-1355. [DOI: 10.1080/14740338.2022.2151584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Paola Di Nardo
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Camilla Lisanti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Mattia Garutti
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
| | - Silvia Buriolla
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Martina Alberti
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Roberta Mazzeo
- Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Fabio Puglisi
- Department of Medical Oncology, CRO Aviano, National Cancer Institute, IRCCS, Aviano, Italy
- Department of Medicine (DAME), University of Udine, Udine, Italy
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15
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Poudel S, Martins G, Cancela ML, Gavaia PJ. Resveratrol-Mediated Reversal of Doxorubicin-Induced Osteoclast Differentiation. Int J Mol Sci 2022; 23:ijms232315160. [PMID: 36499492 PMCID: PMC9738652 DOI: 10.3390/ijms232315160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/16/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
Secondary osteoporosis has been associated with cancer patients undertaking Doxorubicin (DOX) chemotherapy. However, the molecular mechanisms behind DOX-induced bone loss have not been elucidated. Molecules that can protect against the adverse effects of DOX are still a challenge in chemotherapeutic treatments. We investigated the effect and mechanism of DOX in osteoclast differentiation and used the Sirt 1 activator resveratrol (RES) to counteract DOX-induced effects. RAW 264.7 cells were differentiated into osteoclasts under cotreatment with DOX and RES, alone or combined. RES treatment inhibited DOX-induced osteoclast differentiation, reduced the expression of osteoclast fusion marker Oc-stamp and osteoclast differentiation markers Rank, Trap, Ctsk and Nfatc1. Conversely, RES induced the upregulation of antioxidant genes Sod 1 and Nrf 2 while DOX significantly reduced the FoxM1 expression, resulting in oxidative stress. Treatment with the antioxidant MitoTEMPO did not influence DOX-induced osteoclast differentiation. DOX-induced osteoclastogenesis was studied using the cathepsin-K zebrafish reporter line (Tg[ctsk:DsRed]). DOX significantly increased ctsk signal, while RES cotreatment resulted in a significant reduction in ctsk positive cells. RES significantly rescued DOX-induced mucositis in this model. Additionally, DOX-exposed zebrafish displayed altered locomotor behavior and locomotory patterns, while RES significantly reversed these effects. Our research shows that RES prevents DOX-induced osteoclast fusion and activation in vitro and in vivo and reduces DOX-induced mucositis, while improving locomotion parameters.
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Affiliation(s)
- Sunil Poudel
- Centre of Marine Sciences, University of Algarve, 8005-139 Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139 Faro, Portugal
- PhD Program in Biomedical Sciences, FMCB, University of Algarve, 8005-139 Faro, Portugal
| | - Gil Martins
- Centre of Marine Sciences, University of Algarve, 8005-139 Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139 Faro, Portugal
- PhD Program in Biomedical Sciences, FMCB, University of Algarve, 8005-139 Faro, Portugal
| | - M. Leonor Cancela
- Centre of Marine Sciences, University of Algarve, 8005-139 Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139 Faro, Portugal
- Algarve Biomedical Center, University of Algarve, 8005-139 Faro, Portugal
| | - Paulo J. Gavaia
- Centre of Marine Sciences, University of Algarve, 8005-139 Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, 8005-139 Faro, Portugal
- Correspondence: ; Tel.: +351-289-800057 or +351-289-800900 (ext. 7057)
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16
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Bethea TN, Zhai W, Zhou X, Ahles TA, Ahn J, Cohen HJ, Dilawari AA, Graham DMA, Jim HSL, McDonald BC, Nakamura ZM, Patel SK, Rentscher KE, Root J, Saykin AJ, Small BJ, Van Dyk KM, Mandelblatt JS, Carroll JE. Associations between longitudinal changes in sleep disturbance and depressive and anxiety symptoms during the COVID-19 virus pandemic among older women with and without breast cancer in the thinking and living with breast cancer study. Cancer Med 2022; 11:3352-3363. [PMID: 35315588 PMCID: PMC9110906 DOI: 10.1002/cam4.4682] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Several studies have reported sleep disturbances during the COVID-19 virus pandemic. Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety. METHODS Breast cancer survivors aged ≥60 years with a history of nonmetastatic breast cancer (n = 242) and frequency-matched noncancer controls (n = 158) active in a longitudinal cohort study completed a COVID-19 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies-Depression Scale (CES-D). CES-D score (minus the sleep item) captured depressive symptoms; the State-Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates. RESULTS The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (β = 8.16, p < 0.01 and β = 6.14, p < 0.01, respectively), but there were no survivor-control differences in the effect. CONCLUSION Development of sleep disturbances during the COVID-19 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.
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Affiliation(s)
- Traci N. Bethea
- Office of Minority Health and Health Disparities ResearchGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Wanting Zhai
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Xingtao Zhou
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Tim A. Ahles
- Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew York CityUSA
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and BiomathematicsGeorgetown UniversityWashingtonDistrict of ColumbiaUSA
| | - Harvey J. Cohen
- Center for the Study of Aging and Human DevelopmentDuke University Medical CenterDurhamNorth CarolinaUSA
| | - Asma A. Dilawari
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
- Medstar Washington Hospital CenterWashingtonDistrict of ColumbiaUSA
| | - Deena M. A. Graham
- John Theurer Cancer CenterHackensack University Medical CenterHackensackNew JerseyUSA
| | | | - Brenna C. McDonald
- Department of Radiology and Imaging SciencesIndiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
| | - Zev M. Nakamura
- Department of PsychiatryUniversity of North Carolina‐Chapel HillChapel HillNorth CarolinaUSA
| | - Sunita K. Patel
- City of Hope National Medical CenterLos AngelesCaliforniaUSA
| | - Kelly E. Rentscher
- Cousins Center for PsychoneuroimmunologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - James Root
- Department of Psychiatry and Behavioral SciencesMemorial Sloan Kettering Cancer CenterNew YorkNew York CityUSA
| | - Andrew J. Saykin
- Department of Radiology and Imaging SciencesIndiana University School of Medicine and Indiana University Melvin and Bren Simon Comprehensive Cancer CenterIndianapolisIndianaUSA
| | - Brent J. Small
- College of Behavioral and Community Sciences, School of Aging StudiesUniversity of South FloridaTampaFloridaUSA
| | - Kathleen M. Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
| | - Jeanne S. Mandelblatt
- Cancer Prevention and Control ProgramGeorgetown Lombardi Comprehensive Cancer CenterWashingtonDistrict of ColumbiaUSA
| | - Judith E. Carroll
- Cousins Center for PsychoneuroimmunologyUniversity of California, Los AngelesLos AngelesCaliforniaUSA
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral SciencesUniversity of California, Los AngelesLos AngelesCaliforniaUSA
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Sung S, Min YH, Park SK, Lee SB. Hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion in breast cancer survivors during the first 24 months of tamoxifen therapy: a prospective observational study. Front Oncol 2022; 12:844926. [PMID: 35982968 PMCID: PMC9380584 DOI: 10.3389/fonc.2022.844926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose This study aimed to explore symptom trajectories over 24 months for hot flushes and sweating, sleep problems, joint and muscular discomfort, and physical and mental exhaustion experienced by premenopausal women diagnosed with tamoxifen-treated breast cancer. Methods A total of 104 patients participated in the study. The menopausal symptoms were examined using the Menopausal Rating Scale at baseline, 3–6, 12, and 18–24 months after initiating tamoxifen. The changes over four time points were analyzed using repeated measures analysis of variance. The chi-square test was used to examine the differences between “no symptom-to-mild” and “moderate-to-extremely severe” 3–6 months after initiating tamoxifen according to the patients’ chemotherapy treatment experiences. Results All menopausal symptoms occurred in > 70% of patients with breast cancer and persisted until 24 months. More than 50% of patients experienced four menopausal symptoms, with at least two at a serious severity level after initiating tamoxifen. Hot flushes and sweating occurred in the highest number of patients, recording high scores. Sleep problems and physical and mental exhaustion exhibited relatively high scores, even before tamoxifen initiation. There were significant changes over four time points in all symptoms. Young patients aged < 40 years experienced more severe sleep problems, and patients who had previously received chemotherapy experienced more severe joint and muscular discomfort. Conclusions This study’s findings may assist in alerting healthcare providers to menopausal symptoms that develop during tamoxifen therapy and the need for early and active intervention to minimize symptom occurrence and distress.
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Affiliation(s)
- Sumi Sung
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Yul Ha Min
- College of Nursing, Kangwon National University, Kangwon-do, South Korea
- *Correspondence: Yul Ha Min,
| | - Seul Ki Park
- Department of Nursing, Daejeon University, Daejeon, South Korea
| | - Sae Byul Lee
- Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Redeker NS, Conley S, Hwang Y. Sleep Deficiency: A Symptoms Perspective: Exemplars from Chronic Heart Failure, Inflammatory Bowel Disease, and Breast Cancer. Clin Chest Med 2022; 43:217-228. [PMID: 35659020 PMCID: PMC9178708 DOI: 10.1016/j.ccm.2022.02.006] [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] [Indexed: 11/03/2022]
Abstract
Sleep deficiency is associated with disabling daytime symptoms, including excessive daytime sleepiness (EDS) and fatigue. The purpose of this article is to discuss the contributions of sleep deficiency and sleep disorders to fatigue and EDS among people with chronic conditions. We use exemplars from the literature on chronic heart failure, inflammatory bowel disease, and breast cancer to (1) describe the prevalence of fatigue and EDS and their consequences; (2) examine the evidence for the contributions of sleep deficiency and sleep disorders to these symptoms; and (3) recommend implications for future research and practice.
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Affiliation(s)
- Nancy S Redeker
- UCONN School of Nursing, Yale University, University of Connecticut School of Nursing, 231 Glenbrook Road, Unit 4026, Storrs, CT 06269-4026, USA.
| | - Samantha Conley
- Nursing Research Division, Department of Nursing, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Youri Hwang
- Yale School of Nursing, PO Box 27399, West Haven, CT 06516-0972, USA
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Divani A, Heidari ME, Ghavampour N, Parouhan A, Ahmadi S, Narimani Charan O, Shahsavari H. Effect of cancer treatment on sleep quality in cancer patients: A systematic review and meta-analysis of Pittsburgh Sleep Quality Index. Support Care Cancer 2022; 30:4687-4697. [DOI: 10.1007/s00520-021-06767-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/15/2021] [Indexed: 01/13/2023]
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Lee S, Jung S, Jung S, Moon JY, Oh GH, Yeom CW, Son KL, Lee KM, Kim WH, Jung D, Kim TY, Im SA, Lee KH, Shim EJ, Hahm BJ. Psychiatric symptoms mediate the effect of resilience on health-related quality of life in patients with breast cancer: Longitudinal examination. Psychooncology 2021; 31:470-477. [PMID: 34668264 DOI: 10.1002/pon.5829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 08/23/2021] [Accepted: 09/05/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Patients with breast cancer receiving neoadjuvant chemotherapy are at increased risk of poor health-related quality of life (HRQOL). This study examined clinical caseness on depression and anxiety mediate the relationship between resilience and HRQOL in patients with breast cancer. METHODS A total of 193 patients with breast cancer undergoing neoadjuvant chemotherapy completed questionnaires including the Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-Breast before the first session (T0), before the start of the last session (T1), and 6 months after the end (T2) of chemotherapy. Mediation analyses using a bootstrapping method was performed. RESULTS The indirect effect (IE) through T1 depression was significant (IE through depression = 0.043, 95% confidence interval [CI] [0.002-0.090]), while IE through T1 anxiety was not significant (IE through anxiety = 0.037, 95% CI [-0.010-0.097]) in the association between T0 resilience and T2 HRQOL. CONCLUSIONS Clinical caseness on HADS depression subscale during chemotherapy was a mediating factor of the relationship between resilience before chemotherapy and HRQOL after chemotherapy in patients with breast cancer receiving neoadjuvant chemotherapy. Depression during chemotherapy in patients with breast cancer may be a target symptom of screening and intervention to maintain the HRQOL after chemotherapy. Also, patients with low resilience are more likely to develop depression during chemotherapy, and clinicians should carefully monitor whether depression occurs in these patients with low resilience.
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Affiliation(s)
- Sungwon Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Saim Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chan-Woo Yeom
- Department of Psychiatry, National Rehabilitation Center, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | | | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.,Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Eun-Jung Shim
- Department of Psychology, Pusan National University, Busan, Republic of Korea
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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21
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Kim HS, Nho JH, Nam JH. A serial multiple mediator model of sense of coherence, coping strategies, depression, and quality of life among gynecologic cancer patients undergoing chemotherapy. Eur J Oncol Nurs 2021; 54:102014. [PMID: 34509089 DOI: 10.1016/j.ejon.2021.102014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/06/2021] [Accepted: 08/12/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study evaluated whether coping strategies (positive reframing, planning, and active coping) and depression mediate the relationship between sense of coherence (SOC) and quality of life (QoL) using a serial multiple mediator model in patients with gynecologic cancer who are undergoing chemotherapy. METHODS A sample of 148 participants, with a mean age of 52.17 years (range 20-75) and diagnosed with gynecological cancer (e.g., cervix, ovary and endometrium) was surveyed in a cross-sectional study. Data were collected using a structured self-reporting questionnaire. A serial multiple mediator model was analyzed to explain sequential causality among two mediators (coping strategy and depression) and to investigate the direct and indirect effects of the mediator model in SPSSWIN 26.0 and PROCESS macro program. RESULTS The conceptual serial mediation model of SOC, positive reframing, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through single mediation of positive reframing (Effect = 0.925) and depression (Effect = 5.942) and that through both mediators (Effect = 1.161) were statistically significant. The total indirect effect was also statistically significant (Effect = 8.028). Moreover, the conceptual serial mediation model on SOC, planning, depression, and QoL revealed a significant positive total effect (coefficient c = 13.099, SE = 1.647, p < 0.001). The path through both mediation of planning and depression (Effect = 1.162) and the total indirect effect were statistically significant (Effect = 8.172). CONCLUSIONS Helping patients with gynecologic cancer undergoing chemotherapy to strengthen SOC may improve QoL by equipping them with efficient positive reframing or planning strategies to reduce depression.
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Affiliation(s)
- Hee Sun Kim
- College of Nursing · Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
| | - Ju-Hee Nho
- College of Nursing · Research Institute of Nursing Science, Jeonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju-si, Jeollabuk-do, 54896, Republic of Korea.
| | - Joo-Hyun Nam
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea.
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22
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Exercise intervention in cancer patients with sleep disturbances scheduled for elective surgery: Systematic review. Int J Surg 2021; 93:106069. [PMID: 34464753 DOI: 10.1016/j.ijsu.2021.106069] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 07/21/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND & OBJECTIVES Sleep disturbance is one of the patients' major complaints after major surgery and can impair postoperative recovery. Pre-operative exercise has been shown to increase functional capacity and resilience in cancer patients; scarce knowledge is available on the effects of pre-operative exercise on sleep disturbances. This systematic review aims to determine the impact of pre-operative exercise training alone or as part of multimodal prehabilitation on sleep disturbances and sleep quality in cancer patients. METHODS A systematic search including Biosis, Cochrane Library and CENTRAL, EMBASE, MEDLINE, and clinical trial registries (clinicaltrials.gov, International Clinical Trials Registry Platform) was performed to identify studies involving a pre-operative exercise intervention in cancer patients awaiting surgery. Trials had to contain at least one sleep measure, assessed subjectively and objectively were included in the systematic review. The quality of the included trials was assessed using the Cochrane Risk of Bias Tool for assessing the risk of bias in randomized trials tool and the ROBINS-I tool for evaluating the risk of bias in non-randomized studies. RESULTS Seven studies were included (1 RCT, 2 non-RCTs and 4 single-arm design). Due to substantial heterogeneity in the interventions across studies, a meta-analysis was not conducted. The available empirical evidence on the presurgical effect of exercise on sleep outcomes is scarce and, overall, suggests that it has a limited effect. Besides, non-significant improvement of the pre-operative exercise on sleep was unique to the studies that used subjective measures to assess sleep disturbances changes during cancer treatment. CONCLUSION There are conflicting results and a lack of quality data proving the pre-operative exercise on sleep quality and disturbances. More research is needed in the pre-operative period using clinical sleep disturbances such as insomnia as an inclusion criterion, subjectively and objectively assessed.
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23
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Duivon M, Giffard B, Desgranges B, Perrier J. Are Sleep Complaints Related to Cognitive Functioning in Non-Central Nervous System Cancer? A Systematic Review. Neuropsychol Rev 2021; 32:483-505. [PMID: 34355305 DOI: 10.1007/s11065-021-09521-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 07/19/2021] [Indexed: 12/24/2022]
Abstract
Patients with non-central nervous system (CNS) cancer frequently report cognitive complaints, that are recurrent and affect their quality of life. In order to improve supportive care of these cognitive difficulties, it is important to identify associated factors. Sleep disturbance is a good candidate to study, as patients with non-CNS cancer frequently report sleep disorders, and sleep plays a key role in cognitive functioning. The objective of the present systematic review was to summarize the results of studies evaluating the relationship between cognition and sleep in non-CNS cancer, and to highlight the need for further studies. PubMed [Medline] and Scopus databases were screened from April to November 2020 for studies published in English evaluating the association between cognition and sleep in adults with non-CNS cancer. The characteristics and risk of bias for each of the 30 included studies have been reported. Greater cognitive complaints in patients with non-CNS cancer were related to poorer self-reported sleep quality in almost all studies (n = 22/24). By contrast, around half of the studies reported a significant association between poorer neuropsychological performances and sleep complaints (n = 5/11). The studies were found to have several limitations, such as the lack of a control group, which would have shed the light on the period of occurrence of this association (e.g. after cancer diagnosis or after cancer treatments). Our review also identified factors that may influence the relationship between cognition and sleep. Recommendations are given for improving the methodology of future studies and extending the impact of their results.
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Affiliation(s)
- Mylène Duivon
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, GIP Cyceron, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Bénédicte Giffard
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, GIP Cyceron, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France.,Ligue Contre Le Cancer, Cancer & Cognition Platform, 14076, Caen, France
| | - Béatrice Desgranges
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, GIP Cyceron, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Joy Perrier
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, CHU de Caen, GIP Cyceron, U1077, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France.
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24
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Cogan JC, Raghunathan RR, Beauchemin MP, Accordino MK, Elkin EB, Melamed A, Wright JD, Hershman DL. New and persistent controlled substance use among patients undergoing mastectomy and reconstructive surgery. Breast Cancer Res Treat 2021; 189:445-454. [PMID: 34089118 DOI: 10.1007/s10549-021-06275-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Prolonged use of controlled substances can place patients at increased risk of dependence and complications. Women who have mastectomy and reconstructive surgery (M + R) may be vulnerable to becoming new persistent users (NPUs) of opioid and sedative-hypnotic medications. METHODS Using the MarketScan health-care claims database, we identified opioid- and sedative-hypnotic-naïve women who had M + R from 2008 to 2017. Women who filled ≥ 1 peri-operative prescription and ≥ 2 post-operative prescriptions within one year after surgery were classified as NPUs. Univariate and multivariable logistic regression analyses were used to estimate rates of new persistent use and predictive factors. Risk summary scores were created based on the sum of associated factors. RESULTS We evaluated 23,025 opioid-naïve women and 25,046 sedative-hypnotic-naïve women. We found that 17,174 opioid-naïve women filled a peri-operative opioid prescription, and of those, 2962 (17.2%) became opioid NPUs post-operatively. Additionally, 9426 sedative-hypnotic-naïve women filled a peri-operative sedative-hypnotic prescription, and of those, 1612 (17.1%) became sedative-hypnotic NPUs. Development of new persistent sedative-hypnotic use was associated with age ≤ 49 [OR 1.77 (95% CI 1.40-2.24)] and age 50-64 [1.60 (1.27-2.03)] compared to age ≥ 65; Medicaid insurance [2.34 (1.40-3.90)]; southern residence [1.42 (1.22-1.64)]; breast cancer diagnosis [2.24 (1.28-3.91)]; and chemotherapy [2.17 (1.94-2.42)]. Risk of NPU increased with higher risk score. Women with ≥ 3 of these risk factors were three times more likely to become sedative-hypnotic NPUs than patients with 0 or 1 factors [2.94 (2.51-3.43)]. Comparable findings were seen regarding new persistent opioid use. CONCLUSION Women who have M + R are at risk of developing both new persistent opioid and new persistent sedative-hypnotic use. A patient's risk of becoming an NPU increases as their number of risk factors increases. Non-pharmacologic strategies are needed to manage pain and anxiety following cancer-related surgery.
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Affiliation(s)
- Jacob C Cogan
- Columbia University College of Physicians and Surgeons, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.,NewYork-Presbyterian Hospital, New York, USA
| | - Rohit R Raghunathan
- Joseph L. Mailman School of Public Health, Columbia University, New York, USA
| | - Melissa P Beauchemin
- Columbia University College of Physicians and Surgeons, New York, USA.,Joseph L. Mailman School of Public Health, Columbia University, New York, USA.,NewYork-Presbyterian Hospital, New York, USA
| | - Melissa K Accordino
- Columbia University College of Physicians and Surgeons, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.,NewYork-Presbyterian Hospital, New York, USA
| | - Elena B Elkin
- Joseph L. Mailman School of Public Health, Columbia University, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA
| | - Alexander Melamed
- Columbia University College of Physicians and Surgeons, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.,NewYork-Presbyterian Hospital, New York, USA
| | - Jason D Wright
- Columbia University College of Physicians and Surgeons, New York, USA.,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA.,NewYork-Presbyterian Hospital, New York, USA
| | - Dawn L Hershman
- Columbia University College of Physicians and Surgeons, New York, USA. .,Joseph L. Mailman School of Public Health, Columbia University, New York, USA. .,Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York, USA. .,NewYork-Presbyterian Hospital, New York, USA.
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25
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Protective effect of nanocurcumin against neurotoxicity induced by doxorubicin in rat's brain. Neurotoxicology 2021; 85:1-9. [PMID: 33882267 DOI: 10.1016/j.neuro.2021.04.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/07/2021] [Accepted: 04/10/2021] [Indexed: 02/07/2023]
Abstract
Cognitive impairment is one of the serious side effects that cancer-treated patients suffer from after treatment by doxorubicin (DOX). Investigating the mechanisms underlying this impairment is crucial for its treatment or prevention. The current study investigates the cortical and hippocampal neurochemical changes induced by an acute dose of DOX (20 mg/kg, i.p.) and evaluates the neuroprotective effect of nanocurcumin (NC) (50 mg/kg, p.o.) against these changes. Animals were randomly divided into four groups, control, rats treated with either NC or DOX, and the fourth group treated with NC prior to DOX. Cortical dopamine level has significantly increased (71.88 %) after DOX injection. This was associated with a significant rise in the levels of lipid peroxidation (183.99 %, 201.4 %) and nitric oxide (36.54 %, 55 %) and a significant reduction in reduced glutathione (13 %, 21.44 %) in the cortex and hippocampus, respectively. In addition, DOX inhibited the cortical and hippocampal activities of acetylcholinesterase (94.82 %, 62.75 %) and monoamine oxidase (64.40 %, 68.84 %), respectively. Protection with NC mitigates the changes induced in the oxidative stress parameters by DOX. However, the effect on the activities of AchE and MAO was insignificant. This was reflected in the level of dopamine that showed non-significant changes in comparison to control and DOX-treated rats. The present findings indicate that oxidative stress, inhibition in AchE, MAO, and the subsequent elevation in dopamine could have a crucial role in mediating the chemo-brain adverse effects induced by DOX. In addition, protection with NC mitigated some of these adverse effects thus rendering DOX more tolerable.
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26
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The Mediation and Suppression Effect of Demoralization in Breast Cancer Patients After Primary Therapy: A Structural Equation Model. THE JOURNAL OF NURSING RESEARCH : JNR 2021; 29:e144. [PMID: 33661792 DOI: 10.1097/jnr.0000000000000421] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Because of the increasing 5-year survival rate of breast cancer, adjustment to breast cancer survivorship is pertinent to the patient's life after diagnosis. Despite the psychological changes occurring during the transitional period (first 5 years after diagnosis) and after primary therapy having a known, critical effect on survivorship status, the data related to this topic are very limited. PURPOSE This study was designed to examine the relationships among demoralization, stress, sleep disturbance, and psychological well-being in women with breast cancer after primary therapy. METHODS Two hundred eight women with breast cancer (mean age = 51.96 ± 8.27) participated in a cross-sectional study in central Taiwan. Recruitment was conducted using convenience snowball sampling at a local teaching hospital. All of the participants had completed primary therapy and were in the 5-year postdiagnosis period. The average duration of cancer was 28 months. The participants completed the Stress of Breast Cancer after Primary Therapy Scale, Demoralization Scale, Pittsburgh Sleep Quality Inventory, and Ryff's Psychological Well-Being Scale-Short Form. Data were analyzed using a structural equation model to find plausible path relationships among stress, demoralization, sleep disturbances, and psychological well-being. RESULTS Demoralization was shown to completely mediate the effect of stress on sleep disturbances. In addition, the predictive effect of sleep disturbances on psychological well-being was overwhelmingly explained by demoralization when competing with sleep disturbances. Furthermore, a positive path was found between stress and psychological well-being because of the suppression effect of demoralization. CONCLUSIONS/IMPLICATIONS FOR PRACTICE Demoralization was found to be a mediator that suppressed the relationships among stress, sleep disturbances, and psychological well-being in the adaptation process of patients with breast cancer after primary therapy. This article adds to the limited research on women with breast cancer after primary therapy who are in their initial 5 years of diagnosis. In addition, this study used structural equation model to find the plausible path relationships among the psychological factors involved in the well-being of women with breast cancer. Supporting patients with cancer and effectively reducing their perceived demoralization will be key to transforming stress into personal growth and a facilitator of long-term recovery.
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27
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Chan YN, Jheng YW, Wang YJ. Chemotherapy-Induced Peripheral Neurotoxicity as A Risk Factor for Poor Sleep Quality in Breast Cancer Survivors Treated with Docetaxel. Asia Pac J Oncol Nurs 2020; 8:68-73. [PMID: 33426192 PMCID: PMC7785078 DOI: 10.4103/apjon.apjon_51_20] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022] Open
Abstract
Objective: The purpose of this study was to explore sleep quality and to determine whether chemotherapy-induced peripheral neurotoxicity is a risk factor for poor sleep quality in breast cancer survivors who receive docetaxel treatment. Methods: Secondary data analysis from a cross-sectional study. Sample characteristics were collected using an information sheet. Independent variables included the Hospital Anxiety and Depression Scale (HADS), the Patient Neurotoxicity Questionnaire (PNQ), and the Identification Pain Questionnaire (ID pain). Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). We performed descriptive analyses and simple logistic regression. Results: A total of 98 participants were included. More than 60% of them reported poor sleep quality, with their average PSQI score being 7.54 ± 4.45. Poor subjective sleep quality (1.37 ± 0.88) and short sleep duration (1.37 ± 1.08) were their main problems. In addition, significant risk factors for poor sleep quality were chronic illness (odds ratio [OR] = 2.753, P = 0.041), anxiety (OR = 7.714, P = 0.009), neuropathic pain (OR = 11.261, P = 0.022), sensory neuropathy (OR = 2.529, P = 0.032), motor neuropathy (OR = 3.781, P = 0.002), and undergoing chemotherapy (OR = 2.593, P = 0.027). Targeted therapy that some survivors received served as a protective factor (OR = 0.351, P = 0.015). Conclusions: We found a high prevalence of poor sleep quality in breast cancer survivors treated with docetaxel. The results indicated that, in addition to clinical characteristics and psychological discomfort, chemotherapy-induced peripheral neurotoxicity is a significant risk factor for poor sleep quality.
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Affiliation(s)
- Ya-Ning Chan
- School of Nursing, University of North Carolina at Chapel Hill, NC, USA
| | - You-Wun Jheng
- Department of Nursing, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Jung Wang
- Department of Nursing, Da-Yeh University, Changhua, Taiwan.,Department of Nursing, National Yang-Ming University, Taipei, Taiwan
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Marinkovic M, Djordjevic N, Djordjevic L, Ignjatovic N, Djordjevic M, Karanikolic V. Assessment of the quality of life in breast cancer depending on the surgical treatment. Support Care Cancer 2020; 29:3257-3266. [PMID: 33099655 DOI: 10.1007/s00520-020-05838-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of the study is to describe QoL in women who have undergone surgical treatment for breast cancer (BC). The focus of the description is the differences in QoL between women treated by modified radical mastectomy (MRM) and women who underwent breast-conserving surgery (BCS) at the Breast and Endocrine Surgery Department of the Clinical Center of Niš, Serbia. METHOD From January 1, 2014, until December 31, 2017, 300 patients were treated with BCS and 300 patients with MRM. To assess the QOL, a total of 600 BC patients completed the WHOQOL-BREF questionnaires. The results were analyzed using the t test and chi-square test. WHOQOL produces a quality of life profile. It derives four domain scores: physical health, psychological, social relationships, and environment. Social and demographic factors (age, education, marital status) were collected in both groups. RESULT In all four domains, patients treated with conserving surgeries scored higher than patients treated with radical mastectomy. This result was controlled for a set of demographic variables. The differences in QoL scores are present on all levels of controlling variables. CONCLUSION According to the results of this study, the QoL in women after an MRM is significantly lower than the QoL in women after BCS. It is especially true for the environment domain. Conserving surgery should be recommended and specific, and patient-centered interventions for increasing QoL of the patients who opted for radical mastectomy should be designed. The intervention should focus on social and environmental domains.
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Affiliation(s)
- Mirjana Marinkovic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia.
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia.
| | - Nebojsa Djordjevic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Lidija Djordjevic
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Nebojsa Ignjatovic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
| | - Miodrag Djordjevic
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Vesna Karanikolic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
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29
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Souza RCDS, dos Santos MR, das Chagas Valota IA, Sousa CS, Costa Calache ALS. Factors associated with sleep quality during chemotherapy: An integrative review. Nurs Open 2020; 7:1274-1284. [PMID: 32802348 PMCID: PMC7424431 DOI: 10.1002/nop2.516] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 12/17/2022] Open
Abstract
Aim To identify the most important factors associated with sleep pattern changes in patients with cancer during chemotherapy treatment. Design An integrative review of the literature was performed between December 2017-August 2018. Methods Two independent reviewers searching the National Library of Medicine (PubMed/MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Latin American and Caribbean Literature in Health Sciences (LILACS), Scopus and Scielo. The process followed the recommendations of the PRISMA tool. A total of 16 articles were selected for the final study sample, including 11 cohort studies and 5 cross-sectional studies. Results The predisposing factors for the most prevalent sleep disturbances were precipitants related to the disease and the treatment, such as fatigue, pain, depression, anxiety and distress. Predisposing factors related to lifestyle and demographic characteristics have a significant correlation with sleep disturbances.
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Affiliation(s)
| | | | | | - Cristina Silva Sousa
- University of São Paulo School of NursingSao PauloBrazil
- Sirio Libanes HospitalSao PauloBrazil
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Mo Y, Zhu X, Lai X, Li L. Sleep in nasopharyngeal carcinoma patients before chemotherapy, after induction chemotherapy, and after concurrent chemoradiotherapy. Med Hypotheses 2020; 144:109840. [PMID: 32505065 DOI: 10.1016/j.mehy.2020.109840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/27/2020] [Accepted: 05/12/2020] [Indexed: 11/17/2022]
Abstract
Sleep disturbance is frequently observed in cancer patients before, during and after oncology treatment. We explored the sleep features of patients before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy for nasopharyngeal carcinoma (NPC). Ninety eligible patients diagnosed with NPC (stages III to IVc) and treated with induction chemotherapy plus concurrent chemoradiotherapy were included. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy. The median global PSQI scores in patients with NPC before treatment, after induction chemotherapy, and after concurrent chemoradiotherapy were 5, 6, and 10, respectively. The median scores of daytime dysfunction, sleep disturbance and habitual sleep efficiency were statistically significant at the pretreatment, after induction chemotherapy and after concurrent chemoradiotherapy timepoints (P < 0.049, P < 0.001 and P < 0.001, respectively). However, minimal changes were observed in all subscores after induction chemotherapy. Patients with poor sleep quality after induction chemotherapy were more prone to suffer worse sleep after concurrent chemoradiotherapy (OR = 12.6, 95%; CI = 2.4-67.3). Induction chemotherapy had less effect on the quality of sleep in NPC patients. Patients experienced a significant increase in sleep disturbance after concurrent chemoradiotherapy, particularly those with bad sleep after induction chemotherapy.
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Affiliation(s)
- Yanlin Mo
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Xiaodong Zhu
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Xiaoying Lai
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China
| | - Ling Li
- Dept of Radiation Oncology, Guangxi Medical University Cancer Hospital, Cancer Institute of Guangxi Zhuang Autonomous Region, 71 Hedi Road, Nanning 530021, China.
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Tejada M, Viele C, Kober KM, Cooper BA, Paul SM, Dunn LB, Hammer MJ, Wright F, Conley YP, Levine JD, Miaskowski C. Identification of subgroups of chemotherapy patients with distinct sleep disturbance profiles and associated co-occurring symptoms. Sleep 2020; 42:5541565. [PMID: 31361899 DOI: 10.1093/sleep/zsz151] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Revised: 05/31/2019] [Indexed: 01/09/2023] Open
Abstract
STUDY OBJECTIVES Purposes of this study were to identify subgroups of patients with distinct sleep disturbance profiles and to evaluate for differences in demographic, clinical, and various sleep characteristics, as well for differences in the severity of co-occurring symptoms among these subgroups. METHODS Outpatients with breast, gynecological, gastrointestinal, or lung cancer (n = 1331) completed questionnaires six times over two chemotherapy cycles. Self-reported sleep disturbance was evaluated using the General Sleep Disturbance Scale (GSDS). Latent profile analysis was used to identify distinct subgroups. RESULTS Three latent classes with distinct sleep disturbance profiles were identified (Low [25.5%], High [50.8%], Very High [24.0%]) across the six assessments. Approximately 75% of the patients had a mean total GSDS score that was above the clinically meaningful cutoff score of at least 43 across all six assessments. Compared to the Low class, patients in High and Very High classes were significantly younger, had a lower functional status, had higher levels of comorbidity, and were more likely to be female, more likely to have childcare responsibilities, less likely to be employed, and less likely to have gastrointestinal cancer. For all of the GSDS subscale and total scores, significant differences among the latent classes followed the expected pattern (Low < High < Very High). For trait and state anxiety, depressive symptoms, morning and evening fatigue, decrements in attentional function, and decrements in morning and evening energy, significant differences among the latent classes followed the expected pattern (Low < High < Very High). CONCLUSIONS Clinicians need to perform in-depth assessments of sleep disturbance and co-occurring symptoms to identify high-risk patients and recommend appropriate interventions.
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Affiliation(s)
- Maria Tejada
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Carol Viele
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Kord M Kober
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Bruce A Cooper
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Steven M Paul
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
| | - Laura B Dunn
- Department of Physiological Nursing, School of Medicine, Stanford University, Stanford, CA
| | | | - Fay Wright
- Rory Meyers College of Nursing, New York University, New York, NY
| | | | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA
| | - Christine Miaskowski
- Department of Physiological Nursing, School of Nursing, University of California, San Francisco, CA
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Yu CH, Wang TJ, Chang CL, Liang SY, Wu SF, Liu CY, Lu YY. Healthy life styles, sleep and fatigue in endometrial cancer survivors: A cross-sectional study. J Clin Nurs 2020; 29:1372-1380. [PMID: 31970842 DOI: 10.1111/jocn.15189] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/10/2019] [Accepted: 01/10/2020] [Indexed: 12/24/2022]
Abstract
AIMS AND OBJECTIVES The primary aim of this study is to explore the influence of obesity, healthy lifestyle and sleep quality of endometrial cancer survivors on their fatigue level. BACKGROUND As many as 30% of endometrial cancer survivors still suffer from fatigue 5 years after completing therapy. Fatigue may hinder cancer survivors from participating in daily activities or returning to their original roles and functions, thus affecting their health-related quality of life. DESIGN This study adopted a cross-sectional correlational research design. The STROBE checklist for cross-sectional studies was used as a reference for reporting the study. METHODS A consecutive sample of 134 endometrial cancer survivors was recruited from the outpatient clinics of a medical centre in Taipei, Taiwan. Data were collected using structured questionnaires. RESULTS Study subjects scored 44 points (SD = 7.09) on average for the fatigue levels. Results of linear regression showed that sleep quality (ß = -0.38), comorbidity index (ß = -0.024) and age (ß = 0.20) were important predictors of fatigue. However, differences in obesity, vegetable and fruit intake, physical activity did not lead to significant differences in fatigue level. CONCLUSIONS Survivors who had poorer sleep quality, higher comorbidity index and younger age reported higher fatigue. RELEVANCE TO CLINICAL PRACTICE The study findings are relevant for assessing and preventing fatigue in endometrial cancer survivors. Those with poorer sleep quality, higher comorbidity index and younger age are at a greater risk for fatigue and deserve further attention. Although the study results failed to support the link between obesity, vegetable and fruit intake, physical activity and fatigue, the ratio of survivors who comply with recommended healthy lifestyles was low. Hence, it is of urgent necessity that this population receives the help to maintain a healthy lifestyle.
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Affiliation(s)
- Chia-Hui Yu
- Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Tsae-Jyy Wang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Chih-Long Chang
- Department of Medical Research, Department of Obstetrics and Gynecology, Mackay Memorial Hospital, Taipei, Taiwan, ROC
| | - Shu-Yuan Liang
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Shu-Fang Wu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
| | - Chieh-Yu Liu
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Science, Taipei, Taiwan, ROC
| | - Yu Ying Lu
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC
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Pai A, Sivanandh B, Udupa K. Quality of Sleep in Patients with Cancer: A Cross-sectional Observational Study. Indian J Palliat Care 2020; 26:9-12. [PMID: 32132776 PMCID: PMC7017701 DOI: 10.4103/ijpc.ijpc_164_19] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 09/12/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Insomnia and poor sleep quality are common problems in patients with cancer. It interferes with the coping ability, symptoms, and treatment outcomes. The Pittsburgh Sleep Quality Index (PSQI) is a reliable, valid instrument to assess the quality of sleep in patients with cancer. Patients and Methods: The study was conducted at the department of medical oncology of a tertiary cancer care center. Consecutive eligible participants were recruited and evaluated for sleep quality using PSQI questionnaire. The questionnaire was administered only once with the questions evaluating to the quality of sleep over the last 1 month. A PSQI total score of ≤5 was suggestive of good quality of sleep and a score of >5 was indicative of poor quality of sleep. Results: Ninety-two consecutive consenting cancer patients admitted for chemotherapy participated in the study. Thirty-one (33.7%) patients had early cancer and 35 (38%) patients had Stage IV metastatic disease. Thirty-six (39.1%) patients reported sleep of <6 h and 30 (32.6%) patients had impaired functioning during day due to sleepiness. Fifty-three (57.6%) patients had poor total PSQI score, of which 39 (73.5%) were female and 14 (26.5%) were male. The study showed no correlation of the PSQI scores with the stage of the disease, and the prior treatment received. Conclusions: The study showed that Indian cancer patients have short sleep duration and poor quality of sleep. A higher prevalence of sleep disturbances was seen among female cancer patients. PSQI questionnaire can be a cost-effective way of screening cancer patients for poor quality of sleep.
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Affiliation(s)
- Ananth Pai
- Department of Medical Oncology, Kasturba Hospital and College, Manipal Education of Higher Education, Manipal University, Manipal, Karnataka, India
| | - B Sivanandh
- Department of Psychiatry, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Karthik Udupa
- Department of Medical Oncology, Kasturba Hospital and College, Manipal Education of Higher Education, Manipal University, Manipal, Karnataka, India
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Chang WP, Chang YP. Meta-Analysis of Changes in Sleep Quality of Women with Breast Cancer before and after Therapy. Breast Care (Basel) 2019; 15:227-235. [PMID: 32774216 DOI: 10.1159/000502943] [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: 02/25/2019] [Accepted: 08/27/2019] [Indexed: 12/12/2022] Open
Abstract
Cancer treatments may affect the sleep quality and even future quality of life of women with breast cancer. A meta-analysis was performed to understand the changes in the sleep quality of women with breast cancer during their treatment period. In a systematic literature review in compliance with the PRISMA guidelines, we searched for articles published between 2000 and 2018 in databases. A total of 12 study articles were included. The standardized mean differences of the pooling effect size of sleep quality between the period before treatment and 1-8 weeks, 9-16 weeks, 17-24 weeks, and 25-56 weeks after the commencement of treatment were -0.020, -0.162, 0.075, and 0.216, respectively. Although the differences were not statistically significant, in view of the heterogeneity among the studies, we conducted further analysis using a linear mixed effect model. The overall results indicated poorer sleep quality as time passed from the start of the first treatment (p = 0.014). The results of this study revealed that patients experienced better sleep quality in the initial months after the beginning of treatment; however, their sleep quality became poorer between 4 months to approximately 1 year after the beginning of treatment, compared with the sleep quality before treatment, and continued to decline rather than improve during the follow-up period.
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Affiliation(s)
- Wen-Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Ministry of Health and Welfare, New Taipei City, Taiwan.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yu-Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, Ministry of Health and Welfare, New Taipei City, Taiwan
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Yoon HG, Park H. The effect of auricular acupressure on sleep in breast cancer patients undergoing chemotherapy: A single-blind, randomized controlled trial. Appl Nurs Res 2019; 48:45-51. [DOI: 10.1016/j.apnr.2019.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 03/28/2019] [Accepted: 05/07/2019] [Indexed: 10/26/2022]
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LeVan TD, Xiao P, Kumar G, Kupzyk K, Qiu F, Klinkebiel D, Eudy J, Cowan K, Berger AM. Genetic Variants in Circadian Rhythm Genes and Self-Reported Sleep Quality in Women with Breast Cancer. J Circadian Rhythms 2019; 17:6. [PMID: 31303884 PMCID: PMC6611482 DOI: 10.5334/jcr.184] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 06/05/2019] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Women diagnosed with breast cancer (BC) are at increased risk of sleep deficiency. Approximately 30-60% of these women report poor sleep during and following surgery, chemotherapy, radiation therapy, and anti-estrogen therapy. The purpose of this study was to examine the relationship between genetic variation in circadian rhythm genes and self-reported sleep quality in women with BC. METHODS This cross-sectional study recruited women with a first diagnosis of breast cancer at five sites in Nebraska and South Dakota. Sixty women were included in the study. Twenty-six circadian genes were selected for exome sequencing using the Nextera Rapid Capture Expanded Exome kit. 414 variants had a minor allele frequency of ≥5% and were included in the exploratory analysis. The association between Pittsburgh Sleep Quality Index (PSQI) score and genetic variants was determined by two-sample t-test or ANOVA. RESULTS Twenty-five variants were associated with the PSQI score at p < 0.10, of which 19 were significant at p<0.05, although the associations did not reach statistical significance after adjustment for multiple comparisons. Variants associated with PSQI were from genes CSNK1D & E, SKP1, BHLHE40 & 41, NPAS2, ARNTL, MYRIP, KLHL30, TIMELESS, FBXL3, CUL1, PER1&2, RORB. Two genetic variants were synonymous or missense variants in the BHLHE40 and TIMELESS genes, respectively. CONCLUSIONS These exploratory results demonstrate an association of genetic variants in circadian rhythm pathways with self-reported sleep in women with BC. Testing this association is warranted in a larger replication population.
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Affiliation(s)
| | - Peng Xiao
- University of Nebraska Medical Center, US
| | | | | | - Fang Qiu
- University of Nebraska Medical Center, US
| | | | - James Eudy
- University of Nebraska Medical Center, US
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Disruption of sleep, sleep-wake activity rhythm, and nocturnal melatonin production in breast cancer patients undergoing adjuvant chemotherapy: prospective cohort study. Sleep Med 2019; 55:14-21. [DOI: 10.1016/j.sleep.2018.11.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/10/2018] [Accepted: 11/28/2018] [Indexed: 11/21/2022]
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The effect of art therapy on the quality of life in patients with a gynecologic cancer receiving chemotherapy. Gynecol Oncol 2018; 152:334-338. [PMID: 30473256 DOI: 10.1016/j.ygyno.2018.11.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 11/12/2018] [Accepted: 11/16/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Most art therapy research has involved patients with malignancies other than gynecologic cancer. The current study aimed to assess the impact of an art therapy intervention on the quality of life (QOL) in patients with gynecologic cancer who were receiving chemotherapy. METHODS This was a prospective, non-randomized, pilot study. Eligible patients had a primary or recurrent gynecologic malignancy scheduled to be treated with at least 6 cycles of chemotherapy over 18 weeks. The intervention consisted of five sessions of art therapy during the chemotherapy. Patients completed a Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire prior to starting chemotherapy, and again at completion of the fifth session. Differences between the FACT-G scores were examined by paired t-tests. An increase in the mean FACT-G score indicated an improvement in QOL. At each session, the patients completed a separate, supplemental questionnaire to subjectively rate the benefit of the session and to express their experience with the art intervention. RESULTS Twenty-four patients enrolled. Eight did not complete the study, leaving 16 evaluable patients. The mean FACT-G score pre-chemotherapy was 82.3 (95% CI: 75.5, 89.2), and post-art therapy was 78.6 (95% CI: 71.7, 85.5). The mean change in QOL was -3.7 points (95% CI: -10.7, 3.2, p = 0.270). A supplemental questionnaire indicated that 15 of 16 patients felt that art therapy was beneficial at each session. CONCLUSIONS FACT-G scores did not significantly change over the course of chemotherapy in patients with gynecologic cancers receiving art therapy. Several published studies have indicated that chemotherapy is associated with a decline in QOL. Our results suggest art therapy may help to prevent or mitigate this decline.
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Berger AM, Kupzyk KA, Djalilova DM, Cowan KH. Breast Cancer Collaborative Registry informs understanding of factors predicting sleep quality. Support Care Cancer 2018; 27:1365-1373. [PMID: 30112722 DOI: 10.1007/s00520-018-4417-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/08/2018] [Indexed: 12/31/2022]
Abstract
SIGNIFICANCE Poor sleep quality is a common and persistent problem reported by women with breast cancer (BC). Empirical evidence identifies many risk factors for self-reported sleep deficiency, but inconsistencies limit translation to practice. PURPOSE To increase understanding of risk factors predicting self-reported poor sleep quality in women with BC who completed the Breast Cancer Collaborative Registry (BCCR) questionnaire. METHODS This cross-sectional study recruited women with a first diagnosis of BC (n = 1302) at five sites in Nebraska and South Dakota. Women completed the BCCR that includes numerous variables as well as the Pittsburgh Sleep Quality Index (PSQI) and SF36v2 (n = 1260). Descriptive statistics and non-parametric correlations were used to determine associations and create predictive models of sleep quality with BCCR variables and SF36v2 subscales. RESULTS Most women were white (93.7%) and married (71.5%); mean age was 60.1 (21-90) years. Poor sleep was self-reported by 53% of women. Seven variables were highly associated with sleep quality (p ≤ 0.001). The first model found younger age, lower physical activity, and higher fatigue were the strongest combined and independent variables predicting poor sleep quality (F = 23.0 (p < .001), R2 = 0.103). Participants self-reported lower health status on most SF36v2 subscales [Z = 44.9 (11.6) to 49.1 (10.1)]. A second model found that all subscales were predictors of poor sleep; vitality, mental health, bodily pain, and general health were the strongest predictors (F = 101.3 (p < .001), R2 = 0.26). CONCLUSIONS Results confirm previously identified risk factors and reveal inconsistencies in other variables. Clinicians need to routinely screen for the identified risk factors of self-reported poor sleep quality.
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Affiliation(s)
- Ann M Berger
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA.
| | - Kevin A Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Kenneth H Cowan
- Eppley Institute, Fred & Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, USA
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Habibi F, Habibi ME, Gharavinia A, Mahdavi SB, Akbarpour MJ, Baghaei A, Emami MH. Quality of life in inflammatory bowel disease patients: A cross-sectional study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:104. [PMID: 29026420 PMCID: PMC5629832 DOI: 10.4103/jrms.jrms_975_16] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/05/2017] [Accepted: 06/20/2017] [Indexed: 12/21/2022]
Abstract
Background: Inflammatory bowel disease (IBD) has a significant impact on health-related quality of life (HRQOL). This study aims to investigate the variables which can be attributed to HRQOL in IBD patients. Materials and Methods: Seventy-one patients filled in IBD questionnaire (IBDQ-32), Pittsburgh sleep quality index questionnaire, and sociodemographic questionnaire. Disease activity was assessed by Crohn's disease activity index (CDAI) and ulcerative colitis activity index (UCAI). The correlations of sleep quality, sociodemographic variables, and disease characteristics with IBDQ were investigated. Results: IBDQ-32 mean score was lower in patients who had hospitalization (P = 0.01), poor sleep quality (P < 0.001), anemia (P = 0.03), more severe disease (P = 0.01), and those who had not consumed folic acid (P = 0.01) relative to their counterparts. A multivariate regression analysis identified the predictors of decreased HRQOL as not consuming folic acid (P = 0.008), poor sleep quality (P = 0.014), and disease severity (P = 0.043). Conclusion: Impaired HRQOL was significantly associated with poor sleep quality, lack of folic acid consumption, and disease severity in IBD patients. Therefore, evaluation of folic acid level and efficacy of its supplementation in prospective studies is recommended. Treatment of sleep disturbance with pharmacological agents and nonpharmacological methods should be kept in mind as well.
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Affiliation(s)
- Farzaneh Habibi
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Emadoddin Habibi
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Gharavinia
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sadegh Baradaran Mahdavi
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Javad Akbarpour
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abdolmehdi Baghaei
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hassan Emami
- Gastrointestinal Diseases Research Center, Poursina Hakim Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Internal Medicine, Division of Gastroenterology, Isfahan University of Medical Sciences, Isfahan, Iran
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Kuo YH, Tsay SL, Chang CC, Liao YC, Tung HH. Cancer Impact, Complementary/Alternative Medicine Beliefs, and Quality of Life in Cancer Patients. J Altern Complement Med 2017; 24:276-281. [PMID: 28876080 DOI: 10.1089/acm.2016.0396] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The purpose of this study was to explore the relationships among cancer impact, belief in complementary and alternative medicine (CAM), CAM use, and quality of life (QOL). DESIGN The study used a cross-sectional, descriptive correlational design with convenience sampling. A total of 122 cancer patients participated. Data were collected at a medical center in Chunghua, Taiwan. The questionnaires included the Chinese version of the Cancer Problem in Living Scale (CPILS), Complementary and Alternative Medicine Belief Inventory (CAMBI), Complementary and Alternative Medicine scale, and Chinese versions of QOL scales, including the Functional Assessment of Cancer Therapy-General (FACT-G). RESULTS The mean age was 56.5 years, and most participants were male (n = 69, 56.6%), had completed high school or above (n = 56, 45.9%), and were married (n = 109, 89.3%). The most common type of cancer was oral (n = 17, 13.9%), followed by esophageal (n = 15, 12.3%) and colorectal (n = 13, 10.7%). Cancer patients, on average, use one or two types of CAM. The impact of cancer is significantly related to age (F = 7.12, p < 0.05), and income is related to QOL (F = 3.61, p < 0.05). Pearson correlations showed that the use of CAM was positively associated with belief in CAM (CAMBI) (r = 0.26, p = 0.01), and the impact of cancer was highly negatively associated with QOL (r = -0.71, p = 0.001). The predictors of QOL were the impact of cancer and use of CAM, and the impact of cancer accounted for 51% of the variance in QOL. CONCLUSION This study supports research on the impact of cancer, belief in CAM, and use of CAM as related to QOL in cancer patients. These results can be used to provide options to clinicians and cancer patients.
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Affiliation(s)
- Ya-Hui Kuo
- 1 Nursing Department, Chiayi Christian Hospital , Chiayi City, Taiwan, Republic of China
| | - Shiow-Luan Tsay
- 2 College of Nursing and Health Sciences, Da-Yeh University, Changhua, Taiwan, Republic of China
| | - Chun-Chi Chang
- 3 Chunghua Christian Hospital , Changjua City, Taiwan, Republic of China
| | - Yen-Chi Liao
- 1 Nursing Department, Chiayi Christian Hospital , Chiayi City, Taiwan, Republic of China
| | - Heng-Hsin Tung
- 4 National Taipei University of Nursing and Health Science , Taipei, Taiwan, Republic of China.,5 Tungs' Taichung MetroHarbor Hospital , Taiwan, Republic of China
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Kerner H, Samuels N, Ben Moshe S, Sharabi IS, Ben-Arye E. Impact of a patient-tailored complementary/integrative medicine programme on disturbed sleep quality among patients undergoing chemotherapy. BMJ Support Palliat Care 2017; 10:e21. [PMID: 28710110 DOI: 10.1136/bmjspcare-2017-001351] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVES The present study examined the impact of a patient-tailored complementary/integrative medicine (CIM) programme on sleep quality in patients undergoing chemotherapy for breast and gynaecological cancer. METHODS Study participants received standard supportive care, with or without weekly CIM treatments. Disturbed sleep quality was defined as a score of ≥4 on the Edmonton Symptom Assessment Scale (ESAS) or a score of ≥3 on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Adherence to integrative care was defined as attending ≥4 CIM treatments, with ≤30 days between each session. RESULTS Of 388 eligible patients, 264 (68%) reported disturbed sleep quality. Baseline-to-follow up assessment (at 6 weeks) was optimal for 104 patients in the treatment group and for 76 controls, with 75 of treated patients found to be adherent to the CIM intervention. Sleep-related ESAS scores improved more significantly in treated patients (p=0.008), as did sleep-related concerns on EORTC (treatment group, p=0.026). CONCLUSIONS A patient-tailored CIM programme may improve sleep quality and related concerns among patients with breast and gynaecological cancer undergoing chemotherapy. Further research is needed to better understand the impact of CIM on sleep quality in this patient population. TRIAL REGISTRATION NUMBER NCT01860365.
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Affiliation(s)
- Hilit Kerner
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel.,Family Medicine Department, Technion-Israel Institute of Technology, Haifa, Israel
| | - Noah Samuels
- Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Shlomi Ben Moshe
- Sleep Laboratory and Clinics, Clalit Health Services, Haifa and Western Galilee and Carmel Medical Center, Kiryat Bialik, Israel
| | - Ilanit Shalom Sharabi
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel.,Graduate Studies Authority, Haifa University, Haifa, Israel
| | - Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel.,Family Medicine Department, Technion-Israel Institute of Technology, Haifa, Israel
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Modifiable and non-modifiable characteristics associated with sleep disturbance in oncology outpatients during chemotherapy. Support Care Cancer 2017; 25:2485-2494. [PMID: 28281049 DOI: 10.1007/s00520-017-3655-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/20/2017] [Indexed: 01/09/2023]
Abstract
PURPOSE In a sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer who received at least two cycles of chemotherapy (CTX), the purposes were to evaluate for inter-individual differences in the severity of sleep disturbance and determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of sleep disturbance. METHODS A total of 1331 patients completed study questionnaires in their homes, at six time points over two cycles of CTX (prior to CTX administration, approximately 1 week after CTX administration, and approximately 2 weeks after CTX administration). Questionnaires included demographic, clinical, and symptom assessments (i.e., General Sleep Disturbance Scale, Lee Fatigue Scale, Center for Epidemiological Studies-Depression Scale, Spielberger State-Trait Anxiety Inventories, Attentional Function Index). Hierarchical linear modeling based on full maximum likelihood estimation was performed. RESULTS Characteristics associated with higher initial levels of sleep disturbance included higher body mass index, poorer functional status, higher trait anxiety, higher depressive symptoms, and higher evening fatigue. Characteristics associated with the worse trajectories of sleep disturbance were higher levels of education and higher sleep disturbance at enrollment. Characteristics associated with both higher initial levels and worse trajectories of sleep disturbance were higher morning fatigue and worse attentional function. CONCLUSIONS A large amount of inter-individual variability exists in sleep disturbance during CTX. The modifiable and non-modifiable characteristics found in this study can be used to identify higher risk patients and provide earlier interventions to reduce sleep disturbance.
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Mansano-Schlosser TC, Ceolim MF. Factors associated with poor sleep quality in women with cancer. Rev Lat Am Enfermagem 2017; 25:e2858. [PMID: 28301036 PMCID: PMC5363332 DOI: 10.1590/1518-8345.1478.2858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 11/21/2016] [Indexed: 11/22/2022] Open
Abstract
Objectives to analyze the factors associated with poor sleep quality, its characteristics and components in women with breast cancer prior to surgery for removing the tumor and throughout the follow-up. Method longitudinal study in a teaching hospital, with a sample of 102 women. The following were used: a questionnaire for sociodemographic and clinical characterization, the Pittsburgh Sleep Quality Index; the Beck Depression Inventory; and the Herth Hope Scale. Data collection covered from prior to the surgery for removal of the tumor (T0) to T1, on average 3.2 months; T2, on average 6.1 months; and T3, on average 12.4 months. Descriptive statistics and the Generalized Estimating Equations model were used. Results depression and pain contributed to the increase in the score of the Pittsburgh Sleep Quality Index, and hope, to the reduction of the score - independently - throughout follow-up. Sleep disturbances were the component with the highest score throughout follow-up. Conclusion the presence of depression and pain, prior to the surgery, contributed to the increase in the global score of the Pittsburgh Sleep Quality Index, which indicates worse quality of sleep throughout follow-up; greater hope, in its turn, influenced the reduction of the score of the Pittsburgh Sleep Quality Index.
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Affiliation(s)
- Thalyta Cristina Mansano-Schlosser
- Post-doctoral fellow, Faculdade de Enfermagem, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil. Scholarship holder from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Maria Filomena Ceolim
- Associate Professor, Faculdade de Enfermagem, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Zhou ES, Partridge AH, Syrjala KL, Michaud AL, Recklitis CJ. Evaluation and treatment of insomnia in adult cancer survivorship programs. J Cancer Surviv 2017; 11:74-79. [PMID: 27495283 PMCID: PMC5865603 DOI: 10.1007/s11764-016-0564-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/26/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Insomnia is commonly experienced by cancer survivors. Chronic insomnia is associated with significant physical and psychosocial consequences if not properly treated. Both the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) recommend the evaluation of sleep disturbances and evidence-based treatment of insomnia during routine survivorship care. To better understand current clinical practices, we conducted a survey of major cancer centers across the United States (US). METHODS Adult survivorship programs at the 25 US cancer centers that are both NCI-designated comprehensive cancer centers and NCCN member institutions were surveyed about the evaluation and treatment of insomnia in their hospital. RESULTS All institutions responded to the survey. Thirteen centers (56 %) reported screening <25 % of survivors for sleep disorders, and few clinicians providing survivorship care were well-prepared to conduct a proper sleep evaluation. Insomnia was most commonly treated with sleep hygiene, or pharmacotherapy, rather than cognitive-behavioral therapy. No program reported that >50 % of their survivors were receiving optimal insomnia-related care. A variety of methods to improve insomnia care were endorsed by respondents. CONCLUSIONS There is a clear need to improve the evaluation and treatment of insomnia for cancer survivors at institutions across the country. Cancer centers deemed a number of modalities relevant for improving provider confidence in addressing sleep challenges. IMPLICATIONS FOR CANCER SURVIVORS To improve the quality of insomnia care for survivors, systematic interventions to increase standardized screening for sleep disorders, providing additional sleep medicine training for survivorship clinicians, and optimizing the role of sleep medicine specialists in the oncology setting should be considered.
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Affiliation(s)
- Eric S Zhou
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Ann H Partridge
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Seattle, WA, 98109, USA
| | - Alexis L Michaud
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Christopher J Recklitis
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
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Lira FS, Esteves AM, Pimentel GD, Rosa JC, Frank MK, Mariano MO, Budni J, Quevedo J, Santos RVD, de Mello MT. Sleep pattern and locomotor activity are impaired by doxorubicin in non-tumor-bearing rats. ACTA ACUST UNITED AC 2016; 9:232-235. [PMID: 28123667 PMCID: PMC5241611 DOI: 10.1016/j.slsci.2016.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 10/20/2016] [Accepted: 10/27/2016] [Indexed: 02/01/2023]
Abstract
Purpose We sought explore the effects of doxorubicin on sleep patterns and locomotor activity. To investigate these effects, two groups were formed: a control group and a Doxorubicin (DOXO) group. Methods Sixteen rats were randomly assigned to either the control or DOXO groups. The sleep patterns were examined by polysomnographic recording and locomotor activity was evaluated in an open-field test. Results In the light period, the total sleep time and slow wave sleep were decreased, while the wake after sleep onset and arousal were increased in the DOXO group compared with the control group (p<0.05). In the dark period, the total sleep time, arousal, and slow wave sleep were increased, while the wake after sleep onset was decreased in the DOXO group compared with the control group (p<0.05). Moreover, DOXO induced a decrease of crossing and rearing numbers when compared control group (p<0.05). Conclusions Therefore, our results suggest that doxorubicin induces sleep pattern impairments and reduction of locomotor activity.
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Affiliation(s)
- Fabio Santos Lira
- Exercise and Immunometabolism Research Group, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | | | - Gustavo Duarte Pimentel
- Laboratory of Research in Clinical Nutrition and Sports (Labince), Nutrition Faculty (FANUT), Federal University of Goias (UFG), Goiânia, GO, Brazil
| | - José Cesar Rosa
- Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP, Brazil
| | | | | | - Josiane Budni
- Laboratory of Neurosciences, National Institute for Translational Medicine, and Center of Excellence in Applied Neurosciences of Santa Catarina, Postgraduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, 88806-000 Criciúma, SC, Brazil
| | - João Quevedo
- Laboratory of Neurosciences, National Institute for Translational Medicine, and Center of Excellence in Applied Neurosciences of Santa Catarina, Postgraduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, 88806-000 Criciúma, SC, Brazil
| | | | - Marco Túlio de Mello
- Departamento de Esportes, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Boyle T, Vallance JK, Buman MP, Lynch BM. Reallocating Time to Sleep, Sedentary Time, or Physical Activity: Associations with Waist Circumference and Body Mass Index in Breast Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2016; 26:254-260. [PMID: 27780817 DOI: 10.1158/1055-9965.epi-16-0545] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2016] [Revised: 09/27/2016] [Accepted: 10/10/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Moderate-to-vigorous intensity physical activity (MVPA) is inversely associated with waist circumference and body mass index (BMI) among breast cancer survivors. Limited research has focused on behaviors that account for larger portions of the day [sleep, sedentary time, and light-intensity physical activity (LPA)]. We investigated the interdependent associations of self-reported sleep, objectively assessed prolonged and short bouts of sedentary time, total LPA, and total MVPA with waist circumference and BMI. METHODS A cross-sectional sample of breast cancer survivors (N = 256, mean age = 60 years; mean time since diagnosis = 3 years) wore an Actigraph GT3X+ accelerometer during waking hours for 7 days. Participants completed the Pittsburgh Sleep Quality Index and self-reported their waist circumference, height, and weight. An isotemporal substitution approach was used in linear regression models to explore the associations of reallocating time to sleep, sedentary and active behaviors on waist circumference, and BMI, after adjusting for potential confounders. RESULTS Reallocating 30 minutes to MVPA was significantly associated with lower waist circumference when allocated from sleep (-2.50 cm), prolonged sedentary time (-2.51 cm), or LPA (-2.71 cm). Reallocating 30 minutes of prolonged sedentary time to nonprolonged sedentary time was significantly associated with lower waist circumference (-0.94 cm). Similar results were observed for BMI. CONCLUSIONS Reallocating 30 minutes to MVPA was associated with significantly lower waist circumference and BMI, as was reallocating 30 minutes of prolonged sedentary time to 30 minutes of nonprolonged sedentary time. IMPACT Increasing MVPA levels and decreasing time spent in prolonged, unbroken sedentary bouts may be avenues for improving body composition in this population. Cancer Epidemiol Biomarkers Prev; 26(2); 254-60. ©2016 AACR.
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Affiliation(s)
- Terry Boyle
- School of Public Health, Curtin University, Perth, Western Australia, Australia. .,Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.,Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Jeff K Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona
| | - Brigid M Lynch
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria, Australia.,School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.,Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
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Mansano-Schlosser TC, Ceolim MF. Variação longitudinal da qualidade do sono em mulheres com câncer de mama. ACTA PAUL ENFERM 2016. [DOI: 10.1590/1982-0194201600082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Objetivo: Comparar a qualidade do sono, a depressão e a esperança em mulheres com câncer de mama ao longo de aproximadamente um ano. Métodos: Estudo longitudinal, com 107 mulheres, em hospital universitário. Foram utilizados os instrumentos: questionário de caracterização sociodemográfica e clínica; Índice de Qualidade do Sono de Pittsburgh; Inventário de Depressão de Beck e Escala de Esperança de Herth. Os dados foram coletados em T0, antes da cirurgia de retirada do tumor, e após a mesma em: T1, em média 3,2 meses; T2, em média 6,1 meses; em T3, em média 12,4 meses. Resultados: A má qualidade do sono persistiu ao longo do seguimento; a esperança aumentou em T1; a proporção de mulheres com depressão moderada e grave elevou-se em T3. Houve correlação significativa entre os escores indicativos de qualidade do sono, de depressão e de esperança nos quatro tempos. Conclusão: Os achados deste estudo indicam a importância do seguimento por tempo prolongado.
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Li CC, Tsai YF, Chang TC, Chen L. Associations among menopausal symptoms, sleep and fatigue in Taiwanese women with endometrial cancer. Eur J Cancer Care (Engl) 2016; 26. [DOI: 10.1111/ecc.12559] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Chia-Chun Li
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Yun-Fang Tsai
- School of Nursing; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
| | - Ting-Chang Chang
- Department of Obstetrics and Gynecology; College of Medicine; Chang Gung University; Tao-Yuan Taiwan
- Department of Obstetrics and Gynecology; Chang Gung Memorial Hospital; Tao-Yuan Taiwan
| | - Lynn Chen
- School of Nursing; University of Maryland at Baltimore; Baltimore MD USA
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Acupoint stimulation, massage therapy and expressive writing for breast cancer: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2016; 27:87-101. [PMID: 27515882 DOI: 10.1016/j.ctim.2016.06.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 03/23/2016] [Accepted: 06/10/2016] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Researches have accumulated using non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing to manage breast cancer-related symptoms. Results from randomized controlled trials (RCTs) can get contradictory. OBJECTIVE A systematic review and meta-analysis were conducted to determine the effects on the quality of life, negative emotions and disease-related symptoms among women with breast cancer. METHODS Two independent researchers performed a structured search using data sources including MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, PubMed and PsychINFO from the beginning of time until the first week of January 2015. A total of 23 acupoint stimulation, massage therapy and expressive writing RCTs were included in the review. RESULTS The study showed that no single intervention could be put under the spotlight exhibiting an overall effective result on all measured outcomes; however, looking into each one in detail shows different results in specific outcomes. Among the three interventions, acupoint stimulation has a treatment effect for general pain (MD=-1.46, 95% CI=-2.38 to -0.53) and fatigue (MD=-2.22, 95% CI=-3.68 to -0.77), massage therapy has a treatment effect for anxiety (MD=-0.50, 95% CI=-0.77 to -0.24), and expressive writing has a treatment effect for quality of life (MD=7.18, 95% CI=0.38 to 13.98). The measurement other outcomes showed either ineffective or equivocal results. CONCLUSION Non-pharmacologic interventions including acupoint stimulation, massage therapy and expressive writing have an effect on a middle-age woman with breast cancer. However, because of limitations, the seemingly promising results should be interpreted with caution.
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