Longitudinal prospective assessment of sleep quality: before, during, and after adjuvant chemotherapy for breast cancer
Longitudinal prospective assessment of sleep quality: before, during, and after adjuvant chemotherapy for breast cancer
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DOI：
10.1007/s00520-012-1612-7
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发表时间：
2013-04-01
影响因子：
3.1
通讯作者：
Cella, David
中科院分区：
文献类型：
--
作者：
Sanford, Stacy D.;Wagner, Lynne I.;Cella, David
横断面数据表明，许多乳腺癌患者在整个护理过程中都会经历严重的睡眠障碍。了解睡眠障碍的纵向轨迹可能有助于确定与其发病、严重程度或对健康相关生活质量（HRQL）影响相关的因素。研究目的是观察乳腺癌患者辅助化疗前、化疗期间和化疗结束后的睡眠质量，评估其与HRQL的关系，并探索相关性，参与者接受患者报告的结果测量，包括匹兹堡睡眠质量指数（PSQI）和癌症治疗功能评估（FACT-G），评估HRQL。在开始化疗前3-14天、化疗第4周期第1天和化疗开始后6个月前瞻性收集数据。参与者（n = 80）主要是II期（69.0%）乳腺癌女性（97.5%）。在每个时间点，总FACT-G评分与总体PSQI评分呈负相关（rho =-0.46、-0.41、-0.45;所有p < 0.001）。睡眠质量差（PSQI a千分之五）在所有时间点都很普遍（48.5- 65.8%）;然而，随着时间的推移，参与者中没有显着变化。与睡眠质量的相关性在不同时间点有所不同。睡眠质量差的受试者报告总体HRQL、疲劳、抑郁和血管/内分泌症状更差，这些结果表明，在护理过程中，早期识别睡眠障碍和持续评估和治疗相关因素可能会最大限度地减少与化疗相关的症状负担，并预防生存期内的慢性失眠。
Cross-sectional data suggest that many individuals with breast cancer experience significant sleep disturbance across the continuum of care. Understanding the longitudinal trajectory of sleep disturbance may help identify factors associated with its onset, severity, or influence on health-related quality of life (HRQL). Study objectives were to observe sleep quality in breast cancer patients prior to, during, and after completion of adjuvant chemotherapy, evaluate its relationship with HRQL and explore correlates over time.Participants were administered patient-reported outcome measures including the Pittsburgh Sleep Quality Index (PSQI) and the Functional Assessment of Cancer Therapy-General (FACT-G), which assesses HRQL. Data were collected prospectively 3-14 days prior to beginning chemotherapy, cycle 4 day 1 of chemotherapy, and 6 months following initiation of chemotherapy.Participants (n = 80) were primarily women (97.5 %) with stage II (69.0 %) breast cancer. Total FACT-G scores were negatively correlated with global PSQI scores at each time point (rho = -0.46, -0.41, -0.45; all p < 0.001). Poor sleep quality (PSQI a parts per thousand yen 5) was prevalent at all time points (48.5-65.8 %); however, there were no significant changes within participants over time. Correlates with sleep quality varied across time points. Participants with poor sleep quality reported worse overall HRQL, fatigue, depression, and vasomotor/endocrine symptoms.These findings suggest that early identification of sleep disturbance and ongoing assessment and treatment of contributing factors over the course of care may minimize symptom burden associated with chemotherapy and prevent chronic insomnia in survivorship.