Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy
Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy
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DOI：
10.1188/08.onf.635-642
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发表时间：
2008-07-01
影响因子：
1.9
通讯作者：
Shaw, Heather
中科院分区：
文献类型：
--
作者：
Payne, Judith K.;Held, Joanne;Shaw, Heather
目的/目的：比较在接受激素治疗的乳腺癌老年妇女中，以家庭为基础的步行运动干预与常规护理的有效性，并检查皮质醇、血清素、白细胞介素-6和胆红素生物标志物水平与疲劳、睡眠障碍和抑郁症状之间的关系。设计：纵向随机临床试验。地点：美国东南部国家癌症研究所指定的癌症中心。样本：20名接受激素治疗的乳腺癌女性（55岁或以上）。方法：参与者随机分为步行运动干预组和常规护理组。实验室样本和匹兹堡睡眠质量指数（PSQI）， Piper修正疲劳量表和流行病学研究中心抑郁量表在第一次诊所访问和12周时从各组收集。在第2周和第14周收集问卷。主要研究变量：疲劳、睡眠障碍、抑郁症状、生物标志物和运动。结果：运动干预对睡眠评分的影响在两组间有显著性差异。运动组的PSQI得分随着时间的推移显著下降（表明睡眠质量得到改善），尽管对照组的得分没有显著变化。睡眠活动记录仪还显示，锻炼组的实际清醒时间明显缩短，活动量明显减少。血清素水平也受到干预的显著影响。结论：数据表明，步行运动干预可以改善接受激素治疗的乳腺癌老年妇女的睡眠，血清素水平可能是评估该组睡眠障碍的有用生物标志物。对护理的启示：临床医生需要意识到，接受激素治疗乳腺癌的老年妇女可能会出现疲劳、睡眠障碍和抑郁症状。在这个群体中，以家庭为基础的步行活动可以减轻症状的严重程度。
Purpose/Objectives: To compare the effectiveness of a prescribed home-based walking exercise intervention with usual care in older women receiving hormonal treatment for breast cancer, and to examine relationships among levels of the cortisol, serotonin, interleukin-6, and bilirubin biomarkers and fatigue, sleep disturbances, and depressive symptoms.Design: Longitudinal randomized clinical trial.Setting: A National Cancer Institute-designated cancer center in the southeastern United States.Sample: 20 women (aged 55 years or older) with breast cancer receiving hormonal treatment.Methods: Participants were randomized to a walking exercise intervention or usual care. Laboratory samples and the Pittsburgh Sleep Quality Index (PSQI), the Piper Revised Fatigue Scale, and the Center for Epidemiological Studies-Depression Scale were collected at the initial clinic visit and at 12 weeks from the groups. Questionnaires also were collected at weeks 2 and 14.Main Research Variables: Fatigue, sleep disturbances, depressive symptoms, biomarkers, and exercise.Findings: Effect of the exercise intervention on sleep scores was highly significant between groups. Exercise group scores on the PSQI decreased significantly over time (indicating improved sleep quality), although scores did not change significantly within the control group. Sleep actigraphy also showed significantly shorter actual wake time and less movement in the exercise group. Serotonin levels also were significantly affected by the intervention.Conclusions: Data suggest that a walking exercise intervention improves sleep in older women receiving hormonal treatment for their breast cancer Serotonin levels may be a useful biomarker when assessing sleep disturbances in this group.Implications for Nursing: Clinicians need to be aware that older women receiving hormonal treatment for their breast cancer may experience fatigue, sleep disturbances, and depressive symptoms. Homebased walking activity may reduce symptom severity in this group.