One-Year Outcomes of a Behavioral Therapy Intervention Trial on Sleep Quality and Cancer-Related Fatigue
One-Year Outcomes of a Behavioral Therapy Intervention Trial on Sleep Quality and Cancer-Related Fatigue
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DOI：
10.1200/jco.2008.20.8306
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发表时间：
2009-12-10
影响因子：
45.3
通讯作者：
Agrawal, Sangeeta
中科院分区：
文献类型：
--
作者：
Berger, Ann M.;Kuhn, Brett R.;Agrawal, Sangeeta
PurposeTo确定1年的结果，四个组成部分的行为疗法（BT）的睡眠干预（个性化的睡眠促进计划[ISPP]）与健康饮食控制（HEC）对癌症相关的疲劳妇女接受乳腺癌辅助化疗treatment（CTX）.Patients and MethodsA共有219名参与者从12个肿瘤诊所被随机分配在临床试验。在CTX之前，研究护士指导干预参与者制定BT计划，包括刺激控制，修改睡眠限制，放松疗法和睡眠卫生。在每次CTX前和末次CTX后30、60和90天修改BT计划，并在7 ~ 9天后进行加固。HEC的参与者获得了营养信息和同等关注。匹兹堡睡眠质量指数（PSQI），每日日记，腕动仪，和派珀疲劳量表的措施和重复线性混合模型分析后，意向治疗paradig.ResultsSleep质量差异超过1年的时间（F [4，162] = 7.7，P <0.001;按组，F [1，173] = 4.8，P = 0.029;按组随时间推移，F [4，162] = 3.3，P = 0.013）。两两比较显示两组在90天（P = 0.002）时存在显著差异，但在1年时无显著差异（P = 0.052）。七天的日记和体动记录数据与每月反思（PSQI）并不相符。随着时间的推移，各组的夜间觉醒（Activograph）模式存在显著差异（P = 0.046），在90天或1年时，两组之间没有差异。1年时的疲劳程度低于CTX治疗前;未发现任何组效应。结论与HEC组相比，BT组的总体睡眠质量平均有显着改善，但客观睡眠或疲劳结果没有改善。
PurposeTo determine 1-year outcomes of a four-component behavioral therapy (BT) sleep intervention (Individualized Sleep Promotion Plan [ISPP]) versus a healthy eating control (HEC) on cancer-related fatigue in women receiving breast cancer adjuvant chemotherapy treatment (CTX).Patients and MethodsA total of 219 participants from 12 oncology clinics were randomly assigned in a clinical trial. Before CTX, research nurses coached intervention participants to develop a BT plan including stimulus control, modified sleep restriction, relaxation therapy, and sleep hygiene. BT plans were revised before each CTX and 30, 60, and 90 days after the last CTX and reinforced 7 to 9 days later. HEC participants received nutritional information and equal attention. Pittsburgh Sleep Quality Index (PSQI), Daily Diary, Wrist Actigraph, and Piper Fatigue Scale measures and Repeated Linear Mixed Model analysis following the Intent to Treat paradigm were used.ResultsSleep quality differed over 1 years time (F [4,162] = 7.7, P < .001; by group, F [1,173] = 4.8, P = .029; and over time by group, F [4,162] = 3.3, P = .013). Pairwise comparisons revealed significant differences between groups at 90 days (P = .002) but not at 1 year (P = .052). Seven days of diary and actigraphy data did not corroborate with monthly reflections (PSQI). The night awakenings (Actigraph) pattern was significantly different by group over time (P = .046), with no differences between groups at 90 days or at 1 year. Fatigue was lower at 1 year than before CTX; no group effects were found.ConclusionThe BT group, on average, experienced significant improvement on global sleep quality compared with the HEC group, but not on objective sleep or fatigue outcomes.