Association Between Self-Reported Sleep Disturbance and Other Symptoms in Patients with Advanced Cancer
Association Between Self-Reported Sleep Disturbance and Other Symptoms in Patients with Advanced Cancer
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DOI：
10.1016/j.jpainsymman.2010.07.015
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发表时间：
2011-05-01
影响因子：
4.7
通讯作者：
Bruera, Eduardo
中科院分区：
文献类型：
--
作者：
Delgado-Guay, Marvin;Yennurajalingam, Sriram;Bruera, Eduardo
上下文睡眠障碍（SD）是癌症患者痛苦的重要来源。对接受姑息治疗的晚期癌症患者的研究以确定与SD严重程度相关的症状是有限的。在这项研究中，我们试图确定与SD相关的埃德蒙顿症状评估量表（ESAS）测量的症状，如匹兹堡睡眠质量指数（PSQI）测量的。该研究的次要目的是确定SD的发生与其他症状的发生之间的关联，以及ESAS-睡眠项目对PSQI的筛选性能。我们回顾了101例晚期癌症患者完成的ESAS和PSQI评估，这些患者正在接受姑息治疗，并已被纳入我们先前发起的前瞻性临床试验。PSQI评分>= 5的患者被认为具有SD。计算ESAS症状项目的频率和严重程度、它们之间的相关性、PSQI评分以及ESAS-睡眠项目的筛选性能。患者的中位年龄为60岁。大多数是非西班牙裔的白色人（73%），患有肺癌或乳腺癌（41%），并被诊断为SD（85%）。PSQI评分与ESAS疼痛（r = 0.27，P = 0.006）、呼吸困难（r = 0.25，P < 0.001）、幸福感（r = 0.35，P < 0.0001）和睡眠（r = 0.44，P < 0.0001）相关。与非SD患者相比，SD患者更容易报告疼痛（P = 0.0132）、抑郁（P = 0.019）、焦虑（P = 0.01）和较差的幸福感（P = 0.035）。ESAS-Sleep项目临界评分>= 3（10分）导致敏感性为74%，特异性为73%。SD与疼痛、抑郁、焦虑的频率增加和幸福感下降有关。这四个症状应该在所有患有晚期癌症并主诉SD的患者中进行评估。筛查SD的ESAS-睡眠项目的理想截止点是评分>= 3。需要更多的研究来更好地描述这种频繁和令人痛苦的综合征。J Pain Symptom Manage 2011; 41：819-827.爱思唯尔公司出版代表美国癌症疼痛缓解委员会
Context. Sleep disturbance (SD) is a significant source of distress for patients with cancer. Studies of patients with advanced cancer receiving palliative care to identify symptoms associated with the severity of SD are limited.Objectives. In this study, we sought to identify the symptoms measured by the Edmonton Symptom Assessment Scale (ESAS) that are associated with SD, as measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary aims of the study were to determine the association between occurrences of SD with occurrences of other symptoms and screening performance of the ESAS-Sleep item against the PSQI.Methods. We reviewed the completed ESAS and PSQI assessments of 101 patients with advanced cancer who were receiving palliative care and had been admitted to prospective clinical trials previously initiated by us. Patients with a PSQI score of >= 5 were considered to have an SD. The frequency and severity of the ESAS symptoms items, their correlation with each other, the PSQI score, and the screening performance of the ESAS-Sleep item were calculated.Results. The median age of patients was 60 years. Most were white non-Hispanic (73%), had lung or breast cancer (41%), and were diagnosed with SD (85%). The PSQI score was correlated with the ESAS items of pain (r - 0.27, P - 0.006), dyspnea (r = 0.25, P < 0.001), well-being (r = 0.35, P < 0.0001), and sleep (r = 0.44, P < 0.0001). Compared with patients without SD, those with SD were more likely to report pain (P = 0.0132), depression (P = 0.019), anxiety (P = 0.01), and a poorer sense of well-being (P = 0.035). An ESAS-Sleep item cutoff score of >= 3 (of 10) resulted in a sensitivity of 74% and a specificity of 73%.Conclusion. SD is associated with increased frequency of pain, depression, anxiety, and a worse sense of well-being. These four symptoms should be assessed in all patients with advanced cancer with a complaint of SD. The ideal cutoff point of the ESAS-Sleep item for screening for SD is a score of >= 3. More research is needed to better characterize this frequent and distressing syndrome. J Pain Symptom Manage 2011; 41:819-827. Published by Elsevier Inc. on behalf of U.S. Cancer Pain Relief Committee.