Modifiable and non-modifiable characteristics associated with sleep disturbance in oncology outpatients during chemotherapy.
Modifiable and non-modifiable characteristics associated with sleep disturbance in oncology outpatients during chemotherapy.
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DOI：
10.1007/s00520-017-3655-2
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发表时间：
2017-08
期刊：
影响因子：
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通讯作者：
Miaskowski C
中科院分区：
文献类型：
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作者：
Mark S;Cataldo J;Dhruva A;Paul SM;Chen LM;Hammer MJ;Levine JD;Wright F;Melisko M;Lee K;Conley YP;Miaskowski C
在接受至少两个周期化疗(CTX)的乳腺癌、胃肠道癌症、妇科和肺癌门诊患者样本中，目的是：评估睡眠障碍严重程度的个体差异，并确定哪些人口统计学、临床和症状特征与初始水平以及睡眠障碍的轨迹有关。共有1331名患者在家中完成了研究问卷，在两个周期的6个时间点(CTX注射前、CTX注射后约1周和CTX注射后约2周)。问卷包括人口统计学、临床和症状评估(即一般睡眠障碍量表、Lee疲劳量表、流行病学研究中心抑郁量表、斯皮尔伯格状态-特质焦虑量表、注意功能指数)。进行了基于完全极大似然估计的分层线性建模。与初始睡眠障碍水平较高相关的特征包括：较高的身体质量指数、较差的功能状态、较高的特质焦虑、较高的抑郁症状和较高的晚间疲劳感。与较差的睡眠障碍轨迹相关的特征是较高的教育水平和注册时较高的睡眠障碍。与较高的初始睡眠水平和较差的睡眠障碍轨迹相关的特征是较高的晨间疲劳感和较差的注意力功能。CTX期间睡眠障碍存在着大量的个体间变异。这项研究中发现的可修改和不可修改的特征可用于识别高危患者，并提供早期干预以减少睡眠障碍。
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. A total of 1,331 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. 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. 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.