Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy
Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy
复制标题
乳腺癌化疗患者的睡眠障碍和癌因性疲乏症状群
DOI：
10.1007/s00520-019-04834-w
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发表时间：
2020-02-01
影响因子：
3.1
通讯作者：
Malcarne, Vanessa L.
中科院分区：
文献类型：
--
作者：
Fox, Rina S.;Ancoli-Israel, Sonia;Malcarne, Vanessa L.
睡眠障碍和癌症相关性疲劳（CRF）是与乳腺癌及其治疗相关的最常见症状之一。本研究基于化疗前和化疗期间睡眠障碍和CRF的多维评估，确定了乳腺癌患者的症状群。研究对象为152例I-IIIA期乳腺癌患者。数据收集于化疗前（T1）和第四个化疗周期的最后一周（T2）。使用潜在剖面分析来得出每个时间点的患者组，这些患者在每次活动图的白天和夜间睡眠百分比、匹兹堡睡眠质量指数总体得分和多维疲劳症状清单-短表格的五个子量表上得分相似。双变量逻辑回归评估T1时的社会人口学/医学特征是否与每个时间点的群体成员关系相关。结果T1时分为3组（疲劳伴睡眠主诉、平均、轻微症状），T2时分为5组（重度疲劳伴睡眠差、情绪疲劳伴睡眠一般、身体疲劳伴睡眠一般、平均、轻微症状）。在T1时症状更严重的一组中的大多数个体在T2时也属于症状更严重的一组。T1时的社会人口学/医学变量与T1和T2时的群体成员关系显著相关。结论：本研究确定了化疗前和化疗期间存在不同程度睡眠障碍和CRF症状的乳腺癌患者组。确定具有不同症状管理需求的群体，并根据基线社会人口统计学/医学变量区分群体，可以确定有更大症状负担风险的患者。
Purpose Sleep disturbance and cancer-related fatigue (CRF) are among the most commonly reported symptoms associated with breast cancer and its treatment. This study identified symptom cluster groups of breast cancer patients based on multidimensional assessment of sleep disturbance and CRF prior to and during chemotherapy. Methods Participants were 152 women with stage I-IIIA breast cancer. Data were collected before chemotherapy (T1) and during the final week of the fourth chemotherapy cycle (T2). Latent profile analysis was used to derive groups of patients at each timepoint who scored similarly on percent of the day/night asleep per actigraphy, the Pittsburgh Sleep Quality Index global score, and the five subscales of the Multidimensional Fatigue Symptom Inventory-Short Form. Bivariate logistic regression evaluated if sociodemographic/medical characteristics at T1 were associated with group membership at each timepoint. Results Three groups (Fatigued with sleep complaints, Average, Minimal symptoms) were identified at T1, and five groups (Severely fatigued with poor sleep, Emotionally fatigued with average sleep, Physically fatigued with average sleep, Average, Minimal symptoms) at T2. The majority of individuals in a group characterized by more severe symptoms at T1 were also in a more severe symptom group at T2. Sociodemographic/medical variables at T1 were significantly associated with group membership at T1 and T2. Conclusions This study identified groups of breast cancer patients with differentially severe sleep disturbance and CRF symptom profiles prior to and during chemotherapy. Identifying groups with different symptom management needs and distinguishing groups by baseline sociodemographic/medical variables can identify patients at risk for greater symptom burden.