Berger A M, Higginbotham P
College of Nursing, University of Nebraska Medical Center, Omaha, USA.
Oncol Nurs Forum. 2000 Oct;27(9):1443-8.
PURPOSE/OBJECTIVES: To examine patterns of and relationships between activity, sleep, symptom distress, health status, and fatigue during and following adjuvant breast cancer chemotherapy with doxorubicin and cyclophosphamide.
Prospective, descriptive, repeated measures.
Midwestern, urban, oncology clinics.
14 women, ages 32-69 (X = 52.4), with stage I or II breast cancer receiving four cycles of chemotherapy.
Wrist actigraph, modified Morin Sleep Diary, Symptom Experience Scale, Medical Outcomes Study-Short Form 36, and Piper Fatigue Scale were used to collect data two days prior to and during the 21-day cycle 3, and for three days at three weeks and two months following treatment 4.
Activity, sleep, symptom distress, health status, and fatigue.
Fluctuating patterns of lowered activity, disturbed sleep, mild-to-moderate symptom distress, and moderate fatigue were identified. Mean activity levels ranged from 65%-80% of norms during and following treatments. Patterns of sleep (total rest, sleep latency, wake after sleep onset, and sleep efficiency) differed from established norms. Patients experienced the highest levels of fatigue and symptom distress during the first four days after treatment 3. Correlates of fatigue were greater symptom distress, lower activity, and poorer physical and social health status; variables representing disturbed sleep trended toward associations with fatigue.
Activity, sleep, symptom distress, and health status cluster in patterns associated with either lower or higher fatigue.
Efforts to manage symptoms, remain active, and obtain quality sleep, especially in women with poorer health status, may assist in modifying fatigue.
目的/目标：研究在使用多柔比星和环磷酰胺进行辅助性乳腺癌化疗期间及之后，活动、睡眠、症状困扰、健康状况和疲劳之间的模式及关系。
前瞻性、描述性、重复测量。
中西部城市肿瘤诊所。
14名年龄在32 - 69岁（平均年龄 = 52.4岁）的I期或II期乳腺癌女性患者，她们正在接受四个周期的化疗。
使用腕部活动记录仪、改良的莫林睡眠日记、症状体验量表、医学结局研究简表36以及派珀疲劳量表，在第3周期21天的化疗前2天、化疗期间以及治疗4结束后的3周和2个月各3天收集数据。
活动、睡眠、症状困扰、健康状况和疲劳。
确定了活动减少、睡眠紊乱、轻至中度症状困扰和中度疲劳的波动模式。治疗期间及之后，平均活动水平为正常水平的65% - 80%。睡眠模式（总休息时间、入睡潜伏期、睡眠中觉醒时间和睡眠效率）与既定标准不同。患者在治疗3后的头4天经历了最高水平的疲劳和症状困扰。疲劳的相关因素包括更大的症状困扰、更低的活动水平以及更差的身体和社会健康状况；代表睡眠紊乱的变量有与疲劳相关的趋势。
活动、睡眠、症状困扰和健康状况以与较低或较高疲劳相关的模式聚集。
管理症状、保持活动以及获得优质睡眠的努力，尤其是对于健康状况较差的女性，可能有助于改善疲劳。
