Berger Ann M, Grem Jean L, Visovsky Constance, Marunda Heather A, Yurkovich Justin M
University of Nebraska Medical Center in Omaha, USA.
Oncol Nurs Forum. 2010 Nov;37(6):E359-69. doi: 10.1188/10.ONF.E359-E369.
PURPOSE/OBJECTIVES: To examine patterns of fatigue and other variables (sleep quality, sleep-wake variables, activity and rest, circadian rhythms, quality of life [QOL], blood counts, and demographic and medical variables) during colon and rectal cancer adjuvant chemotherapy, as well as feasibility of the study.
Longitudinal, descriptive feasibility study.
Two oncology clinics in the midwestern region of the United States.
From April 2006-December 2008, 27% of screened subjects (n = 21) enrolled and 14 completed the study. Participants were middle aged, partnered, and employed and had postsecondary education.
Measurements completed during the first week of three two-week cycles (chemotherapy 1-3) and at six weeks (before chemotherapy 4) were the Piper Fatigue Scale, Pittsburgh Sleep Quality Index, wrist actigraphy, Functional Assessment of Cancer Therapy-Colon, blood counts, and demographic and medical data form. Analysis included descriptive statistics and repeated-measures analysis of variance.
Fatigue, sleep quality, sleep-wake variables, activity-rest, circadian activity rhythms, and QOL.
Fatigue was mild at baseline and rose to moderate levels during chemotherapy 1-3. Sleep quality was poor the months prior to chemotherapy 1 and chemotherapy 4. Actigraphy data revealed disturbed sleep, low daytime activity, and impaired circadian activity rhythms during the first week after chemotherapy 1-3. QOL ratings were similar to those in other cancer populations. Fatigue increased, and white blood cell counts decreased significantly over time.
During adjuvant chemotherapy, patients reported moderate fatigue and poor sleep quality; actigraphs confirmed problems with sleep maintenance as well as low daytime activity and disturbed circadian rhythms. Multiple barriers were encountered during the study.
Clinicians should screen for fatigue and sleep-wake variables and use guidelines to select interventions.
目的/目标：研究结肠癌和直肠癌辅助化疗期间的疲劳模式及其他变量（睡眠质量、睡眠-觉醒变量、活动与休息、昼夜节律、生活质量[QOL]、血细胞计数以及人口统计学和医学变量），以及该研究的可行性。
纵向描述性可行性研究。
美国中西部地区的两家肿瘤诊所。
2006年4月至2008年12月，27%的筛查对象（n = 21）入组，14人完成研究。参与者为中年、已婚且有工作，拥有高等教育学历。
在三个为期两周的化疗周期（化疗1 - 3）的第一周以及六周时（化疗4之前）完成的测量包括派珀疲劳量表、匹兹堡睡眠质量指数、手腕活动记录仪、癌症治疗功能评估-结肠、血细胞计数以及人口统计学和医学数据表格。分析包括描述性统计和重复测量方差分析。
疲劳、睡眠质量、睡眠-觉醒变量、活动-休息、昼夜活动节律和生活质量。
疲劳在基线时较轻，在化疗1 - 3期间升至中度水平。化疗1和化疗4前几个月睡眠质量较差。活动记录仪数据显示，化疗1 - 3后第一周睡眠紊乱、白天活动量低且昼夜活动节律受损。生活质量评分与其他癌症人群相似。随着时间推移，疲劳增加，白细胞计数显著下降。
在辅助化疗期间，患者报告有中度疲劳和睡眠质量差；活动记录仪证实存在睡眠维持问题以及白天活动量低和昼夜节律紊乱。研究过程中遇到了多个障碍。
临床医生应筛查疲劳和睡眠-觉醒变量，并使用指南选择干预措施。
