Department of Nursing, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at Lin-Kou, Taiwan.
Cancer Nurs. 2011 Sep-Oct;34(5):354-60. doi: 10.1097/NCC.0b013e3182037bf3.
Hepatocellular carcinoma patients often experience sleep disturbance after undergoing transcatheter arterial chemoembolization (TACE).
The objectives of this study were to (1) examine and compare symptom distress, depression, and sleep quality in hepatocellular carcinoma patients undergoing TACE with sleep disturbance versus without sleep disturbance and (2) examine the determinants of sleep disturbance in these patients.
Hepatocellular carcinoma patients undergoing TACE were recruited. The patients were evaluated 1 week (T1) and 1 month (T2) after receiving TACE in terms of performance status, symptom distress, depression (T1), and sleep disturbance (T2). Logistic regression was used to determine the predictive factors of sleep disturbance.
Patients with sleep disturbance reported significantly higher overall symptom distress and depression and lower sleep quality than patients without sleep disturbance. The 5 leading causes of symptom distress in both groups were fatigue, pain, poor appetite, chest tightness, and fever. Older age, greater symptom distress, and higher levels of depression were significantly associated with sleep disturbance.
The results of this study show significant associations among symptom distress, depression at baseline, and sleep problems 1 month after undergoing TACE. Clinicians should be aware of the possibility of lasting sleep disturbance in hepatocellular carcinoma patients undergoing TACE.
In clinical care, symptom management, psychological consultation, and relaxation training may promote sleep quality.
肝细胞癌患者在接受经导管动脉化疗栓塞（TACE）后常出现睡眠障碍。
本研究旨在（1）比较并比较 TACE 术后有睡眠障碍和无睡眠障碍的肝细胞癌患者的症状困扰、抑郁和睡眠质量；（2）探讨这些患者睡眠障碍的决定因素。
招募接受 TACE 的肝细胞癌患者。在接受 TACE 后 1 周（T1）和 1 个月（T2），评估患者的表现状态、症状困扰、抑郁（T1）和睡眠障碍（T2）。采用逻辑回归确定睡眠障碍的预测因素。
有睡眠障碍的患者报告的总体症状困扰、抑郁和睡眠质量明显低于无睡眠障碍的患者。两组中导致症状困扰的 5 个主要原因是疲劳、疼痛、食欲不振、胸闷和发热。年龄较大、症状困扰较大和抑郁程度较高与睡眠障碍显著相关。
本研究结果表明，TACE 后 1 个月，症状困扰、基线时的抑郁与睡眠问题之间存在显著关联。临床医生应注意 TACE 后肝细胞癌患者可能存在持续的睡眠障碍。
在临床护理中，症状管理、心理咨询和放松训练可能会促进睡眠质量。
