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癌症化疗患者新发失眠症:患病率、风险因素及其与其他症状的相关性。

New-onset insomnia among cancer patients undergoing chemotherapy: prevalence, risk factors, and its correlation with other symptoms.

机构信息

School of Nursing, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR.

Faculty of Nursing, Phenikaa University, Hanoi, Vietnam.

出版信息

Sleep Breath. 2020 Mar;24(1):241-251. doi: 10.1007/s11325-019-01839-x. Epub 2019 Apr 23.

Abstract

STUDY OBJECTIVES

Although insomnia is common among cancer patients, its prevalence remains variable, and its risk factors and correlation with other cancer-related symptoms are not fully explored in the literature. This study aims to determine the prevalence and severity of insomnia as well as risk factors and sleep-related symptom clusters in a sample of cancer patients.

METHODS

A cross-sectional survey was conducted collecting data from 213 cancer patients undergoing chemotherapy (age = 53.1 ± 11.3 years, 60% female). Insomnia was measured using the Insomnia Severity Index, a sleep log, and Actigraph, while symptoms were assessed using the Memorial Symptom Assessment Scale and the Hospital Anxiety and Depression Scale. Quality of life was measured with the Functional Assessment of Cancer Therapy-General.

RESULTS

Of the participants, 42.8% reported insomnia, with 31.9% of those with insomnia reporting severe insomnia. Insomnia occurrence and severity were not correlated with the participants' characteristics, cancer-related or treatment-related factors, only with the participants' anxiety/depression scores. Principal component analysis showed that insomnia, depression, and anxiety formed a symptom cluster (p < 0.001). There was no difference between sleep parameters measured by Actigraphy in insomnia and non-insomnia participants.

CONCLUSION

This study demonstrated that the prevalence of insomnia was high and indicated a symptom cluster of insomnia, depression, and anxiety. Therefore, interventions to reduce this symptom cluster may benefit cancer patients who are trying to manage these symptoms.

摘要

研究目的

尽管癌症患者中普遍存在失眠问题,但失眠的患病率仍存在差异,其风险因素以及与其他癌症相关症状的相关性在文献中尚未得到充分探讨。本研究旨在确定癌症患者样本中失眠的患病率和严重程度,以及其风险因素和与睡眠相关的症状群。

方法

本研究采用横断面调查方法,收集了 213 名正在接受化疗的癌症患者(年龄=53.1±11.3 岁,60%为女性)的数据。使用失眠严重程度指数、睡眠日志和活动记录仪来测量失眠,使用纪念症状评估量表和医院焦虑抑郁量表来评估症状,使用癌症治疗功能评估-一般量表来测量生活质量。

结果

在参与者中,42.8%报告存在失眠,其中 31.9%的失眠患者报告存在严重失眠。失眠的发生和严重程度与参与者的特征、癌症相关或治疗相关因素无关,仅与参与者的焦虑/抑郁评分相关。主成分分析表明,失眠、抑郁和焦虑形成了一个症状群(p<0.001)。在使用活动记录仪测量的睡眠参数方面,失眠组和非失眠组之间没有差异。

结论

本研究表明,失眠的患病率较高,并提示存在失眠、抑郁和焦虑的症状群。因此,干预该症状群可能有益于试图管理这些症状的癌症患者。

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