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癌症盆腔-腹部放射治疗期间的睡眠:一项纵向研究,特别关注与恶心和生活质量相关的睡眠。

Sleep During Pelvic-Abdominal Radiotherapy for Cancer: A Longitudinal Study With Special Attention to Sleep in Relation to Nausea and Quality of Life.

机构信息

Author Affiliations: Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden (Dr Blom); Division of Psychiatry, Haukeland University Hospital, Bergen, Norway (Dr Blom); and Department of Caring Science, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden (Dr Efverman).

出版信息

Cancer Nurs. 2021;44(4):333-344. doi: 10.1097/NCC.0000000000000826.

Abstract

BACKGROUND

Poor sleep, nausea, psychological distress, and a lowered quality of life are common during radiotherapy for cancer. There is a lack of studies on the relationship between radiotherapy-induced nausea and sleep. This longitudinal study analyzes data from 196 patients who underwent pelvic-abdominal radiotherapy for cancer.

OBJECTIVE

The aim of this study was to investigate sleep parameters weekly before, during, and after radiotherapy in relation to nausea and other patient characteristics, clinical characteristics, psychological distress, and quality of life.

METHODS

Patients (n = 196, 84% women; mean age, 63 years; 68% had gynecological tumor, 28% had colorectal tumor, and 4% had other tumors) longitudinally answered questionnaires before, during, and after their radiotherapy over the abdominal and pelvic fields.

RESULTS

Poor sleep was experienced by 30% of the participants, and sleep (quality and difficulty falling asleep) improved during and after treatment compared with baseline. Experiencing nausea during treatment was associated with worse sleep quality during radiotherapy. Baseline anxiety was associated with worse sleep quality before, during, and after treatment. Poor sleep was associated with worse quality of life.

CONCLUSION

Nausea, more than a number of other variables, is a possible predictor of poor sleep in patients during radiotherapy for cancer.

IMPLICATIONS FOR PRACTICE

The results indicate that effectively managing nausea may be important for sleep quality, and possibly quality of life, in patients undergoing radiotherapy for cancer. More research is needed before recommendations for practice can be made.

摘要

背景

癌症放射治疗期间常出现睡眠不佳、恶心、心理困扰和生活质量下降。目前,关于放射治疗引起的恶心与睡眠之间关系的研究较少。本纵向研究分析了 196 名接受盆腔腹部放射治疗的癌症患者的数据。

目的

本研究旨在探讨放射治疗前、中、后每周的睡眠参数与恶心以及其他患者特征、临床特征、心理困扰和生活质量的关系。

方法

196 名患者(84%为女性;平均年龄 63 岁;68%为妇科肿瘤,28%为结直肠肿瘤,4%为其他肿瘤)在接受腹部和盆腔放射治疗期间,前瞻性地每周回答一次关于放射治疗前、中、后的问卷。

结果

30%的参与者睡眠质量较差,且与治疗前相比,治疗期间和治疗后睡眠质量(包括睡眠质量和入睡困难)有所改善。治疗期间出现恶心与放射治疗期间睡眠质量较差有关。基线焦虑与治疗前、中、后睡眠质量较差有关。睡眠质量差与生活质量差有关。

结论

与其他许多变量相比,恶心更有可能成为癌症放射治疗患者睡眠不佳的预测因素。

实践意义

研究结果表明,在癌症放射治疗患者中,有效控制恶心可能对睡眠质量,可能对生活质量具有重要意义。在提出实践建议之前,还需要开展更多的研究。

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