Department of Psychology, Rutgers University, Camden, NJ.
National Jewish Health, Denver, CO.
Pediatr Blood Cancer. 2020 Sep;67(9):e28535. doi: 10.1002/pbc.28535. Epub 2020 Jul 10.
Rates of sleep disturbances vary widely across pediatric cancer studies, partly due to differences in measurement tools. Patient-reported outcomes measurement information system (PROMIS) offers a rigorously developed, well-validated pair of pediatric sleep health instruments needed to advance sleep research and clinical practice in pediatric cancer. The current study evaluated the clinical validity of PROMIS pediatric sleep scales (sleep disturbances [SD] and sleep-related impairment [SRI]) among children in active cancer treatment.
Caregiver-patient dyads were enrolled during cancer treatment in 2-12 months after diagnosis: 45 children (ages 8-17 years) and 102 caregivers of children (ages 5-17 years) completed PROMIS SD and SRI 8-item short form self-report or caregiver-proxy scales, and caregivers reported the prior week's cancer treatments and blood counts.
Both scales demonstrated strong internal consistency reliability across reporters. SD and SRI were higher than the PROMIS general population calibration sample for caregivers and patients. Oncology caregivers reported lower SD and SRI than sleep clinic caregivers, but oncology patients were similar to sleep clinic patients. Convergent validity was evidenced through moderate correlations between scales by reporter and both scales being significantly higher in patients taking medications for sleep. There were no significant differences in SD or SRI by diagnostic group, receiving radiation, or having low blood counts.
The PROMIS SD and SRI short forms are promising measures for pediatric oncology, demonstrating strong internal consistency reliability and multiple indications of clinical validity. Although groups did not differ based on treatment variables, results suggest the need for universal screening for sleep problems during pediatric cancer treatment.
儿科癌症研究中的睡眠障碍发生率差异很大，部分原因是测量工具的差异。患者报告结局测量信息系统（PROMIS）提供了经过严格开发和充分验证的儿科睡眠健康工具，可用于推进儿科癌症的睡眠研究和临床实践。本研究评估了 PROMIS 儿科睡眠量表（睡眠障碍[SD]和睡眠相关损害[SRI]）在癌症治疗活跃期儿童中的临床有效性。
在诊断后 2-12 个月的癌症治疗期间，招募了照顾者-患者二人组：45 名儿童（8-17 岁）和 102 名儿童照顾者（5-17 岁）完成了 PROMIS SD 和 SRI 8 项简短形式自我报告或照顾者代理量表，照顾者报告了前一周的癌症治疗和血液计数。
两个量表在报告者之间均表现出较强的内部一致性信度。SD 和 SRI 均高于照顾者和患者的 PROMIS 一般人群校准样本。肿瘤学照顾者报告的 SD 和 SRI 低于睡眠诊所照顾者，但肿瘤学患者与睡眠诊所患者相似。通过报告者之间的量表中度相关性以及药物治疗睡眠的患者的量表显著升高，证明了收敛有效性。SD 或 SRI 与诊断组、接受放疗或血液计数低无显著差异。
PROMIS SD 和 SRI 简短形式是儿科肿瘤学有前途的测量工具，表现出较强的内部一致性信度和多种临床有效性的迹象。尽管基于治疗变量，各组之间没有差异，但结果表明需要在儿科癌症治疗期间对睡眠问题进行普遍筛查。
