Calvo-Schimmel Alejandra, Paul Steven M, Cooper Bruce A, Shin Joosun, Harris Carolyn, Oppegaard Kate, Hammer Marilyn J, Cartwright Frances, Conley Yvette P, Kober Kord M, Levine Jon D, Miaskowski Christine
Author affiliations: School of Nursing, University of California, San Francisco (Drs Calvo-Schimmel, Paul, Cooper, Kober, and Miaskowski and Mss Shin, Harris, and Oppegaard); Dana Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); Department of Nursing, Mount Sinai Medical Center, New York (Dr Cartwright); School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Conley); and School of Medicine, University of California, San Francisco (Drs Levine and Miaskowski).
Cancer Nurs. 2023;46(6):417-431. doi: 10.1097/NCC.0000000000001139. Epub 2022 Dec 1.
Anxiety and sleep disturbance are frequent symptoms during chemotherapy.
Purposes were to identify subgroups of oncology outpatients with distinct joint anxiety and sleep disturbance profiles, as well as evaluate for differences in demographic and clinical characteristics, sleep disturbance characteristics, severity of common symptoms, and quality-of-life outcomes among these subgroups.
Oncology outpatients (n = 1331) completed self-report measures of anxiety and sleep disturbance 6 times over 2 chemotherapy cycles. Latent profile analysis was done to identify subgroups of patients with distinct joint anxiety and sleep disturbance profiles.
Three profiles were identified (ie, no anxiety and low sleep disturbance (59.7%), moderate anxiety and high sleep disturbance (32.5%), high anxiety and very high sleep disturbance (7.8%)). Compared with the no anxiety and low sleep disturbance class, the other 2 classes were younger; less likely to be married; had a lower annual household income; and had childcare responsibilities. Patients in the 2 worse profiles had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and evening fatigue, as well as lower levels of morning and evening energy, cognitive function, and poorer quality of life.
More than 40% of patients had moderate or high levels of anxiety and high or very high levels of sleep disturbance. Modifiable risk factors associated with these profiles may be used to develop targeted interventions for 1 or both symptoms.
Clinicians need to assess for the co-occurrence of anxiety and sleep disturbance.
焦虑和睡眠障碍是化疗期间常见的症状。
旨在识别出具有不同联合焦虑和睡眠障碍特征的肿瘤门诊患者亚组，并评估这些亚组在人口统计学和临床特征、睡眠障碍特征、常见症状严重程度以及生活质量结果方面的差异。
1331名肿瘤门诊患者在2个化疗周期内6次完成焦虑和睡眠障碍的自我报告测量。进行潜在剖面分析以识别具有不同联合焦虑和睡眠障碍特征的患者亚组。
识别出三个剖面（即无焦虑且睡眠障碍程度低（59.7%）、中度焦虑且睡眠障碍程度高（32.5%）、高度焦虑且睡眠障碍程度极高（7.8%））。与无焦虑且睡眠障碍程度低的类别相比，其他两个类别年龄更小；结婚可能性更低；家庭年收入更低；并且有育儿责任。处于两个较差剖面的患者在入睡和维持睡眠方面都存在问题。这些患者报告的抑郁症状、特质和状态焦虑以及晚间疲劳水平更高，而早晨和晚间的精力、认知功能水平更低，生活质量更差。
超过40%的患者存在中度或高度焦虑以及高度或极高程度的睡眠障碍。与这些剖面相关的可改变风险因素可用于针对一种或两种症状制定有针对性的干预措施。
临床医生需要评估焦虑和睡眠障碍的共现情况。
