Park Minkyoung, Suh Eunyoung E
Department of Nursing, Samsung Medical Center, Seoul, Republic of Korea.
Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul, Republic of Korea.
Asia Pac J Oncol Nurs. 2022 May 18;9(9):100082. doi: 10.1016/j.apjon.2022.100082. eCollection 2022 Sep.
In this study, the sleep time and efficiency of recipients of hematopoietic stem cell transplantation (HSCT) were investigated throughout treatment and compared objective measurements with subjective self-reported data.
Sleep time and efficiency were measured using both objective and subjective methods throughout the treatment period in inpatients receiving HSCT. The participants were recruited among HSCT inpatients at a tertiary hospital in Seoul, South Korea, between August 2019 and August 2020. Actigraphy was used to measure objective sleep time and efficiency. Subjective sleep time and quality were measured using the sleep diary and Insomnia Severity Index. Measurement data from 40 patients were analyzed. Repeated-measures analysis of variance was used to compare the differences between objective and subjective values in total sleep time and sleep efficiency.
The total sleep time was the lowest during the administration of anticancer drugs before stem cell transplantation. The total sleep time of patients with HSCT differed significantly over time when offsetting the difference in the measurement method. There were no significant differences between subjective and objective results for sleep time, and the interaction between the two methods over time was not significant. However, meaningful differences were found among the groups in sleep efficiency throughout the treatment period and between objective and subjective methods, as well as a statistically significant interaction between the two methods over time.
Actigraphy misclassified patients' low-energy state with little movement due to immune system impairment during treatment as sleep, resulting in high measured sleep efficiency, whereas their self-reported sleep efficiency was very low. Therefore, subjective measures might be more accurate for measuring sleep efficiency in HSCT patients.
在本研究中，对造血干细胞移植（HSCT）受者在整个治疗过程中的睡眠时间和效率进行了调查，并将客观测量结果与主观自我报告数据进行了比较。
在接受HSCT的住院患者的整个治疗期间，使用客观和主观方法测量睡眠时间和效率。研究对象为2019年8月至2020年8月期间韩国首尔一家三级医院的HSCT住院患者。采用活动记录仪测量客观睡眠时间和效率。使用睡眠日记和失眠严重程度指数测量主观睡眠时间和质量。对40例患者的测量数据进行分析。采用重复测量方差分析比较总睡眠时间和睡眠效率的客观值与主观值之间的差异。
在干细胞移植前使用抗癌药物期间，总睡眠时间最短。在抵消测量方法差异后，HSCT患者的总睡眠时间随时间有显著差异。睡眠时间的主观和客观结果之间没有显著差异，两种方法随时间的交互作用也不显著。然而，在整个治疗期间，各组之间在睡眠效率以及客观和主观方法之间发现了有意义的差异，并且两种方法随时间的交互作用具有统计学意义。
活动记录仪将治疗期间因免疫系统损害而活动很少的患者的低能量状态误分类为睡眠，导致测量的睡眠效率很高，而他们自我报告的睡眠效率很低。因此，主观测量方法可能更准确地测量HSCT患者的睡眠效率。
