School of Nursing, University of California, 2 Koret Way - Box 0610, San Francisco, CA, 94143-0610, USA.
School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA.
Support Care Cancer. 2022 Nov;30(11):9243-9254. doi: 10.1007/s00520-022-07350-6. Epub 2022 Sep 6.
Sleep disturbance and cancer-related cognitive impairment (CRCI) are two of the most common symptoms reported by patients undergoing chemotherapy. Less is known about how these symptoms co-occur and their associated risk factors. Study purposes were to identify subgroups of patients with distinct sleep disturbance and CRCI profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, symptom severity scores, and QOL outcomes.
A total of 1,333 oncology outpatients receiving chemotherapy completed self-report questionnaires on sleep disturbance and cognitive dysfunction six times over two cycles of chemotherapy. Latent profile analysis was used to identify distinct sleep disturbance AND cognitive dysfunction profiles. Parametric and non-parametric tests were used to evaluate for differences among the classes.
Two distinct profiles were identified (i.e., Low = low levels of both sleep disturbance and cognitive dysfunction (53.5%); High = high levels of both sleep disturbance and cognitive dysfunction (45.5%)). Patients in the High class were younger, more likely to be female, had a lower functional status and a higher level of comorbidity. In addition, these patients had a higher symptom burden and a lower quality of life.
Almost half of the patients undergoing chemotherapy experienced clinically meaningful levels of both symptoms. Of note, sleep disturbance is frequently overlooked by both clinicians and patients. Clinicians need to recommend cognitive rehabilitation and physical activity programs to decrease patients' symptom burden.
睡眠障碍和与癌症相关的认知障碍（CRCI）是接受化疗的患者最常报告的两种症状。关于这些症状如何同时发生及其相关的危险因素知之甚少。本研究的目的是确定具有不同睡眠障碍和认知障碍特征的患者亚组，并评估亚组之间在人口统计学和临床特征、症状严重程度评分和生活质量结果方面的差异。
共有 1333 名接受化疗的肿瘤门诊患者在两个化疗周期内完成了六次关于睡眠障碍和认知功能障碍的自我报告问卷。潜在剖面分析用于确定不同的睡眠障碍和认知功能障碍特征。参数和非参数检验用于评估类之间的差异。
确定了两种不同的特征（即低=睡眠障碍和认知功能障碍水平均较低（53.5%）；高=睡眠障碍和认知功能障碍水平均较高（45.5%））。高类患者更年轻、更可能是女性、功能状态更低、合并症更多。此外，这些患者的症状负担更高，生活质量更低。
近一半接受化疗的患者经历了两种症状的临床意义水平。值得注意的是，睡眠障碍经常被临床医生和患者忽视。临床医生需要建议认知康复和体育活动计划，以减轻患者的症状负担。
