Author Affiliations: School of Nursing, College of Nursing, National Taipei University of Nursing and Health Sciences (Drs Chen and Lee); Department of Nursing, Taipei Veterans General Hospital (Mss Tian and Dai); Division of Thoracic Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University (Dr Wu); and Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital (Drs Huang and Hsu), Taipei, Taiwan; Faculty of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam; Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam (Ms Duong).
Cancer Nurs. 2024;47(2):112-120. doi: 10.1097/NCC.0000000000001188. Epub 2023 Jan 14.
Although rest-activity circadian rhythm (RACR) disruption is associated with mortality in patients with cancer, few studies have examined the effect of RACR on patients with esophageal and gastric cancer.
The aim of this study was to identify the predictors of RACR.
This cross-sectional, single-site study included 276 patients with esophageal and gastric cancer recruited from chest-surgery and general-surgery outpatient departments. Actigraphy was used to assess objective physical activity (PA), daylight exposure, and RACR, and 3-day PA was used to indicate the subjective amount of PA. The parameter of objective PA was the up activity mean; the parameter of daylight exposure was >500 lx, and the parameters of RACR were the 24-hour correlation coefficient, in-bed less than out-of-bed dichotomy index, midline estimating statistic of rhythm, and amplitude. The subjective amount of PA was calculated as the sum of mild, moderate, and vigorous PA.
The up activity mean predicted 24-hour correlation coefficient. The PA amount and up activity mean predicted in-bed less than out-of-bed dichotomy index. The up activity mean and >500-lx daylight exposure predicted midline estimating statistic of rhythm. Finally, the PA amount and up activity mean predicted the amplitude.
Increased PA and daylight exposure may improve RACR.
Patients with esophageal and gastric cancer should be encouraged to engage in outdoor PA during the daytime as part of their regular lifestyle to maintain a robust circadian rhythm.
尽管休息-活动昼夜节律（RACR）紊乱与癌症患者的死亡率有关，但很少有研究探讨 RACR 对食管癌和胃癌患者的影响。
本研究旨在确定 RACR 的预测因素。
这是一项横断面、单站点研究，纳入了 276 名来自胸外科和普通外科门诊的食管癌和胃癌患者。使用活动记录仪评估客观体力活动（PA）、日光暴露和 RACR，3 天的 PA 用于指示主观 PA 量。客观 PA 的参数为活动均值；日光暴露的参数为>500 lx，RACR 的参数为 24 小时相关系数、卧床与起床二分指数、节律中值估计统计量和振幅。主观 PA 量计算为轻度、中度和剧烈 PA 的总和。
活动均值预测了 24 小时相关系数。PA 量和活动均值预测了卧床与起床二分指数。活动均值和>500 lx 的日光暴露预测了节律中值估计统计量。最后，PA 量和活动均值预测了振幅。
增加 PA 和日光暴露可能会改善 RACR。
食管癌和胃癌患者应鼓励他们在白天进行户外 PA，作为其日常生活方式的一部分，以维持强大的昼夜节律。
