Wu Horng-Shiuann, Gao Feng, Given Charles
Author Affiliations: College of Nursing, Michigan State University (Drs Wu and Given), East Lansing; and Division of Public Health Sciences, Washington University School of Medicine (Dr Gao), St Louis, Missouri.
Cancer Nurs. 2023 Jan 16. doi: 10.1097/NCC.0000000000001200.
Many cancer survivors endure multiple symptoms while striving to return to a normal life. Those symptoms often co-occur and exacerbate one another; however, their interplay is not fully understood.
This study aimed to examine the occurrence and concurrence of sleep disturbance, fatigue, depressive mood, and cognitive dysfunction in posttreatment breast cancer survivors.
The data for this descriptive analysis were collected as part of the screening for a clinical trial. The occurrences of sleep disturbance, depressive mood, and cognitive dysfunction were each determined by the cutoff scores of the Pittsburgh Sleep Quality Index, Center for Epidemiological Studies Depression Scale, and Montreal Cognitive Assessment, respectively; fatigue was determined by meeting the International Classification of Diseases cancer-related fatigue criteria.
A convenience sample of 81 women completed chemotherapy or/and radiation for stage I-III breast cancer an average of 23.1 (±SD = 9.0) months ago. Sleep disturbance (85%) was most prevalent, followed by fatigue (67%), depressive mood (46%), and cognitive dysfunction (29%). Of the survivors, 80% reported 2 or more co-occurring symptoms. Worsened subjective sleep quality, sleep disturbance, and daytime dysfunction significantly increased the risk of fatigue by 5.3, 4.3, and 4.3 times (all P < .001) and depression by 2.0, 2.7, and 3.0 times (all P < .05), respectively.
Sleep disturbance significantly increased the risk of survivors' fatigue and/or depressive mood after cancer treatment completion.
Effectively managing sleep disturbance and improving the individual's sleep perception may subsequently reduce fatigue and/or depressive mood among breast cancer survivors. Nonpharmacological strategies for managing multiple posttreatment symptoms are needed.
许多癌症幸存者在努力回归正常生活的过程中忍受着多种症状。这些症状常常同时出现且相互加剧；然而，它们之间的相互作用尚未完全被理解。
本研究旨在调查乳腺癌幸存者治疗后睡眠障碍、疲劳、抑郁情绪和认知功能障碍的发生情况及共现情况。
作为一项临床试验筛查的一部分，收集了本描述性分析的数据。睡眠障碍、抑郁情绪和认知功能障碍的发生情况分别由匹兹堡睡眠质量指数、流行病学研究中心抑郁量表和蒙特利尔认知评估的临界值确定；疲劳则通过符合国际疾病分类中与癌症相关的疲劳标准来确定。
一个由81名女性组成的便利样本平均在23.1（±标准差 = 9.0）个月前完成了I - III期乳腺癌的化疗或/和放疗。睡眠障碍（85%）最为普遍，其次是疲劳（67%）、抑郁情绪（46%）和认知功能障碍（29%）。在这些幸存者中，80%报告有2种或更多共现症状。主观睡眠质量变差、睡眠障碍和日间功能障碍分别使疲劳风险显著增加5.3倍、4.3倍和4.3倍（所有P < .001），使抑郁风险分别增加2.0倍、2.7倍和3.0倍（所有P < .05）。
睡眠障碍显著增加了癌症治疗结束后幸存者出现疲劳和/或抑郁情绪的风险。
有效管理睡眠障碍并改善个体的睡眠感知可能会降低乳腺癌幸存者的疲劳和/或抑郁情绪。需要采用非药物策略来管理多种治疗后的症状。
