Yu Li, Jiang Ying, Zhou Qin
School of Nursing, Qingdao University, Qingdao, People's Republic of China.
Department of Hematology, Yantai Yuhuangding Hospital, Yantai, People's Republic of China.
J Multidiscip Healthc. 2025 Aug 12;18:4957-4968. doi: 10.2147/JMDH.S541748. eCollection 2025.
Sleep disorders frequently affect acute leukemia patients during chemotherapy, significantly impacting treatment outcomes and quality of life. Using the biopsychosocial model, this study explores young and middle-aged patients' perceptions and influencing factors of sleep disturbances to guide targeted interventions.
Purposive sampling method was used to select 16 patients from the Department of Hematology of a tertiary hospital in Yantai City from December 2024 to January 2025 for semi-structured interviews, based on the biopsychosocial model, and Colaizzi's seven-step analysis method was used to refine the themes.
Seven themes were extracted: 1) Chemotherapy and the physiological burden of the disease itself (discomfort symptoms such as body pain and fatigue, particularly severe sleep problems during the induced remission period); 2) The physical and mental reactions caused by the uncertainty of disease progression and treatment (anxiety about the condition and treatment, fear of disease progression, and concern about recurrent pain); 3) Cognitive and emotional distress towards sleep (excessive sleep expectations, rumination further affecting sleep); 4) Polarization in coping (actively implementing self-regulation and generating negative avoidance thoughts); 5) Medical environment and institutional barriers (poor hospitalization environment, unmet sleep management needs of medical staff); 6) Economic and role pressures (heavy economic pressure, insufficient social support); 7) Family and peer relationships (yearning for family support and striving to establish peer support).
Young and Middle-Aged Adults leukemia patients during chemotherapy have poor sleep quality, which is influenced by multiple biological, psychological, and social factors. These findings provide new insights into the challenges of patient-centered sleep management during chemotherapy and highlight the inadequacy of psychosocial support and institutional care. Clinicians should combine these influencing factors to develop targeted interventions to improve patients' sleep quality and enhance their quality of life.
睡眠障碍在急性白血病患者化疗期间经常出现，对治疗效果和生活质量有显著影响。本研究运用生物心理社会模型，探讨中青年患者对睡眠障碍的认知及影响因素，以指导针对性干预。
采用目的抽样法，于2024年12月至2025年1月从烟台市某三级医院血液科选取16例患者进行半结构式访谈，基于生物心理社会模型，采用Colaizzi七步分析法提炼主题。
提炼出七个主题：1）化疗及疾病本身的生理负担（身体疼痛和疲劳等不适症状，诱导缓解期睡眠问题尤为严重）；2）疾病进展和治疗不确定性引起的身心反应（对病情和治疗的焦虑、对疾病进展的恐惧以及对反复疼痛的担忧）；3）对睡眠的认知和情绪困扰（过高的睡眠期望、反刍思维进一步影响睡眠）；4）应对方式的两极分化（积极进行自我调节并产生消极回避想法）；5）医疗环境和制度障碍（住院环境差、医护人员睡眠管理需求未得到满足）；6）经济和角色压力（经济压力大、社会支持不足）；7）家庭和同伴关系（渴望家庭支持并努力建立同伴支持）。
中青年急性白血病患者化疗期间睡眠质量较差，受多种生物、心理和社会因素影响。这些发现为化疗期间以患者为中心的睡眠管理挑战提供了新见解，凸显了心理社会支持和制度性照护的不足。临床医生应结合这些影响因素制定针对性干预措施，以改善患者睡眠质量，提高其生活质量。
