The purposes of this study were to identify distinct latent classes of individuals based on subjective reports of sleep disturbance; to examine differences in demographic, clinical, and symptom characteristics between the latent classes; and to evaluate for variations in pro- and anti-inflammatory cytokine genes between the latent classes. Among 167 oncology outpatients with breast, prostate, lung, or brain cancer and 85 of their FCs, growth mixture modeling (GMM) was used to identify latent classes of individuals based on General Sleep Disturbance Scale (GSDS) obtained prior to, during, and for four months following completion of radiation therapy. Single nucleotide polymorphisms (SNPs) and haplotypes in candidate cytokine genes were interrogated for differences between the two latent classes. Multiple logistic regression was used to assess the effect of phenotypic and genotypic characteristics on GSDS group membership. Two latent classes were identified: lower sleep disturbance (88.5%) and higher sleep disturbance (11.5%). Participants who were younger and had a lower Karnofsky Performance status score were more likely to be in the higher sleep disturbance class. Variation in two cytokine genes (i.e., IL6, NFKB) predicted latent class membership. Evidence was found for latent classes with distinct sleep disturbance trajectories. Unique genetic markers in cytokine genes may partially explain the interindividual heterogeneity characterizing these trajectories.
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" with larger sample sizes are needed to confirm these findings and identify additional latent classes and / or significant phenotypic predictors . Differences in demographic ( e . g . , gender ) and clinical ( e . g . , homogenous versus heterogeneous cancer diagnoses ) characteristics between partici - pants in this study and our previous study ( Miaskowski et al . , 2012b"
[Show abstract][Hide abstract] ABSTRACT: To attempt to replicate the associations found in our previous study of patients and family caregivers between interleukin 6 (IL6) and nuclear factor kappa beta 2 (NFKB2) and sleep disturbance and to identify additional genetic associations in a larger sample of patients with breast cancer.
Patients with breast cancer (n = 398) were recruited prior to surgery and followed for six months. Patients completed a self-report measure of sleep disturbance and provided a blood sample for genomic analyses. Growth mixture modeling was used to identify distinct latent classes of patients with higher and lower levels of sleep disturbance.
Patients who were younger and who had higher comorbidity and lower functional status were more likely to be in the high sustained sleep disturbance class. Variations in three cytokine genes (i.e., IL1 receptor 2 (IL1R2), IL13, NFKB2) predicted latent class membership.
Polymorphisms in cytokine genes may partially explain inter-individual variability in sleep disturbance. Determination of high risk phenotypes and associated molecular markers may allow for earlier identification of patients at higher risk for developing sleep disturbance and lead to the development of more targeted clinical interventions.
European journal of oncology nursing: the official journal of European Oncology Nursing Society 09/2013; 18(1). DOI:10.1016/j.ejon.2013.08.004 · 1.43 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
The current healthcare climate is characterized by a constant battle for the provision of quality care with limited resources and with patient satisfaction receiving increased attention, there is a need for reliable and valid assessment measures. This study describes the adaptation, testing and validation of the Risser Patient satisfaction Scale in an oncology care setting in Greece. The rationale for this study lies in the scarcity of such measures in the Greek language.
This is a test retest validation study in Greece. Data were collected from 298 hospitalized cancer patients. The validation methodology included the assessment of the item internal consistency, using the Cronbach alpha coefficient. The test-retest reliability was tested by the Kappa correlation coefficient.
The scale demonstrated very good psychometric properties. The internal consistency of the instrument was good, Cronbach’s alpha was found to be 0.78 (p<0.001) and Kappa coefficient for reproducibility was found to be K=0.89 (95% CI: 0.83-0.91 p<0.0001).
The findings demonstrated strong agreement of the scale, suggesting that the Greek version offers substantial reliability. This study provides a valid and reliable tool to assess patient satisfaction in oncology settings. Means to monitor patient satisfaction, a key aspect of the policy agenda for quality care remain important for nurse leaders to develop better care in oncology settings.
[Show abstract][Hide abstract] ABSTRACT: Subgroups of individuals may be at greater risk of cytokine-induced changes in attentional function. The purposes of this study were to identify subgroups of individuals with distinct trajectories of attentional function and evaluate for phenotypic and genotypic (i.e., cytokine gene polymorphisms) differences among these subgroups. Self-reported attentional function was evaluated in 252 participants (167 oncology patients and 85 family caregivers) using the Attentional Function Index before radiation therapy and at six additional assessments over 6 months. Three latent classes of attentional function were identified using growth mixture modeling: moderate (36.5%), moderate-to-high (48.0%), and high (15.5%) attentional function. Participants in the moderate class were significantly younger, with more comorbidities and lower functional status, than those in the other two classes. However, only functional status remained significant in multivariable models. Included in the genetic association analyses were 92 single nucleotide polymorphisms (SNPs) among 15 candidate genes. Additive, dominant, and recessive genetic models were assessed for each SNP. Controlling for functional status, only Interleukin 6 (IL6) rs1800795 remained a significant genotypic predictor of class membership in multivariable models. Each additional copy of the rare "G" allele was associated with a 4-fold increase in the odds of belonging to the lower attentional function class (95% confidence interval: [1.78, 8.92]; p = .001). Findings provide preliminary evidence of subgroups of individuals with distinct trajectories of attentional function and of a genetic association with an IL6 promoter polymorphism.
Biological Research for Nursing 03/2013; 16(2). DOI:10.1177/1099800413479441 · 1.43 Impact Factor