Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy. Sch Inq Nurs Pract 14(4):275-290; discussion 291-278
College of Nursing Rutgers, The State University of New Jersey, Newark, NJ, USA.Research and Theory for Nursing Practice 02/2000; 14(4):275-90; discussion 291-8.
The purposes of this study were to examine: (a) the relationships between the symptoms of insomnia and fatigue and the psychological factors of anxiety and depression, and; (b) the relationships between these psychological and symptom variables and quality of life in cancer patients who were receiving chemotherapy. The Theory of Unpleasant Symptoms was the framework for the study. A descriptive correlational design was used in a secondary analysis of data obtained from a sample of 263 cancer patients who were undergoing chemotherapy. Insomnia, fatigue, depression, and anxiety were positively correlated with one another (r = .26 to r = .69, p < .001) and negatively correlated with quality of life (r = -.28 to r = -.63, p < .001). Women had more anxiety and fatigue and poorer quality of life than did men. Older age was associated with better quality of life and less insomnia, fatigue, anxiety, and depression. Multiple regression analysis revealed that the symptoms and psychological variables explained 47% of the variance in quality of life, with the largest proportion of the variance explained by depression. Fatigue and insomnia explained only 4% of the variance in quality of life in excess of that contributed by the psychological factors. Although overall depression levels were low in this sample, these findings suggest that insomnia and fatigue are related to depression and that depression is more closely associated with quality of life than are insomnia and fatigue.
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- "Our finding that those with both 12-months MDD and sleep disturbance did not differ in terms of impairment and quality of life as compared with those without sleep disturbance might provide a possible explanation for the lack of association between sleep and suicide behaviors. Research has suggested that depression itself has been more closely associated with quality of life than are insomnia and fatigue (Redeker et al., 2000 ). In addition, diagnostic-specific measures were also found to explain only a small proportion of the variance in quality of life or satisfaction scores and individual's perception may be a more important factor (Rapaport et al., 2005). "
ABSTRACT: Background: Sleep problems are common with major depressive disorder (MDD), which has been identified as the most pervasive mental disorder in Singapore. Aims: This study aimed to establish the prevalence of sleep disturbance among adults with lifetime and 12-month MDD, as well as its socio-demographic and clinical correlates. Method: Data were collected from the Singapore Mental Health Study, a cross-sectional epidemiological survey of the local residential population aged ≥18 years. Using the CIDI 3.0, 417 and 181 respondents with lifetime and 12-month MDD were included in the analysis. Results: The prevalence of insomnia-related sleep disturbance among those with lifetime and 12-month MDD was 90.9% and 91.4%, respectively. Multiple logistic regression analyses revealed ethnicity, education and the number of depressive episodes as well as clinical comorbidities such as obsessive compulsive disorder, diabetes and hypertension to be significantly associated with sleep disturbance among those with lifetime MDD. However, only 28.6% of those with sleep disturbance sought help from a professional. Conclusions: The proportion of Singaporeans with MDD who have sleep disturbance is high, with increased risk for mental and physical health problems. Given the low rate of treatment contact, individuals with MDD must be screened and treated for sleep disturbance.
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- "La fatiga relacionada con el cáncer se caracteriza por una crónica y anormal experiencia de cansancio en todo el cuerpo, la cual disminuye la capacidad física y mental por el persistente agotamiento desproporcionado , en relación con el esfuerzo y no se alivia con el reposo (Bower et al., 2000; Patarca-Montero, 2004). Por sus características, la fatiga se ha relacionado positivamente con sintomatología depresiva y alteraciones de sueño, estos síntomas ocurren simultáneamente , puede compartir una causa común y se relacionan con una menor calidad de vida (Jacobsen, Donovan y Weitzner, 2003; Redeker, Lev y Ruggiero, 2000; Roscoe et al., 2007). Por lo que actualmente la investigación se enfoca no solamente en la etiología de estos síntomas sino en comprender como se relacionan e influencian (Fiorentino, Rissling, Liu y Ancoli-Israel, 2011). "
ABSTRACT: El objetivo de este estudio fue evaluar la relación entre la fatiga, la sintomatología de depresión y la calidad de sueño con indicadores de cortisol y determinar cuáles son las variables que explican la fatiga en mujeres con cáncer de mama. Participaron 17 mujeres con cáncer de mama previo al tratamiento de quimioterapia, las cuales proporcionaron 12 muestras de saliva durante dos días consecutivos y respondieron las escalas de Fatiga (MFI), Depresión (BDI) y Calidad de Sueño (ICSP). Los resultados obtenidos muestran que la latencia de sueño explica en un 41.7% la reducción de la actividad y que la disfunción diurna explica en un 48.8% de la fatiga mental, lo que nos sugiere un enfoque de intervención en esta fase del proceso del cáncer.
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- "During cancer treatment, many patients nap during the day, leading to circadian rhythm problems, which exacerbate sleep problems.2 While there is some awareness of sleep–wake disturbances in the context of symptom clusters5,7–9 during a patient’s cancer trajectory, what is not known is the impact of sleep on the physical, functional, and social aspects of quality of life (QOL).10 "
ABSTRACT: Purpose: Evidence suggests a high prevalence of sleep-wake disturbances in patients with cancer, occurring at diagnosis, during treatment, and continuing to survivorship. Yet associations between sleep-wake disturbances and the impact on quality of life outcomes is less clear. The purpose of this narrative review of the literature is to evaluate sleep-wake disturbances in patients with cancer, to describe the influence of poor sleep on quality of life as an outcome, and to evaluate the evidence to recommend future interventions.
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