|
1
|
Mao Y, Shi RX, Gao LM, Xu AY, Li JN, Wang B, Wu JY. Construction of a nomogram-based risk prediction model for depressive symptoms in middle-aged and young breast cancer patients. World J Clin Oncol 2025; 16:102208. [DOI: 10.5306/wjco.v16.i4.102208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2024] [Revised: 01/04/2025] [Accepted: 02/14/2025] [Indexed: 03/26/2025] Open
Abstract
BACKGROUND Breast cancer (BC) is the second most common malignancy globally. Young and middle-aged patients face more pressures from diagnosis, treatment, costs, and psychological issues like self-image concerns, social barriers, and professional challenges. Compared to other age groups, they have higher recurrence rates, lower survival rates, and increased risk of depression. Research is lacking on factors influencing depressive symptoms and predictive models for this age group.
AIM To analyze factors influencing depressive symptoms in young/middle-aged BC patients and construct a depression risk predictive model.
METHODS A total of 360 patients undergoing BC treatment at two tertiary hospitals in Jiangsu Province, China from November 2023 to April 2024 were included in the study. Participants were surveyed using a general information questionnaire, the patient health questionnaire depression scale, the visual analog scale for pain, the revised family support scale, and the long form of the international physical activity questionnaire. Univariate and multivariate analyses were conducted to identify the factors affecting depression in middle-aged and young BC patients, and a predictive model for depression risk was developed based on these findings.
RESULTS Among the 360 middle-aged and young BC patients, the incidence rate of depressive symptoms was 38.61% (139/360). Multivariate analysis revealed that tumor grade, patient’s monthly income, pain score, family support score, and physical activity score were factors influencing depression in this patient group (P < 0.05). The risk prediction model constructed based on these factors yielded an area under the receiver operating characteristic curve of 0.852, with a maximum Youden index of 0.973, sensitivity of 86.80%, specificity of 89.50%, and a diagnostic odds ratio of 0.552. The Hosmer-Lemeshow test for goodness of fit indicated an adequate model fit (χ2 = 0.360, P = 0.981).
CONCLUSION The constructed predictive model demonstrates good predictive performance and can serve as a reference for medical professionals to early identify high-risk patients and implement corresponding preventive measures to decrease the incidence of depressive symptoms in this population.
Collapse
Affiliation(s)
- Ye Mao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Rui-Xin Shi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Lei-Ming Gao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - An-Ying Xu
- School of Artificial Intelligence and Information Technology, Nanjing University of Chinese Medicine, Nanjing 210023, Jiangsu Province, China
| | - Jia-Ning Li
- Department of Nursing, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| | - Bei Wang
- Department of Nursing, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
- Department of Nursing, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| | - Jun-Yuan Wu
- Department of Critical Care Medicine, Province Academy of Traditional Chinese Medicine, Nanjing 210028, Jiangsu Province, China
| |
Collapse
|
|
2
|
Hinz A, Friedrich M, Schulte T, Petrowski K, Tibubos AN, Hartung TJ. The Pittsburgh Sleep Quality Index (PSQI) Applied to Cancer Patients: Psychometric Properties and Factors Affecting Sleep Quality. Cancer Invest 2025; 43:103-113. [PMID: 39749569 DOI: 10.1080/07357907.2024.2446941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2024] [Revised: 12/03/2024] [Accepted: 12/21/2024] [Indexed: 01/04/2025]
Abstract
OBJECTIVE Cancer patients frequently report sleep problems. The Pittsburgh Sleep Quality Index (PSQI) is a 19-item instrument for assessing sleep problems. The main objective of this study was to analyze the usefulness of the PSQI in oncological research. METHODS A sample of 1,733 cancer patients with mixed diagnoses were included. In addition to the PSQI, the following questionnaires were adopted: the Insomnia Severity Index (ISI), the Jenkins Sleep Scale (JSS) and the sleep scale of the EORTC QLQ-SURV100. RESULTS The internal consistency of the PSQI was α = 0.79. Of the PSQI subscales, the subjective sleep quality correlated most strongly with the other sleep instruments (r between 0.68 and 0.77). In total, 69.2% of the sample were poor sleepers; the effect size of the difference between the PSQI total scores of the patients and a general population sample was d = 0.83. Female patients experienced more sleep problems than male patients (d = -0.49), and younger patients (<60 years) reported more sleep problems than older patients (≥60 years) (d = 0.21). CONCLUSIONS The PSQI can be recommended for use in clinical practice since its sub-dimensions provide detailed information on the sleep situation of cancer patients.
Collapse
Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany, University Medical Center Leipzig, Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany
| | - Katja Petrowski
- Department of Medical Psychology and Medical Sociology, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Ana N Tibubos
- Department of Nursing Science, Diagnostics in Healthcare and eHealth, University of Trier, Trier, Germany
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Tim J Hartung
- Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
|
3
|
Sohrabi M, Gholami A, Hassanzadeh P, Hatami S, Ajdarkosh H, Zamani F, Doustmohammadian A. Examining the factor structure of the Pittsburgh Sleep Quality Index and its determinants among GI cancer patients. BMC Cancer 2024; 24:1577. [PMID: 39725909 DOI: 10.1186/s12885-024-13347-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 12/16/2024] [Indexed: 12/28/2024] Open
Abstract
BACKGROUND Poor sleep quality is one of the prevalent manifestations experienced by cancer patients. There is a lack of research focusing specifically on sleep quality and affecting factors in Gastrointestinal (GI) cancer patients. This study aimed to assess the potential interaction between dietary, comorbid conditions, demographic, and socioeconomic determinants of sleep quality in GI cancer patients. METHODS In a cross-sectional study, the Pittsburg Sleep Quality Index (PSQI) was completed for 875 adult patients suffering from GI cancer in a referral hospital. We conducted structural equation modeling analyses to evaluate the potential interaction between dietary and socioeconomic determinants of sleep quality in GI cancer patients. RESULTS This study demonstrated that the PSQI encompasses two factors (perceived sleep quality and sleep disturbances) in GI cancer patients in Iran. Based on the standardized coefficients for the structural paths, the wealth index (WI) partially mediated the effect of food insecurity (FI) on the sleep quality index. There was a direct predictive effect of the WI on the PSQI (β = 0.10, P = 0.01). In addition, WI indirectly through FI (effect of WI on FI: β = -0.21, P = 0.01 & effect of FI on PSQI: β = 0.07, P = 0.03) had a negative effect on PSQI. Our finding suggested the full mediation effect of age on PSQI through the number of comorbidities (effect of age on number of comorbidities: β = 0.25, P < 0.001 & the effect of number of comorbidities on PSQI: β = 0.13, P < 0.001). Structural path outputs for gender-model indicated the full mediation effect of age on PSQI through the number of comorbidities among males and through the FI among females. CONCLUSION These findings highlight the importance of considering the bi-dimensional construct of the PSQI for assessing sleep quality among GI cancer patients. The current study demonstrated that food insecurity and comorbidity prevalence mediated the relationship between socio-demographic determinants of sleep quality in patients with GI cancer.
Collapse
Affiliation(s)
- Masoudreza Sohrabi
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Gholami
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
- Department of Epidemiology & Biostatistics, School of Public Health, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Parvin Hassanzadeh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sara Hatami
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hosein Ajdarkosh
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Azam Doustmohammadian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
|
4
|
Mao Y, Li J, Shi R, Gao L, Xu A, Wang B. Construction of a nomogram risk prediction model for depressive symptoms in elderly breast cancer patients. Sci Rep 2024; 14:26433. [PMID: 39488580 PMCID: PMC11531583 DOI: 10.1038/s41598-024-78038-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Accepted: 10/28/2024] [Indexed: 11/04/2024] Open
Abstract
The primary objective of this study was to identify the factors associated with the development of depressive symptoms in elderly breast cancer (BC) patients and to construct a nomogram model for predicting these symptoms. We recruited 409 patients undergoing BC treatment in the breast departments of two tertiary-level hospitals in Jiangsu Province from November 2023 to April 2024 as our study cohort. Participants were categorized into depressed and non-depressed groups based on their clinical outcomes. Univariate and multivariate logistic regression analyses were employed to identify independent risk factors for depression among BC patients. Multivariate analysis revealed that monthly income, pain score, family support score, and physical activity score significantly influenced the onset of depression in older BC patients (P < 0.05).The risk prediction model, constructed using these identified factors, demonstrated excellent discriminatory power, as evidenced by an area under the ROC curve (AUC) of 0.824. The maximum Youden index was 0.627, with a sensitivity of 90.60%, specificity of 72.10%, and a diagnostic threshold value of 1.501. The results of the Hosmer-Lemeshow goodness-of-fit test (χ² = 3.181, P = 0.923) indicated that the model fit the data well. The calibration curve for the model closely followed the ideal curve, suggesting a strong fit and high predictive accuracy. Our nomogram model exhibited superior predictive performance, enabling healthcare professionals to identify high-risk patients early and implement preventative measures to mitigate the development of depressive symptoms. This study is a cross-sectional study that lacks longitudinal data and has a small sample size. Future research could involve larger samples, multicenter studies, and prospective designs to build better clinical predictive models.
Collapse
Affiliation(s)
- Ye Mao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jianing Li
- Nursing Department, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China
| | - Ruixin Shi
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Leiming Gao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Anying Xu
- School of Artificial Intelligence and Information Technology, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Bei Wang
- Nursing Department, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
- Nursing Department, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.
| |
Collapse
|
|
5
|
Wang H, Reid BM, Richmond RC, Lane JM, Saxena R, Gonzalez BD, Fridley BL, Redline S, Tworoger SS, Wang X. Impact of insomnia on ovarian cancer risk and survival: a Mendelian randomization study. EBioMedicine 2024; 104:105175. [PMID: 38823087 PMCID: PMC11169961 DOI: 10.1016/j.ebiom.2024.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND Insomnia is the most common sleep disorder in patients with epithelial ovarian cancer (EOC). We investigated the causal association between genetically predicted insomnia and EOC risk and survival through a two-sample Mendelian randomization (MR) study. METHODS Insomnia was proxied using genetic variants identified in a genome-wide association study (GWAS) meta-analysis of UK Biobank and 23andMe. Using genetic associations with EOC risk and overall survival from the Ovarian Cancer Association Consortium (OCAC) GWAS in 66,450 women (over 11,000 cases with clinical follow-up), we performed Iterative Mendelian Randomization and Pleiotropy (IMRP) analysis followed by a set of sensitivity analyses. Genetic associations with survival and response to treatment in ovarian cancer study of The Cancer Genome Atlas (TCGA) were estimated controlling for chemotherapy and clinical factors. FINDINGS Insomnia was associated with higher risk of endometrioid EOC (OR = 1.60, 95% CI 1.05-2.45) and lower risk of high-grade serous EOC (HGSOC) and clear cell EOC (OR = 0.79 and 0.48, 95% CI 0.63-1.00 and 0.27-0.86, respectively). In survival analysis, insomnia was associated with shorter survival of invasive EOC (OR = 1.45, 95% CI 1.13-1.87) and HGSOC (OR = 1.4, 95% CI 1.04-1.89), which was attenuated after adjustment for body mass index and reproductive age. Insomnia was associated with reduced survival in TCGA HGSOC cases who received standard chemotherapy (OR = 2.48, 95% CI 1.13-5.42), but was attenuated after adjustment for clinical factors. INTERPRETATION This study supports the impact of insomnia on EOC risk and survival, suggesting treatments targeting insomnia could be pivotal for prevention and improving patient survival. FUNDING National Institutes of Health, National Cancer Institute. Full funding details are provided in acknowledgments.
Collapse
Affiliation(s)
- Heming Wang
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Brett M Reid
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Rebecca C Richmond
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, UK; Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Oxford Health Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Jacqueline M Lane
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Richa Saxena
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA; Children's Mercy Hospital, Kansas City, MO, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA; Department of Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Shelley S Tworoger
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA; Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - Xuefeng Wang
- Department of Biostatistics and Bioinformatics, Moffitt Cancer Center, Tampa, FL, USA.
| |
Collapse
|
|
6
|
Soleymani Moghadam M, Parvizifard A, Foroughi A, Ahmadi SM, Farshchian N. An investigation of the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer: a randomized controlled trial. J Cancer Res Clin Oncol 2024; 150:128. [PMID: 38485807 PMCID: PMC10940429 DOI: 10.1007/s00432-024-05655-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 02/18/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Breast cancer is an extremely unpleasant and unbearable experience that can have a profound impact on a person's life. Compared to other types of cancer, breast cancer has a more severe psychological impact on women. PURPOSE This study aimed to investigate the effect of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function in Iranian women with breast cancer. METHOD A sample of 30 women with breast cancer were randomly divided into intervention and control groups. The research was conducted in the oncology division of Imam Reza Hospital in Kermanshah by the clinical trial method with a two-group pretest-posttest design and a 2 month follow-up. Participants in the intervention group received Mindfulness-integrated cognitive behavior therapy for eight sessions. The intervention was carried out individually in weekly 60 min sessions. While the control group received self-help treatment (through an educational book). A demographic questionnaire, Demoralization Scale (DS-II), Body Image Scale (BIS), and Female Sexual Function Index (FSFI) were used to collect data. For data analysis, means and standard deviations were calculated and repeated measures and the Bonferroni test was conducted using SPSS 26. RESULTS The results showed the effectiveness of mindfulness-integrated cognitive behavior therapy on demoralization, body image, and sexual function (p < 0.05). Concerning demoralization in the intervention group, the pre-test mean was 16.73 ± 3.33, and it reduced to 11.93 ± 1.49 in the post-test. The body image mean score showed a decreasing trend in the intervention group, from 12.47 ± 1.88 in the pre-test to 8.80 ± 3.21 in the post-test. The mean score for sexual function showed an increasing trend, increasing from 18.06 ± 2.29 in the pre-test to 23.07 ± 0.91 in the post-test. There was no significant difference in the mean score of the post-test compared to the pre-test and follow-up in the control group (p < 0.05). CONCLUSION MICBT can be used in conjunction with pharmaceuticals and medical treatments to improve the psychological symptoms of women with breast cancer, according to this study's results. Trial registration (IRCT20160103025817N6). 2022-04-06.
Collapse
Affiliation(s)
| | - Aliakbar Parvizifard
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Aliakbar Foroughi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Mojtaba Ahmadi
- Department of Clinical Psychology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Farshchian
- Department of Radiation Oncology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
|
7
|
Nong J, Tong J, Wang R, Shi K, Zhang Y. Associations of sleep disorders with all-cause and cause-specific mortality in cancer survivors: a cross-sectional analysis of the NHANES 2005-2016. BMC Psychiatry 2024; 24:118. [PMID: 38347467 PMCID: PMC10863252 DOI: 10.1186/s12888-024-05589-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/05/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND The circadian clock and endoplasmic reticulum stress signaling play important roles in oncogenesis and development of cancer. Sleep disorders have been linked to an elevated risk of mortality in general populations. Nonetheless, the evidence for the sleep disorders-mortality association among cancer patients is limited. We aimed to prospectively investigate the association of sleep disorders with all-cause, cancer, and cardiovascular disease (CVD) mortality among cancer individuals. METHODS We assessed 3187 participants with cancer from the National Health and Nutrition Examination Survey 2005-2016 cohorts with a median follow-up time of 83.0 months. Multivariable Cox proportional hazards models estimated the adjusted hazard ratio (HR) and 95% confidence interval (CI). RESULTS Multivariable Cox proportional hazards models showed that sleep disorders were associated with a higher risk of all-cause mortality (HR 1.23, 95%CI: 1.06,1.42), cancer mortality (HR 1.30, 95%CI: 1.02, 1.66), and cardiovascular disease mortality (HR 1.35, 95%CI: 1.02, 1.80). After the total group was stratified by gender, the high HRs were observed in men (P < 0.05), not in women. The correlation between sleep disorders and higher long-term mortality was also significant after individuals who died within 2 years of follow-up were excluded, with HR 1.24 (95%CI: 1.07, 1.45) in model I, HR 1.20 (95%CI: 1.02, 1.42) in model II for long-term all-cause mortality, HR (95%CI: 1.00, 1.74) in model I for long-term cancer mortality, and HR 1.5 (95%CI:1.12, 2.02) in model I, HR 1.45 (95%CI: 1.06, 1.99) in model II for long-term CVD mortality. CONCLUSIONS Sleep disorders were associated with a higher risk of all-cause mortality, cancer mortality, and CVD mortality, as well as long-term mortality in cancer patients. Our finding underlies the importance of screening for sleep disorders for all cancer survivors and the urge to integrate sleep health as an important part of cancer care more effectively. Male individuals may be particularly vulnerable and could benefit from more frequent screening.
Collapse
Affiliation(s)
- Jingying Nong
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, Beijing, 100053, China.
| | - Jinzhuo Tong
- Experimental School of Beihang University, Xueyuan Road 37#, Beijing, 100083, China
| | - Ruotian Wang
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, Beijing, 100053, China
| | - Kejian Shi
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, Beijing, 100053, China
| | - Yi Zhang
- Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Changchun Street 45#, Beijing, 100053, China
| |
Collapse
|
|
8
|
Li L, Li X, Huang Y, Li H, Li C, Ma Y, Zhang J, Peng F, Lyu S. An RCT META analysis based on the effect of tai chi exercise therapy on the outcome of elderly patients with moderate-to-severe sleep disorders-A systematic review study. Heliyon 2024; 10:e24085. [PMID: 38293413 PMCID: PMC10826669 DOI: 10.1016/j.heliyon.2024.e24085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/16/2023] [Accepted: 01/03/2024] [Indexed: 02/01/2024] Open
Abstract
Background According to statistics, about one-fifth of the world's elderly people suffer from sleep disorders, and the problem of sleep disorders in the elderly is extremely serious, and this problem is one of the important causes of chronic diseases such as hypertension, hyperlipidemia, diabetes mellitus, and coronary heart disease in the elderly. The positive effect of Tai Chi exercise therapy on sleep problems has been confirmed, but at present, the effect of the specific duration of Tai Chi exercise on the improvement of elderly people with moderate to severe sleep disorders varies. Objective META analysis was used to investigate and find that long-term Tai Chi exercise therapy has the best effect on improving sleep in elderly patients with moderate to severe sleep disorders. Methods: META analysis was performed using Revman 5.3 after searching Web of science, Pubmed, Scopus, The Cochroae Library, OVID, CBM, CNKI, VIP, and other databases, and then filtering and extracting. Results A total of seven papers were included. Meta-analysis showed that tai chi exercise was more effective in improving sleep problems in elderly patients with sleep disorders compared to the control group, and the difference was significant. This was demonstrated by a decrease in the global Pittsburgh Sleep Quality Index (PSQI) score [SMD = -0.66, 95 % CI (-0.91, -0.41), P < 0.00001], as well as its subdomains of subjective sleep quality [SMD = -0.79, 95 % CI (-1.06, -0.52), P < 0.00001], sleep latency [SMD = -0.80, 95 % CI (-1.21, -0.40), P < 0.00001], sleep duration [SMD = -0.38, 95 % CI (-0.72, -0.04), P = 0.03], habitual sleep efficiency [SMD = -0.58, 95 % CI (-0.84, -0.31), P < 0.0001], sleep disturbance [SMD = -0.51, 95 % CI (-0.78, -0.25), P = 0.00001] and daytime dysfunction [SMD = -0.33, 95 % CI (-0.59, -0.07), P = 0.01]. Improvement was also observed in the Epworth Sleepiness Scale (ESS) and Insomnia Severity Index Scale (ISI). The results showed that the optimal duration and frequency of Tai Chi exercise therapy for improving moderately severe elderly patients with sleep disorders was long-term. Conclusion This study systematically assessed the efficacy of Tai Chi exercise therapy for elderly patients with moderate-to-severe sleep disorders. Through a meta-analysis of relevant randomized controlled trials (RCTs), it aims to determine the effectiveness of Tai Chi exercise in improving sleep quality in elderly patients with moderate-to-severe sleep disorders, as well as to compare its effects with those of traditional treatments; to analyze the safety of Tai Chi exercise for this patient population and assess its feasibility as a non-pharmacological therapy; and to fill the research gaps and provide more comprehensive and systematic evidence support. This study provides a practical approach to reducing the risk of medication side effects in older adults with sleep disorders and offers a potentially effective non-pharmacological treatment option, especially for those who are unable or unwilling to use medication. Tai chi exercise may not only improve sleep, but also improve coordination, muscle strength, balance, and reduce stress and anxiety in older adults. It also helps older adults socialize and enhances their social connections and emotional support. This study suggests that community centers or activity centers for the elderly can organize tai chi classes to promote the participation of older adults, and can be used as a scientific exercise rehabilitation tool in clinical treatment, incorporating tai chi practice into daily life, such as tai chi practice at a fixed time every day or every week, which not only helps to improve the sleep disorders of older adults, but also improves their overall quality of life.
Collapse
Affiliation(s)
- Lujia Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Xiaozheng Li
- Department of Psychiatric, Tianjin Anding Hospital, No. 13 Liulin Road, Hexi District, China
| | - Yuerong Huang
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Haojie Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Cuihan Li
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Yuxin Ma
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Jianwei Zhang
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| | - Fang Peng
- Leisure and Health Teaching and Research Department, Department of Physical Education, Hainan Medical College, China
| | - Shaojun Lyu
- School of Physical Education and Exercise, Beijing Normal University, Beijing 100875, China
| |
Collapse
|
|
9
|
Deng L, Chen B. Two-scale assessment of anxiety and depression in postoperative non-small cell lung cancer patients: their prevalence, risk factors, and prognostic potency. Ir J Med Sci 2023; 192:2613-2619. [PMID: 36826710 DOI: 10.1007/s11845-023-03321-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/13/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE Anxiety and depression commonly occur and correlate with poor prognosis in patients with cancer. The study aimed to assess the anxiety and depression in patients with postsurgical non-small cell lung cancer (NSCLC) using both Hospital Anxiety and Depression Scale (HADS) and Self-Rating Anxiety/Depression Scale (SAS/SDS) and to investigate their risk factors and linkage with prognosis. METHODS HADS and SAS/SDS were assessed in 350 patients with NSCLC at 3 months after surgical resection and 100 healthy controls (HCs). Patients with NSCLC were followed up for a median period of 27.0 (range: 6.0-52.0) months for prognostic evaluation. RESULTS HADS-identified anxiety rate (39.7% vs. 10.0%, P < 0.001), SAS-identified anxiety rate (34.9% vs. 9.0%, P < 0.001), HADS-identified depression rate (29.7% vs. 5.0%, P < 0.001), and SDS-identified depression rate (27.1% vs. 6.0%, P < 0.001) were all elevated in patients with NSCLC vs. HCs. Multivariate logistic regression analysis uncovered that diabetes, adjuvant therapy, postoperative complications, and poor differentiation were independently linked with increased HADS- or SAS-identified anxiety risk (all P < 0.05); meanwhile, female gender, hypertension, diabetes, poor differentiation, adjuvant therapy, postoperative complications, and TNM stage were independently linked with increased HADS- or SDS-identified depression risk (all P < 0.05). Furthermore, HADS-identified anxiety, SAS-identified anxiety, HADS-identified depression, and SDS-identified depression independently predicted shorter disease-free survival and overall survival (all P < 0.05). CONCLUSION Anxiety and depression are prevalent and linked with poor survival in patients with postsurgical NSCLC. Meanwhile, gender, comorbidities, advanced tumor features, adjuvant therapy, and postoperative complications relate to the prevalence of anxiety and depression.
Collapse
Affiliation(s)
- Liping Deng
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bei Chen
- Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China.
| |
Collapse
|
|
10
|
He C, He Y, Yang T, Wu C, Lin Y, Yan J, Chang W, Chang F, Wang Y, Wu S, Cao B. Relationship of sleep-quality and social-anxiety in patients with breast cancer: a network analysis. BMC Psychiatry 2023; 23:887. [PMID: 38017507 PMCID: PMC10683122 DOI: 10.1186/s12888-023-05262-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND There is a complex relationship between social anxiety and sleep quality. However, network analysis studies of associations between social anxiety and sleep quality are lacking, particularly among patients with breast cancer. The current study aimed to extend this research to a sample of patients with breast cancer and to examine symptom-level associations between social anxiety and sleep quality using network analysis. METHODS Network analysis was conducted to explore their associations and identify bridge items of social anxiety and sleep quality. RESULTS The network structure revealed 9 important edges between social anxiety and sleep quality. "Subjective sleep quality" had the highest EI value in the network. "Working difficulty under watching" and "Sleep disorders" had the highest BEI values in their own communities. CONCLUSION There are complex pathological correlation pathways between social anxiety and sleep quality in breast cancer patients. "Subjective sleep quality", "Working difficulty under watching" and "Sleep disorders" have the potential to be intervention targets for sleep disorder-social anxiety comorbidity. Medical staff can take corresponding interventions according to the the centrality indices and bridge centrality indicators identified in this study, which is likely to effectively reduce the comorbidity of sleep disorders and social anxiety.
Collapse
Affiliation(s)
- Chunyan He
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yang He
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Tianqi Yang
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Chao Wu
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Yawei Lin
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Jiaran Yan
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Wei Chang
- Center for Aerospace Clinical Medicine, Department of Aerospace Medicine, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China
| | - Fenxia Chang
- Department of Obstetrics and Gynecology, Xi 'an Daxing Hospital, Xi'an, 710000, Shaanxi, China
| | - Yameng Wang
- School of Clinical Medicine, Anhui Medical University, Hefei, 230000, Anhui, China
| | - Shengjun Wu
- Department of Psychology, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
| | - Baohua Cao
- Department of Nursing, Fourth Military Medical University, Xi'an, 710032, Shaanxi, China.
| |
Collapse
|
|
11
|
Drozd C, Curtit E, Jacquinot Q, Marquine C, Mansi L, Chaigneau L, Dobi E, Viot J, Meynard G, Paillard MJ, Goujon M, Roux P, Vernerey D, Gillet V, Bourdin H, Galli S, Meneveau N, Mougin F. A randomized trial to evaluate the effects of a supervised exercise program on insomnia in patients with non-metastatic breast cancer undergoing chemotherapy: design of the FATSOMCAN study. BMC Cancer 2023; 23:449. [PMID: 37198562 DOI: 10.1186/s12885-023-10902-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 04/28/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Up to 70% of breast cancer patients report symptoms of insomnia during and after treatment. Despite the ubiquity of insomnia symptoms, they are under-screened, under-diagnosed and poorly managed in breast cancer patients. Sleep medications treat symptoms but are ineffective to cure insomnia. Other approaches such as cognitive behavioral therapy for insomnia, relaxation through yoga and mindfulness are often not available for patients and are complex to implement. An aerobic exercise program could be a promising treatment and a feasible option for insomnia management in breast cancer patients, but few studies have investigated the effects of such a program on insomnia. METHODS This multicenter, randomized clinical trial evaluate the effectiveness of a moderate to high intensity physical activity program (45 min, 3 times per week), lasting 12 weeks, in minimizing insomnia, sleep disturbances, anxiety/depression, fatigue, and pain, and in enhancing cardiorespiratory fitness. Patients with breast cancer be recruited from six hospitals in France and randomly allocated to either the "training" or the "control" group. Baseline assessments include questionnaires [Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index questionnaire (PSQI), Hospital Anxiety Depression Scale (HADS), Epworth Sleepiness Scale (ESS)], home polysomnography (PSG), and 7-day actigraphy coupled with completion of a sleep diary. Assessments are repeated at the end of training program and at six-month follow-up. DISCUSSION This clinical trial will provide additional evidence regarding the effectiveness of physical exercise in minimizing insomnia during and after chemotherapy. If shown to be effective, exercise intervention programs will be welcome addition to the standard program of care offered to patients with breast cancer receiving chemotherapy. TRIAL REGISTRATION National Clinical Trials Number (NCT04867096).
Collapse
Affiliation(s)
- Chloé Drozd
- Sports Science Faculty, University of Franche-Comté, Besançon, 25000, France.
- Research Unit EA3920, University of Franche-Comté, Besançon, 25000, France.
- Sleep Medicine Center, Ellipse, Besançon, 25000, France.
| | - Elsa Curtit
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
- INSERM U1098 RIGHT, University of Franche-Comté, Besançon, France
| | - Quentin Jacquinot
- Research Unit EA3920, University of Franche-Comté, Besançon, 25000, France
- Regional Federative Cancer Institute of Franche-Comté, Besançon, France
| | - Charlène Marquine
- Sports Science Faculty, University of Franche-Comté, Besançon, 25000, France
| | - Laura Mansi
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
- INSERM U1098 RIGHT, University of Franche-Comté, Besançon, France
| | - Loïc Chaigneau
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | - Erion Dobi
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | - Julien Viot
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | - Guillaume Meynard
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | | | - Morgan Goujon
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | - Pauline Roux
- Department of Physiology-Functional Explorations, University Hospital, Besançon, 25000, France
| | - Dewi Vernerey
- Methodology and Quality of Life Unit, UMR 1098, University Hospital, Besançon, 25000, France
| | | | - Hubert Bourdin
- Research Unit EA481, Unit of Sleep Disorder, University of Franche-Comté, Besançon, 25000, France
| | - Silvio Galli
- Department of Neurology, University Hospital, Besançon, 25000, France
| | - Nathalie Meneveau
- Department of Medical Oncology, University Hospital, Besançon, 25000, France
| | - Fabienne Mougin
- Sports Science Faculty, University of Franche-Comté, Besançon, 25000, France
- Research Unit EA3920, University of Franche-Comté, Besançon, 25000, France
| |
Collapse
|
|
12
|
D'cunha K, Park Y, Protani MM, Reeves MM. Circadian rhythm disrupting behaviours and cancer outcomes in breast cancer survivors: a systematic review. Breast Cancer Res Treat 2023; 198:413-421. [PMID: 36422754 PMCID: PMC10036454 DOI: 10.1007/s10549-022-06792-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 10/30/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Circadian rhythm disruptors (e.g., night-shift work) are risk factors for breast cancer, however studies on their association with prognosis is limited. A small but growing body of research suggests that altered sleep patterns and eating behaviours are potential mechanistic links between circadian rhythm disruptors and breast cancer. We therefore systematically summarised literature examining the influence of circadian rhythm disrupting behaviours on cancer outcomes in women with breast cancer. METHODS A systematic search of five databases from inception to January 2021 was conducted. Original research published in English, assessing the relationship between post-diagnosis sleep patters and eating behaviours, and breast cancer outcomes were considered. Risk of bias was assessed using the Newcastle-Ottawa Assessment Scale for Cohort Studies. RESULTS Eight studies published original evidence addressing sleep duration and/or quality (k = 7) and, eating time and frequency (k = 1). Longer sleep duration (≥ 9 h versus [referent range] 6-8 h) was consistently associated with increased risk of all outcomes of interest (HR range: 1.37-2.33). There was limited evidence to suggest that measures of better sleep quality are associated with lower risk of all-cause mortality (HR range: 0.29-0.97). Shorter nightly fasting duration (< 13 h versus ≥ 13 h) was associated with higher risk of all breast cancer outcomes (HR range: 1.21-1.36). CONCLUSION Our review suggests that circadian rhythm disrupting behaviours may influence cancer outcomes in women with breast cancer. While causality remains unclear, to further understand these associations future research directions have been identified. Additional well-designed studies, examining other exposures (e.g., light exposure, temporal eating patterns), biomarkers, and patient-reported outcomes, in diverse populations (e.g., breast cancer subtype-specific, socio-demographic diversity) are warranted.
Collapse
Affiliation(s)
- Kelly D'cunha
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Melinda M Protani
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Marina M Reeves
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|
|
13
|
Wang Q, Hu S, Pan NC, Zhang T, Ren L, Wang Y. Association of sleep complaints with all-cause and heart disease mortality among US adults. Front Public Health 2023; 11:1043347. [PMID: 37026138 PMCID: PMC10070800 DOI: 10.3389/fpubh.2023.1043347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 02/20/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Compared with sleep disorders, no consensus has been reached on whether a subjective complaint of having trouble sleeping is associated with increased all-cause and heart disease mortality risk. Previous studies displayed considerable heterogeneity in population disease characteristics and duration of follow-up. Therefore, the aims of this study were to examine the relationship between sleep complaints and all-cause and heart disease mortality and whether the associations were influenced by follow-up time and population disease characteristics. In addition, we aimed to figure out the influence of the joint effects of sleep duration and sleep complaints on mortality risk. Methods The present study utilized data from five cycles of the National Health and Nutrition Examination Survey (NHANES) (2005~2014) linked with the most updated 2019 National Death Index (NDI). Sleep complaints were determined by answers to "Have you ever told a doctor or other health professional that you have trouble sleeping?" and "Have you ever been told by a doctor or other health professional that you have a sleep disorder?". Those who answered 'Yes' to either of the aforementioned two questions were considered as having sleep complaints. Results A total of 27,952 adult participants were included. During a median follow-up of 9.25 years (interquartile range, 6.75-11.75 years), 3,948 deaths occurred and 984 were attributable to heart disease. A multivariable-adjusted Cox model revealed that sleep complaints were significantly associated with all-cause mortality risk (HR, 1.17; 95% CI, 1.07-1.28). Subgroup analysis revealed that sleep complaints were associated with all-cause (HR, 1.17; 95% CI, 1.05-1.32) and heart disease (HR, 1.24; 95% CI, 1.01-1.53) mortality among the subgroup with cardiovascular disease (CVD) or cancer. In addition, sleep complaints were more strongly associated with short-term mortality than long-term mortality. The joint analysis of sleep duration and sleep complaints showed that sleep complaints mainly increased the mortality risk in those with short (< 6 h/day, sleep complaints HR, 1.40; 95% CI, 1.15-1.69) or recommended (6-8 h/day, sleep complaints HR, 1.15; 95% CI, 1.01-1.31) sleep duration group. Discussion In conclusion, sleep complaints were associated with increased mortality risk, indicating a potential public benefit of monitoring and managing sleep complaints in addition to sleep disorders. Of note, persons with a history of CVD or cancer may represent a potentially high-risk group that should be targeted with a more aggressive intervention of sleep problems to prevent premature all-cause and heart disease death.
Collapse
Affiliation(s)
- Qiao Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Shimin Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Na Clara Pan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Tingting Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| | - Liankun Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
- Beijing Key Laboratory of Neuromodulation, Beijing, China
- Institute of Sleep and Consciousness Disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
| |
Collapse
|
|
14
|
Li Z, Wang Q, Xu J, Song Q, Ling X, Gao Y, Lei J. Comparative efficacy and acceptability of interventions for insomnia in breast cancer patients: A protocol for systematic review and network meta-analysis. PLoS One 2023; 18:e0282614. [PMID: 36881596 PMCID: PMC9990914 DOI: 10.1371/journal.pone.0282614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/18/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Symptoms of insomnia are highly prevalent in patients with breast cancer. There are a large number of pharmacological and non-pharmacological interventions that can be used for the management of insomnia in breast cancer patients; however, their comparative effectiveness and acceptability remain uncertain. This review aims to evaluate the efficacy and acceptability of different interventions for insomnia in breast cancer patients using a Bayesian network meta-analysis (NMA). METHODS We will perform a comprehensive literature search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and PsycINFO from inception to November 2022. We will include randomized controlled trials (RCTs) that compared the effects of different interventions on the management of insomnia in breast cancer patients. We will assess the risk of bias assessment using a modified Cochrane instrument. We will conduct a Bayesian random-effects framework NMA to estimate relative effects of interventional procedures. We will use Grading of Recommendations Assessment, Development and Evaluation to rate the certainty of evidence. DISCUSSION To our knowledge, this will be the first systematic review and network meta-analysis to compare the effectiveness and acceptability of all currently available interventions for insomnia in patients with breast cancer. The results of our review will help provide more evidence for the treatment of insomnia in breast cancer patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021282211.
Collapse
Affiliation(s)
- Zhifan Li
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Qian Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Junxia Xu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Qihua Song
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xiaoling Ling
- Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Gao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Junqiang Lei
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- * E-mail:
| |
Collapse
|
|
15
|
Hofmeister D, Schulte T, Mehnert-Theuerkauf A, Geue K, Zenger M, Esser P, Götze H, Hinz A. The association between sleep problems and general quality of life in cancer patients and in the general population. Front Psychol 2022; 13:960029. [PMID: 36591026 PMCID: PMC9800265 DOI: 10.3389/fpsyg.2022.960029] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Objective It is well-known that patients with cancer frequently experience sleep problems, and that sleep quality is associated with general quality of life (QoL). The aims of this study were to analyze the relationship between sleep problems and other components of QoL in more detail and to investigate sex and age differences in sleep quality in cancer patients in comparison with the general population. Method This study comprised one general population sample (n = 4,476) and eight samples with cancer patients (n between 323 and 4,020). Sleep Quality was measured using the QoL questionnaire EORTC QLQ-C30. Results All of the cancer patient groups reported more sleep problems than the general population. Sleep problems were associated with all facets of QoL both in cancer patients and in the general population. The highest associations were found in cancer patients for fatigue (r = 0.52) and emotional functioning (r = -0.47). The association between sleep quality and general QoL was lower in the cancer samples (r = -0.37) than in the general population (r = -0.46). Female cancer patients reported markedly more sleep problems than male patients did (d = 0.45), while this sex difference was lower in the general population (d = 0.15). In contrast to the general population, younger cancer patients had greater trouble sleeping than older patients did (d = -0.17). Conclusion The results underline the significance of the role mental factors play in sleep problems. Health care providers should pay special attention to female patients and younger patients concerning this issue.
Collapse
Affiliation(s)
- Dirk Hofmeister
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Markus Zenger
- Department of Applied Human Studies, University of Applied Sciences Magdeburg-Stendal, Stendal, Germany,Integrated Research and Treatment Center Adiposity Diseases, Leipzig University, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Heide Götze
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, Leipzig University, Leipzig, Germany,*Correspondence: Andreas Hinz,
| |
Collapse
|
|
16
|
Oh MJ, Kim HS. Research Trends of Non-Pharmacological Interventions for Sleep-Wake Disturbances in Cancer Patients. ASIAN ONCOLOGY NURSING 2022. [DOI: 10.5388/aon.2022.22.3.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Moon Ju Oh
- Assistant Professor, Department of Nursing, Songwon University, Gwangju, Korea
| | - Hee Sun Kim
- Associate Professor, College of Nursing · Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
| |
Collapse
|
|
17
|
Efficacy and Safety of Auricular Acupuncture for the Treatment of Insomnia in Breast Cancer Survivors: A Randomized Controlled Trial. Cancers (Basel) 2021; 13:cancers13164082. [PMID: 34439234 PMCID: PMC8394534 DOI: 10.3390/cancers13164082] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 01/10/2023] Open
Abstract
Among women, breast cancer is the most commonly diagnosed cancer worldwide. Sleep problems impair 40-70% of breast cancer survivors. This randomized controlled trial evaluates the effect of auricular acupuncture on sleep quality in breast cancer survivors suffering from insomnia. Fifty-two female breast cancer survivors with insomnia (mean age 55.73 ± 8.10 years) were randomized either to 10 treatments of auricular acupuncture within five weeks (n = 26), or to a single session of psychoeducation plus an insomnia advice booklet (n = 26). The primary outcome was sleep quality (measured by the Pittsburgh Sleep Quality Index) at week 5. Secondary outcomes were inflammation parameter (interleukin-6), stress, anxiety, depression, quality of life, and fatigue at week 5, and sleep quality, stress, anxiety, depression, quality of life, and fatigue 17 and 29 weeks after randomization. Intention-to-treat analysis showed a significantly stronger increase in sleep quality in the auricular acupuncture group compared to the psychoeducation group (p = 0.031; η2p = 0.094) at week 5. Furthermore, auricular acupuncture improved stress (p = 0.030; η2p = 0.094), anxiety (p = 0.001; η2p = 0.192), and fatigue (p = 0.006; η2p = 0.148) at week 5 compared to psychoeducation. No significant group difference was found concerning the other outcomes at week 5, or in any outcome at week 17 or week 29. No serious adverse events occurred during the study period. In conclusion, a semi-standardized group auricular acupuncture might be an effective and safe intervention in treating insomnia in breast cancer survivors in the short term, and may reduce stress, anxiety, and fatigue as well. Long-term effects remain questionable.
Collapse
|