Vivian Huang1, Lynda Mackin1, Kord M Kober1, Steven M Paul1, Bruce A Cooper1, Yvette P Conley2, Marilyn J Hammer3, Jon D Levine4, Christine Miaskowski5,6. 1. School of Nursing, University of California, 2 Koret Way - Box 0610, San Francisco, CA, 94143-0610, USA. 2. School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. 3. Dana Farber Cancer Institute, Boston, MA, USA. 4. School of Medicine, University of California, San Francisco, CA, USA. 5. School of Nursing, University of California, 2 Koret Way - Box 0610, San Francisco, CA, 94143-0610, USA. chris.miaskowski@ucsf.edu. 6. School of Medicine, University of California, San Francisco, CA, USA. chris.miaskowski@ucsf.edu.
Abstract
PURPOSE: Sleep disturbance and cancer-related cognitive impairment (CRCI) are two of the most common symptoms reported by patients undergoing chemotherapy. Less is known about how these symptoms co-occur and their associated risk factors. Study purposes were to identify subgroups of patients with distinct sleep disturbance and CRCI profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, symptom severity scores, and QOL outcomes. METHODS: A total of 1,333 oncology outpatients receiving chemotherapy completed self-report questionnaires on sleep disturbance and cognitive dysfunction six times over two cycles of chemotherapy. Latent profile analysis was used to identify distinct sleep disturbance AND cognitive dysfunction profiles. Parametric and non-parametric tests were used to evaluate for differences among the classes. RESULTS: Two distinct profiles were identified (i.e., Low = low levels of both sleep disturbance and cognitive dysfunction (53.5%); High = high levels of both sleep disturbance and cognitive dysfunction (45.5%)). Patients in the High class were younger, more likely to be female, had a lower functional status and a higher level of comorbidity. In addition, these patients had a higher symptom burden and a lower quality of life. CONCLUSION: Almost half of the patients undergoing chemotherapy experienced clinically meaningful levels of both symptoms. Of note, sleep disturbance is frequently overlooked by both clinicians and patients. Clinicians need to recommend cognitive rehabilitation and physical activity programs to decrease patients' symptom burden.
PURPOSE: Sleep disturbance and cancer-related cognitive impairment (CRCI) are two of the most common symptoms reported by patients undergoing chemotherapy. Less is known about how these symptoms co-occur and their associated risk factors. Study purposes were to identify subgroups of patients with distinct sleep disturbance and CRCI profiles and evaluate for differences among the subgroups in demographic and clinical characteristics, symptom severity scores, and QOL outcomes. METHODS: A total of 1,333 oncology outpatients receiving chemotherapy completed self-report questionnaires on sleep disturbance and cognitive dysfunction six times over two cycles of chemotherapy. Latent profile analysis was used to identify distinct sleep disturbance AND cognitive dysfunction profiles. Parametric and non-parametric tests were used to evaluate for differences among the classes. RESULTS: Two distinct profiles were identified (i.e., Low = low levels of both sleep disturbance and cognitive dysfunction (53.5%); High = high levels of both sleep disturbance and cognitive dysfunction (45.5%)). Patients in the High class were younger, more likely to be female, had a lower functional status and a higher level of comorbidity. In addition, these patients had a higher symptom burden and a lower quality of life. CONCLUSION: Almost half of the patients undergoing chemotherapy experienced clinically meaningful levels of both symptoms. Of note, sleep disturbance is frequently overlooked by both clinicians and patients. Clinicians need to recommend cognitive rehabilitation and physical activity programs to decrease patients' symptom burden.
Authors: Marie Atallah; Bruce Cooper; Ricardo F Muñoz; Steven M Paul; Joaquin Anguera; Jon D Levine; Marilyn Hammer; Fay Wright; Lee-May Chen; Michelle Melisko; Yvette P Conley; Christine Miaskowski; Laura B Dunn Journal: Cancer Nurs Date: 2020 Sep/Oct Impact factor: 2.592