Sleep, Activity and Fatigue in Women Receiving a Sleep Intervention During Adjuvant Breast Cancer Chemotherapy

2.50
Hdl Handle:
http://hdl.handle.net/10755/154694
Type:
Presentation
Title:
Sleep, Activity and Fatigue in Women Receiving a Sleep Intervention During Adjuvant Breast Cancer Chemotherapy
Abstract:
Sleep, Activity and Fatigue in Women Receiving a Sleep Intervention During Adjuvant Breast Cancer Chemotherapy
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Berger, Ann, RN, PhD, AOCN, FAAN
P.I. Institution Name:University of Nebraska Medical Center
Title:Associate Professor
Objective: The purposes of the study were to evaluate the feasibility and outcomes of an intervention designed to promote sleep and modify fatigue during 4 cycles of adjuvant breast cancer chemotherapy. Design: A prospective, repeated measures design was used. Population, Sample, Setting, Years: Women without unstable co-morbidities diagnosed with Stage I-II breast cancer who were post-operative and receiving Adriamycin based chemotherapy were eligible. The sample included 25 Caucasian women, ages 40-65 (X=54.3), most of whom were married and employed, who began chemotherapy treatments at a out-patient clinic between 6/99 and 1/00. Intervention and Outcome Variables: An Individualized Sleep Promotion Plan (ISPP) was developed, consisting of 4 components: sleep hygiene counseling, relaxation therapy, stimulus control and sleep curtailment instructions. The ISPP was negotiated prior to or during the first week of cycle 1 of chemotherapy with regular reinforcements on day 8 of each cycle and revisions prior to each treatment/follow-up time. Outcome variables included sleep and fatigue. Methods: Data were collected for 9 days at each cycle ( 2 days prior and 7 days after chemotherapy). Reliable and valid instruments were used and included: Morin Sleep Diary, Pittsburgh Sleep Quality Index, Wrist Actigraph, Piper Fatigue Scale, and Symptom Experience Scale. Epi-Info, Action 3 and SPSS programs were used for analysis. Findings: Adherence rates with the 4 components of the ISPP varied and ranged at cycles 1-4 from a low of 45-67% for stimulus control to a high of 76-80% for sleep curtailment. Significant findings were: a) mean total rest time remained stable at 8 ½ hrs., b) mean sleep latency remained less than 30 minutes/night, c) mean time awake after sleep onset (WASO) remained stable, ranging from 1/2 to1 hour/night, d) mean sleep efficiency scores remained stable at 84-88%, e) mean activity scores (mesor and amplitude) remained stable during the first 4 days of each cycle, f) mean daytime awakenings increased over time, but nighttime awakenings trended downward, e) mean daily fatigue intensity scores were lower at cycle 3 than at cycle 1, but rebounded back up at cycle 4. Conclusions: The study was feasible, adherence rates varied but improved over time, mean scores for sleep approached normal values, for activity remained lower than normal but stable, and for fatigue improved over time. Daytime activity levels and nighttime rest improved compared to previous examination (with no intervention). Implications: Results have guided the design of a larger, experimental behavioral intervention study.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSleep, Activity and Fatigue in Women Receiving a Sleep Intervention During Adjuvant Breast Cancer Chemotherapyen_GB
dc.identifier.urihttp://hdl.handle.net/10755/154694-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Sleep, Activity and Fatigue in Women Receiving a Sleep Intervention During Adjuvant Breast Cancer Chemotherapy</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Berger, Ann, RN, PhD, AOCN, FAAN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Nebraska Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">aberger@unmc.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: The purposes of the study were to evaluate the feasibility and outcomes of an intervention designed to promote sleep and modify fatigue during 4 cycles of adjuvant breast cancer chemotherapy. Design: A prospective, repeated measures design was used. Population, Sample, Setting, Years: Women without unstable co-morbidities diagnosed with Stage I-II breast cancer who were post-operative and receiving Adriamycin based chemotherapy were eligible. The sample included 25 Caucasian women, ages 40-65 (X=54.3), most of whom were married and employed, who began chemotherapy treatments at a out-patient clinic between 6/99 and 1/00. Intervention and Outcome Variables: An Individualized Sleep Promotion Plan (ISPP) was developed, consisting of 4 components: sleep hygiene counseling, relaxation therapy, stimulus control and sleep curtailment instructions. The ISPP was negotiated prior to or during the first week of cycle 1 of chemotherapy with regular reinforcements on day 8 of each cycle and revisions prior to each treatment/follow-up time. Outcome variables included sleep and fatigue. Methods: Data were collected for 9 days at each cycle ( 2 days prior and 7 days after chemotherapy). Reliable and valid instruments were used and included: Morin Sleep Diary, Pittsburgh Sleep Quality Index, Wrist Actigraph, Piper Fatigue Scale, and Symptom Experience Scale. Epi-Info, Action 3 and SPSS programs were used for analysis. Findings: Adherence rates with the 4 components of the ISPP varied and ranged at cycles 1-4 from a low of 45-67% for stimulus control to a high of 76-80% for sleep curtailment. Significant findings were: a) mean total rest time remained stable at 8 &frac12; hrs., b) mean sleep latency remained less than 30 minutes/night, c) mean time awake after sleep onset (WASO) remained stable, ranging from 1/2 to1 hour/night, d) mean sleep efficiency scores remained stable at 84-88%, e) mean activity scores (mesor and amplitude) remained stable during the first 4 days of each cycle, f) mean daytime awakenings increased over time, but nighttime awakenings trended downward, e) mean daily fatigue intensity scores were lower at cycle 3 than at cycle 1, but rebounded back up at cycle 4. Conclusions: The study was feasible, adherence rates varied but improved over time, mean scores for sleep approached normal values, for activity remained lower than normal but stable, and for fatigue improved over time. Daytime activity levels and nighttime rest improved compared to previous examination (with no intervention). Implications: Results have guided the design of a larger, experimental behavioral intervention study.</td></tr></table>en_GB
dc.date.available2011-10-26T13:12:12Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T13:12:12Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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