Quality of Sleep and Related Factors in Children with Cancer During and After Hospitalization
Date Issued
2011
Date
2011
Author(s)
Lan, Hsiang-Yun
Abstract
Changes in sleep patterns in children with cancer may be a very common problem during hospitalization. The quality of sleep in cancer children during hospitalization thus warrants detailed investigation. The purposes of current research were: (1) to investigate the quality of sleep and related factors, (2) to compare the differences in quality of sleep between hospitalization and after discharge, and (3) to explore predictors of quality of sleep in children with cancer.
A longitudinal and correlation design was used. Children with cancer aged 7-18 years old were enrolled from a medical center in Taipei. Data collection used a set of questionnaires including a Personal Information Form, the Adolescent Sleep Hygiene Scale, the PedsQL Multidimensional Fatigue Scale, the Memorial Symptom Assessment Scale, the Sleep Quality Index, a sleep log, and a 24-hour activity monitor (wrist actigraph) and chart review. Information was collected at three time points, the first day and fifth day of a cycle of hospitalization for chemotherapy and the fifth day after discharge.
A total of 20 participants (with 60 pieces of data) were recruited for the analysis. The average age of participants was 12 ± .67 years with a range of 7-17 years. Seventy five percent of the participants were boys. Most of the participants were diagnosed with leukemia (35%) and neuroblastoma (35%). The average of length of hospital stay was 35.8 ± 6.9 days. The use of pain medicine was correlated with significantly poorer quality of sleep at both day 5 and at home after discharge (F = 5.88, P =.03, F = 4.24, P = .05, respectively). Those participants who used sleep medicine had significantly poorer quality of sleep (F = 5.09, P = .04). With respect to psycho-somatic health, fatigue was significantly positively correlated with negative quality of sleep at both day 5 and at home after discharge (r = 0.44-0.46, P = 0.04-0.05). The severity, frequency, perplexity of symptom was significantly positively correlated with negative quality of sleep at all three time points (r = 0.53-0.62, P = 0.00-0.02). That is, the higher the scores of frequency, severity and suffering scores, the poorer of quality of sleep. With respect to sleep hygiene, there was no significant correlation between hospitalization and sleeping at home, and between sleep hygiene and quality of sleep.
Sleep at home was perceived to be of higher quality at home than that during hospitalization by participants (t = 4.76, P < 0.01). The results recorded by sleep log and wrist actigraph showed that the frequency of awakening at night was higher during hospitalization and subjects had better quality of sleep and mental health at home after discharge. Using the statistical method of Mixed model, the severity, frequency, perplexity of symptom and does use the pain-killer are the important variables to predict the sleep quality.
The findings of the current study provide evidence for clinical practice and increase feasibility of this issue for the health care providers. They may also improve the quality of care and life during hospitalization for both cancer children and their caregivers.
Subjects
childhood cancer
quality of sleep
sleep hygiene
actigraph
SDGs
Type
thesis
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