Study on influencing factors of sleep quality in elderly patients with advanced lung cancer undergoing chemotherapy

doi:10.19983/j.issn.2096-8493.20230028

Abstract

Abstract:

Objective: To explore the influencing factors of sleep quality in elderly patients with advanced lung cancer undergoing chemotherapy, and to provide references for accurate nursing. Methods: A cross-sectional survey was conducted on 145 elderly patients with advanced lung cancer undergoing chemotherapy admitted to the Oncology Department of Shanghai Pulmonary Hospital from October 2022 to January 2023, using a patient general information questionnaire and the Pittsburgh sleep quality index (PSQI) scale and the Alcohol Use Disorder Identification Test (AUIDT) scale. PSQI≥8 was defined as the cutoff point for sleep disorders, the status of sleep quality and its influencing factors were analyze. Results: The average PSQI score of elderly patients with advanced lung cancer undergoing chemotherapy was (8.41±3.96), and the incidence of sleep disorders was 51.03% (74/145). The total PSQI score ($\bar{x}±s$) of female was (10.78±3.11), and the scores of subjective sleep quality ($\bar{x}±s$), time to sleep (M(Q₁,Q₃)), sleep duration (M(Q₁,Q₃)), and usage of hypnotic drugwere (M(Q₁,Q₃)) were (1.65±0.48), (1.87 (1.47,2.29), (1.78 (1.31,2.28)), and (1.09 (0.83,1.39)), respectively, which were significantly higher than those of men ((7.96±2.33), (1.13±0.33), (1.30 (1.26,1,33)), (1.22 (0.89,1.52)), and (0.19 (0.16,0.29)), respectively), the differences were statistically significant (t=2.673, 2.555, 2.421,U=2.667, and 2.924; P=0.013, 0.012, 0.022, 0.013, and 0.007, respectively). The scores of sleeping time ($\bar{x}±s$) and hypnotic drug usage ($\bar{x}±s$) in smokers were (1.67±0.48) and (0.93±0.29), respectively, which were significantly higher than those in non-smokers ((1.22±0.39) and (0.17±0.05), respectively), the differences were statistically significant (t=2.700 and 2.914; P=0.008 and 0.006, respectively). The score of hypnotic drug use (M(Q₁,Q₃)) dimension of those who with alcohol dependence history was (0.10 (0.06,0.12), which was significantly lower than that of those who without alcohol dependence history (0.39 (0.35,0.50)), (U=2.616, P=0.010). Patients with abnormal white blood cell counts had significantly higher total PSQI score (M(Q₁,Q₃)), sleep time ($\bar{x}±s$), and sleep disorder scores (M(Q₁,Q₃) compared to patients with normal white blood cell counts ((8.60 (4.36,8.73)vs. (6.88 (3.56,7.12), U=2.267, P=0.032; (1.45±0.43) vs. (0.94±0.28), t=2.137, P=0.034; and (1.30 (0.65,1.40)) vs. (1.01 (0.68,1.36), U=3.531,P=0.001, respectively). The daytime dysfunction ($\bar{x}±s$) dimension scores of individuals with abnormal hemoglobin and red blood cell count (1.25±0.36, 1.12±0.28) were higher than those of normal individuals (0.67±0.15, 0.76±0.18), and the differences were statistically significant (t=-3.475, -2.120; P=0.01, 0.036, respectively). The dimension score of hypnotic drug usage (M(Q₁,Q₃)) of patients with abnormal glutamic transaminase and direct bilirubin was higher than that of normal patients (0.36 (0.24,0.49) vs. 0.01 (0.00,0.01), 0.40 (0.26,0.51) vs. 0.11 (0.08,0.13), and the difference was statistically significant (U=4.425, 2.198; P=0.00, 0.030, respectively). Conclusion: The incidence of sleep disorders in elderly patients with advanced lung cancer undergoing chemotherapy is relatively high. In clinic, gender, smoking and alcohol history, daily activity ability, blood routine, and liver function indicators should be pay close attention to develop precise nursing plans.

Key words: Sleep initiation and maintenance disorders, Lung neoplasms, Factor analysis, statistical

CLC Number:

R473.73

Fan Panyu, Li Yumei, Yang Lei, Fan Jiaxin. Study on influencing factors of sleep quality in elderly patients with advanced lung cancer undergoing chemotherapy[J]. Journal of Tuberculosis and Lung Disease , 2023, 4(3): 210-215. doi: 10.19983/j.issn.2096-8493.20230028

Figures/Tables 2

血生化指标	主观睡眠质量 ($bar{x}±s$) [M(Q₁,Q₃)]	入睡时间 ($bar{x}±s$) [M(Q₁,Q₃)]	睡眠时间 ($bar{x}±s$) [M(Q₁,Q₃)]	睡眠效率 ($bar{x}±s$)	睡眠障碍 ($bar{x}±s$) [M(Q₁,Q₃)]	催眠药物使用 [M(Q₁,Q₃)]/ ($bar{x}±s$)	日间功能障碍 ($bar{x}±s$)	匹兹堡睡眠质量指数总分 [M(Q₁,Q₃)]/ ($bar{x}±s$)
血红蛋白
正常	1.14±0.36	1.38±0.21	1.30±0.25	1.89±0.43	1.27±0.39	0.23 (0.14,0.28)	0.67±0.15	8.07 (5.22,10.34)
异常	1.34±0.23	1.42±0.33	1.32±0.43	2.11±0.57	1.36±0.38	0.39 (0.23,0.48)	1.25±0.36	9.00 (5.78,11.54)
统计检验值	t=-1.260	t=-0.219	t=0.093	t=-1.318	t=-1.026	U=1.148	t=-3.475	U=-1.468
P值	0.210	0.827	0.926	0.189	0.307	0.253	0.001	0.145
红细胞计数
正常	1.20 (0.65,1.30)	1.30 (0.69,1.31)	1.22±0.36	1.94±0.51	1.27±0.39	0.16±0.02	0.76±0.18	8.40±1.33
异常	1.20 (0.77,1.54)	1.44 (0.87,1.72)	1.36±0.26	2.04±0.53	1.36±0.39	0.42±0.12	1.12±0.28	8.41±2.19
统计检验值	U=0.141	U=0.936	t=0.951	t=-0.602	t=-1.007	t=1.918	t=-2.120	t=0.017
P值	0.888	0.351	0.343	0.548	0.316	0.057	0.036	0.987
白细胞计数
正常	1.10 (0.57,1.12)	0.94±0.28	1.13±0.24	1.81±0.39	1.01 (0.68,1.36)	0.01 (0.00,0.01)	0.81±0.21	6.88 (3.56,7.12)
异常	1.20 (0.63,1.26)	1.45±0.43	1.33±0.32	1.99±0.61	1.30 (0.65,1.40)	0.37 (0.23,0.46)	0.89±0.23	8.60 (4.36,8.73)
统计检验值	U=0.568	t=2.137	t=0.947	t=0.692	U=3.531	U=4.437	t=0.300	U=2.267
P值	0.575	0.034	0.345	0.490	0.001	0.000	0.765	0.032
血小板计数
正常	1.04±0.33	1.28 (0.63,1.24)	1.29±0.33	1.96±0.35	1.00 (0.56,1.11)	0.32±0.09	0.87±0.29	8.12 (4.08,8.15)
异常	1.25±0.24	1.42 (0.75,1.48)	1.40±0.42	1.98±0.49	1.31 (0.73,1.45)	0.40±0.05	0.96±0.22	8.47 (4.66,9.31)
统计检验值	t=1.045	U=0.799	t=-0.593	t=0.069	U=2.937	t=-0.417	t=-0.428	U=0.471
P值	0.298	0.429	0.554	0.945	0.005	0.677	0.669	0.640
谷丙转氨酶
正常	1.21±0.22	1.36±0.22	1.28±0.22	1.94±0.48	1.27±0.39	0.01 (0.00,0.01)	0.84±0.28	8.34±1.98
异常	1.27±0.11	1.40±0.42	1.64±0.32	2.36±0.62	1.31±0.37	0.36 (0.24,0.49)	1.36±0.33	9.27±2.88
统计检验值	t=-0.222	t=0.111	t=-1.360	t=-1.384	t=0.215	U=4.425	t=-1.687	t=-0.769
P值	0.825	0.912	0.176	0.169	0.830	0.000	0.094	0.457
直接胆红素
正常	1.20 (0.64,1.27)	1.31±0.27	1.20 (0.68,1.36)	1.91±0.57	1.29±0.30	0.11 (0.08,0.13)	0.87±0.21	8.00±1.13
异常	1.20 (0.76,1.50)	1.42±0.35	1.30 (0.71,1.43)	1.99±0.31	1.31±0.36	0.40 (0.26,0.51)	0.91±0.25	8.54±2.41
统计检验值	U=0.115	t=0.584	U=0.485	t=0.402	t=0.245	U=2.198	t=-0.216	t=0.696
P值	0.909	0.560	0.629	0.688	0.807	0.030	0.830	0.488

References 10

[1]	刘海洋, 张晓菊. 预测模型在肺癌早期诊断中的应用. 结核与肺部疾病杂志, 2021, 2(3): 262-266. doi:10.3969/j.issn.2096-8493.20210037. doi: 10.3969/j.issn.2096-8493.20210037
[2]	Lbw A, Wzw A, Pk A, et al. Beneficial effects of exercise on chemotherapy-induced peripheral neuropathy and sleep disturbance: A review of literature and proposed mechanisms. Gynecol Oncol Rep, 2022, 39:100927. doi:10.1016/j.gore.2022.100927. doi: 10.1016/j.gore.2022.100927
[3]	李峥. 护理学研究方法. 北京: 人民卫生出版社, 2012.
[4]	王丽. 中国原发性肺癌诊疗规范(2015年版)解读. 世界临床药物, 2016, 37(7):433-436. doi:10.13683/j.wph.2016.07.001. doi: 10.13683/j.wph.2016.07.001
[5]	刘贤臣, 唐茂芹. 匹兹堡睡眠质量指数的信度和效度研究. 中华精神科杂志, 1996, 29(2):103-107.
[6]	Youri H, Samantha C, Sangchoon J, et al. Factors associated with sleep health in young women after breast cancer treatment. Res Nurs Health, 2022, 45(6):680-692. doi:10.1002/nur.22264. doi: 10.1002/nur.22264 pmid: 36102624
[7]	张聪, 杨国平, 李圳, 等. 中文版酒精使用障碍筛查量表信度和效度评价. 中华流行病学杂志, 2017, 38(8):1064-1067. doi:10.3760/cma.j.issn.0254-6450.2017.08.013. doi: 10.3760/cma.j.issn.0254-6450.2017.08.013
[8]	徐晓程, 张晗, 邹天森, 等. 淮河流域男性居民戒烟与呼吸道慢性病关系的研究. 结核与肺部疾病杂志, 2022, 3(4):261-268. doi:10.19983/j.issn.2096-8493.20220036. doi: 10.19983/j.issn.2096-8493.20220036
[9]	Plotogea OM, Diaconu CC, Gheorghe G, et al. The Prevalence and Association of Cognitive Impairment with Sleep Distur-bances in Patients with Chronic Liver Disease. Brain Sci, 2022, 12(4):444. doi:10.3390/brainsci12040444. doi: 10.3390/brainsci12040444 URL
[10]	马孔永, 王月霞, 杜超, 等. 支持-表达性团体干预联合健康教育护理对肺癌化疗患者负性情绪、疾病认知和睡眠质量的影响. 肿瘤基础与临床, 2023, 36(1):71-75. doi:10.3969/j.issn.1673-5412.2023.01.016. doi: 10.3969/j.issn.1673-5412.2023.01.016

临床特征	主观睡眠质量 ($\bar{x}±s$)	入睡时间 [M(Q₁,Q₃)]/ ($\bar{x}±s$)	睡眠时间 [M(Q₁,Q₃)]/ ($\bar{x}±s$)	睡眠效率 ($\bar{x}±s$)	睡眠障碍 ($\bar{x}±s$)	催眠药物使用 [M(Q₁,Q₃)]/ ($\bar{x}±s$)	日间功能障碍 ($\bar{x}±s$)/ [M(Q₁,Q₃)]	匹兹堡睡眠质量指数总分 ($\bar{x}±s$)/ [M(Q₁,Q₃)]
性别
男性	1.13±0.33	1.30 (1.26,1.33)	1.22 (0.89,1.52)	1.95±0.46	1.29±0.27	0.19 (0.16,0.29)	0.88±0.28	7.96±2.33
女性	1.65±0.48	1.87 (1.47,2.29)	1.78 (1.31,2.28)	2.09±0.58	1.39±0.38	1.09 (0.83,1.39)	0.91±0.24	10.78±3.11
统计检验值	t=2.555	U=2.421	U=2.667	t=0.611	t=0.936	U=2.924	t=0.159	t=2.673
P值	0.012	0.022	0.013	0.542	0.351	0.007	0.874	0.013
吸烟史
无	1.14±0.28	1.31 (1.24,1.89)	1.22±0.39	1.95±0.56	1.30±0.28	0.17±0.05	0.87 (0.47,0.92)	7.96 (4.38,8.76)
有	1.50±0.31	1.70 (1.53,2.49)	1.67±0.48	2.07±0.35	1.33±0.35	0.93±0.29	0.93 (0.64,1.20)	10.10 (6.65,12.30)
统计检验值	t=1.944	U=1.786	t=2.700	t=0.591	t=0.374	t=2.914	U=0.313	U=2.37
P值	0.054	0.085	0.008	0.555	0.709	0.006	0.754	0.023
酒精依赖史
无	1.19±0.31	1.38±0.33	1.28±0.31	1.97±0.56	1.28±0.29	0.39 (0.35,0.50)	0.86±0.21	8.38±1.97
有	1.31±0.33	1.45±0.37	1.41±0.21	2.01±0.47	1.38±0.39	0.10 (0.06,0.12)	0.89±0.22	8.52±2.01
统计检验值	t=-0.634	t=-0.362	t=-0.750	t=-0.169	t=-0.931	U=2.616	t=0.125	t=-0.167
P值	0.527	0.718	0.455	0.866	0.354	0.010	0.900	0.868

[1]	LI Xiang-nan, ZHANG Xiao-ju. Research progress of tumor ablation in lung cancer [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 256-261.
[2]	ZHANG Qun-cheng, LI Xiang-nan, XU Zhi-wei, SUN Guan-nan, YANG Hui-zhen, CHENG Dong-jun, ZHANG Xiao-ju. Diagnostic value of bronchoscopic cryobiopsy for diagnosing peripheral lung nodule [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 205-209.
[3]	LIU Hai-yang, ZHANG Xiao-ju. Application of predictive model in early diagnosis of lung cancer [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 262-266.
[4]	YANG Hui-zhen, ZHANG Qun-cheng, ZHANG Xiao-ju. Advances in clinical application of endobronchial ultrasound-guided transbronchial needle aspiration [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 267-272.
[5]	CUI Kai, ZHANG Xiao-ju. Research progress on the application of biomarkers in differential diagnosis of benign and malignant pulmonary nodules [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(3): 273-276.
[6]	XIN Wu-qun, CHEN Xiao, TANG Jin-xing, XU Gao-jun, ZHOU Zhen-qiang, HE Yi. Factors of persistent cough secondary to thoracoscopic resection of lung cancer [J]. Journal of Tuberculosis and Lung Disease, 2021, 2(1): 31-37.
[7]	BU Jing, DU Yun, JI Xiao-kun, WU Jia-ning. Inhibitory effect of cisplatin combined with rapamycin or 3-methyladenine in lung adenocarcinoma A549 cells [J]. Journal of Tuberculosis and Lung Health, 2020, 9(1): 37-43.
[8]	Yang TAN,Tai-chun QIU,Jian-lin WU,Guan-nan ZHANG,Guo-qing ZHANG. Differential diagnosis of lung cancers associated with cystic airspaces and cavitary pulmonary tuberculosis by CT [J]. Journal of Tuberculosis and Lung Health, 2018, 7(4): 241-244.
[9]	XIONG Jing-tong, WU Hao, SHEN Jing, WU Jian-lin, ZHANG Guan-nan, ZHANG Guo-qing, GE Ying. Comparison study of CT features between cavitary tuberculosis and peripheral lung cancer with cavity formation [J]. Journal of Tuberculosis and Lung Health, 2015, 4(3): 157-161.
[10]	YANG Xian-ming, CHEN Wei-sheng, WENG Jia-hao, ZHENG Shao-ting, CHEN Ming-hua. Application of transbronchial needle aspiration under CT-guided in diagnosing mediastinal mass and pulmonary hilar mass [J]. Journal of Tuberculosis and Lung Health, 2015, 4(2): 109-112.
[11]	ZHU Hai-xing,ZHOU Ling,SHI Guo-chao,WANG Lin-lin,PAN Li-na,WAN Huan-ying. The prevalence of blood Thl7 and CD4⁺CD25⁺Treg cells in patients with non-small-cell lung cancer [J]. Journal of Tuberculosis and Lung Health, 2013, 2(2): 100-105.
[12]	LIU Bao-dong, ZHI Xiu-yi. Status and progress of CT-guided percutaneous radiofrequency ablation in lung cancer [J]. Journal of Tuberculosis and Lung Health, 2013, 2(1): 59-63.
[13]	HU Mu, LIU Lei, QIAN Kun, CHEN Dong-hong, LIU Bao-dong, ZHI Xiu-yi. The early image follow-up of CT scan after treatment with radiofrequency ablation of 226 cases lung malignant neoplasm [J]. Journal of Tuberculosis and Lung Health, 2013, 2(1): 14-18.
[14]	WANG Zhi-hong^*, LI Lu, LIN Yi, SHAO Zhuang,SONG Xiao-yong, ZHOU Jun-jun. Therapeutic evaluation for radiofrequency ablation (RFA) combination with gefitinib for advanced lung adenocarcinoma [J]. Journal of Tuberculosis and Lung Health, 2013, 2(1): 11-13.
[15]	LIU Bao-dong, LIU Lei, HU Mu, QIAN Kun, LI Yuan-bo, WANG Ruo-tian, ZHI Xiu-yi. Clinical evaluation of CT-guided percutaneous radiofrequency ablation for the treatment of pulmonary malignancies located in unusual regions [J]. Journal of Tuberculosis and Lung Health, 2013, 2(1): 7-10.