Oncology Outpatients with Worse Anxiety and Sleep Disturbance Profiles Are at Increased Risk for a Higher Symptom Burden and Poorer Quality of Life

Alejandra Calvo-Schimmel, Steven M. Paul, Bruce A. Cooper, Joosun Shin, Carolyn Harris, Kate Oppegaard, Marilyn J. Hammer, Frances Cartwright, Yvette P. Conley, Kord M. Kober, Jon D. Levine, Christine Miaskowski

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background Anxiety and sleep disturbance are frequent symptoms during chemotherapy. Objectives Purposes were to identify subgroups of oncology outpatients with distinct joint anxiety and sleep disturbance profiles, as well as evaluate for differences in demographic and clinical characteristics, sleep disturbance characteristics, severity of common symptoms, and quality-of-life outcomes among these subgroups. Methods Oncology outpatients (n = 1331) completed self-report measures of anxiety and sleep disturbance 6 times over 2 chemotherapy cycles. Latent profile analysis was done to identify subgroups of patients with distinct joint anxiety and sleep disturbance profiles. Results Three profiles were identified (ie, no anxiety and low sleep disturbance (59.7%), moderate anxiety and high sleep disturbance (32.5%), high anxiety and very high sleep disturbance (7.8%)). Compared with the no anxiety and low sleep disturbance class, the other 2 classes were younger; less likely to be married; had a lower annual household income; and had childcare responsibilities. Patients in the 2 worse profiles had problems with both sleep initiation and maintenance. These patients reported higher levels of depressive symptoms, trait and state anxiety, and evening fatigue, as well as lower levels of morning and evening energy, cognitive function, and poorer quality of life. Conclusions More than 40% of patients had moderate or high levels of anxiety and high or very high levels of sleep disturbance. Modifiable risk factors associated with these profiles may be used to develop targeted interventions for 1 or both symptoms. Implications for Practice Clinicians need to assess for the co-occurrence of anxiety and sleep disturbance.

Original languageEnglish
Pages (from-to)417-431
Number of pages15
JournalCancer Nursing
Volume46
Issue number6
DOIs
StatePublished - 29 Nov 2023

Keywords

  • Anxiety
  • Cancer
  • Chemotherapy
  • Latent profile analysis
  • Sleep disturbance

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