This study is a descriptive survey investigating the fatigue, sleep disturbances, and quality of life (QOL) in breast cancer patients receiving radiotherapy.
Data were collected from December 10, 2013, to March 27, 2014, through questionnaires distri...
This study is a descriptive survey investigating the fatigue, sleep disturbances, and quality of life (QOL) in breast cancer patients receiving radiotherapy.
Data were collected from December 10, 2013, to March 27, 2014, through questionnaires distributed to 201 breast cancer patients of a specialized cancer hospital in Gyeonggi-do. Fatigue was measured using the Korean version of the Functional Assessment of Chronic Illness Therapy(FACIT) Fatigue Scale. Sleep disturbance was measured with the Pittsburgh Sleep Quality Index(PSQI), as developed by the University of Pittsburgh’s Sleep Medicine Institute and translated by Choi, Kim, Kim, and Kim (2012), and quality of life was measured using the Korean version of the Functional Assessment of Cancer Therapy – Breast Cancer Version 4 (FACT-B), as developed by FACIT.
Data analysis consisted of analyzing the scores, percentages, means, and standard deviations of the given variables, using SPSS 21.0. The inter-subject differences in fatigue, sleep disturbances, and quality of life depending on the general and cancer-specific characteristics of the respondents were analyzed using t-tests and ANOVA, and post-hoc comparisons were made using Scheffe’s test. The correlations between fatigue, sleep disturbance, and quality of life were analyzed using Pearson’s correlation coefficients, and multiple regression analysis was used to determine the factors influencing respondents’ fatigue, sleep disturbances, and quality of life.
The results of the current study were as follows:
1. The subjects showed the following general characteristics: the mean age was 47.36 ± 8.46, 50.2% (n = 101) were educated above the university level, 71.6% (n = 144) were religious, 82.6% (n = 166) were married, 79.6% (n = 160) were employed, 59.2% (n = 119) earned less than 2 million won (2000 USD) per month, 60.2% (n = 121) exercised at least twice a week, and 43.3% (n = 87) received emotional support from their spouses.
In terms of disease-specific characteristics, 35.3% (n = 71) were in Stage II and 63.7% (n = 128) had undergone surgery, chemotherapy, and radiotherapy. More than half (57.7%; n = 116) were diagnosed between 6 and 12 months after their first clinical presentation, 76.6% (n = 154) received hypofraction therapy, and 70.1% (n = 141) received only local treatments on tumor sites
2. On average, the respondents rated fatigue as 19.6 ± 10.894, and sleep disturbance as 7.55 ± 4.24. The average QOL score was 92.16 ± 20.95, and the subscale score values were 19.57 ± 6.33 for physical well-being, 16.26 ± 5.33 for social well-being, 17.00 ± 4.87 for emotional well-being, 16.14 ± 6.22 for functional well-being, and 23.17 ± 6.90 for miscellaneous breast cancer-related factors.
3. The fatigue scores differed significantly, based on their religion (t = -2.902, p = .004), monthly income (t = -2.130, p = .035), exercise level (F = 5.291, p = .006), and time of diagnosis (F = 3.743, p = .025). The sleep disturbance scores showed statistically significant differences, depending on their education levels (F = 3.192, p = .43) and time of diagnosis (F = 9.143, p < .001). Their QOL values were also significantly different, based on education level (F = 3.192, p = .43), marriage status (F = 3.828, p = .023), exercise amount (F = 12.909, p < .001), treatment method (t = 2.253, p = .025), time of diagnosis (F = 3.109, p = .047), and irradiation site (F = 3.310, p = .039). In most cases, exercise and the timeframe of the diagnosis showed significant differences in their correlations with fatigue, sleep disturbance, and QOL.
4. As for the correlations between fatigue, sleep disturbances, and QOL, fatigue and sleep disturbances (r = .403, p < .001) showed positive statistically significant correlations, while fatigue and QOL (r = -.545, p < .001), and sleep disturbances and QOL (r = -.449, p < .001) showed statistically significant negative correlations.
5. The multiple regression analysis, which was used to determine the variables affecting breast cancer patients’ QOL after receiving radiotherapy, resulted in a significant regression model (F = 49.114, p < .001), which accounted for approximately 41.9% of the explanatory power. Fatigue (β = -.337, p < .001) and sleep disturbances (β = -.203, p < .001) were revealed to adversely affect quality of life.
To summarize the above study results, QOL decreased in proportion to increases in fatigue and sleep disturbance. Exercise was associated with significant inter-subject differences in fatigue and QOL, and diagnosis time frame was a significantly influential factor for QOL. This suggests the importance of nursing interventions aimed at reducing fatigue and sleep disturbance, cutting the diagnosis timeframe, and promoting exercise in order to enhance breast cancer patients’ QOL of patients while receiving radiotherapy.
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