Poor sleep quality, depression and hope before breast cancer surgery.

AIM: This study aims to identify the predictors of poor sleep quality and the associations between depression, hope and sleep in a sample of 156 women with breast cancer prior to surgery. BACKGROUND: The care and treatment of breast cancer is among the most important scientific challenges in public health. Sleep disturbances and depression are the important complaint of cancer patients. However, they are often neglected. Patients diagnosed with breast cancer also experience prejudice, fear of death, suffering, mutilation, fear of lymphedema, as well as feelings of social devaluation leading to hopelessness Several studies point to hope as an effective strategy to help patients cope with difficulties and achieve their goals, especially patients with cancer. METHODS: This is a report of baseline data extracted from a longitudinal study. DATA COLLECTION TOOLS: Pittsburgh Sleep Quality Index, Beck Depression Inventory, and the Herth Hope Index. Data were analyzed with the Spearman's Rank Correlation test and Multiple Logistic Regression analysis. RESULTS: The majority of women had tumors in initial stages (78.7%), reported poor sleep quality (58.9%), and had moderate to severe or severe depression (27.2%). Significant correlations were found between hope and depression (Spearman r=-0.4341), and between sleep quality and depression (Spearman r=0.3938). Significant associations were found between poor sleep quality and pain, symptoms of menopause and depression. Depression and symptoms of menopause were independent predictors of poor sleep quality. CONCLUSION: The evaluation of sleep quality, depression and hope should be implemented in clinical practice. Increased hope lessens depression and may positively affect sleep quality, all of which improves quality of life for women with breast cancer.

Distress During Radiation Therapy: Assessment Among Patients With Breast or Prostate Cancer.

BACKGROUND: Distress is regarded as the sixth vital sign in cancer care, but few studies describe distress in patients undergoing radiation therapy. OBJECTIVES: The purpose of this study was to assess distress levels among patients with breast or prostate cancer undergoing radiation therapy and investigate which problems contribute to patients' distress levels. METHODS: A retrospective medical record review was conducted for 217 patients with breast or prostate cancer at a midwestern community cancer center. Demographic data, distress scores, and problems or concerns from the patient-completed Distress Thermometer and associated Problem List were collected. Descriptive and bivariate statistics were calculated. FINDINGS: The average distress of patients with breast cancer was significantly higher than that of patients with prostate cancer, and patients with breast cancer reported more problems than those with prostate cancer.

The effects of an online educational program on nurse practitioners' knowledge of obstructive sleep apnea in adults.

PURPOSE: This study was conducted to determine the effects of an online educational program on nurse practitioner's (NP's) knowledge of identifying and evaluating adults at-risk for obstructive sleep apnea (OSA). DATA SOURCES: Knowledge was assessed with a 15 question pre-test and post-test, after a 53 minute narrated PowerPoint educational session. Pre-test and post-test answers were compared to determine the change in knowledge. Fifty-four participants entered the study, and 38 (70.4%) completed. CONCLUSIONS: NPs that completed the entire OSA program (n = 38) had a significant improvement in post-test scores as compared to pre-test scores (p < .001, t(37 = -5.024). This was particularly evident (p = .05) in the areas of clinical prevalence, routine health evaluation, signs and symptoms, high risk situations and screening tools. After the educational session, 97.4% of participants indicated they were "very likely" or "likely" to evaluate their patients for OSA. IMPLICATIONS FOR PRACTICE: NPs have limited formal education on sleep disorders, although are in a key position to make a significant impact on evaluating adults for OSA. Regular screening to identify adults with OSA would likely lead to improving the rate of diagnosis and reducing the associated chronic health problems.

Screening & treating patients with sleep/wake disorders.

Sleep/wake disorders are common, underdiagnosed, and associated with serious consequences. Patients tend not to mention sleep problems and clinicians often do not ask about them. Using a few simple screening questions and tools can uncover sleep/wake disorders that will respond to treatment. Consider asking about sleep during annual physicals and regular visits for chronic conditions. This is especially relevant when following patients with conditions linked to sleep/wake disorders. Educating patients about normal sleep and good sleep hygiene may improve sleep and prompt mention of unhealthy sleep/wake patterns.The use of CPAP leads to beneficial outcomes in OSA. Psychological and behavioral measures offer the best choice for patients with chronic insomnia. Bright light can help retrain the circadian rhythm in patients with circadian rhythm sleep disorders. Dopamine agonists are approved for treatment of RLS. Through a greater awareness of sleep/wake disorders and taking a proactive approach to patient questioning, diagnosis, education, and management, clinicians can better detect and treat sleep/wake disorders and improve patient outcomes and quality of life.