Effectiveness of the integrated sleep support to enhance the sleep quality of caregivers of advance cancer patient

• Main Authors: Ying-Juong Jiang, 江迎君
• Other Authors: Kwo-Chen Lee
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/82677721676702906270

碩士 === 中國醫藥大學 === 護理學系碩士班 === 102 === Background: Advance cancer patients exhibit symptoms with complexity and diversity, therefore, caregivers always face complicated tasks and challenges, sustaining considerable care loads which makes caregivers liable to mental and physical problems such as the most commonly occurred poor sleep quality. Purpose: Purpose of the study includes 1) intervention with an integrated sleep support program to improve and elevate sleep quality for caregivers of cancer patients; 2) evaluation on predictors affecting sleep quality of caregivers for terminally ill cancer patients. Method: The study uses a prospective, randomized, experimental grouping design. Study subjects are 41 (control group n=20, experimental group n=21) caregivers for cancer patients included from cancer ward of a specific medical center in central area of Taiwan. Inclusion criteria are: 1) primary caregivers for patients with distant organ metastasis declared by physicians or recorded by pathology reports, 2) caregivers granted by patients with care time longer than 6 hours per day, 3) being capable to communicate in both Mandarin and Taiwanese, 4) being willing to wear Actigraph on the non-dominant hand, 5) PSQI (Pittsburgh Sleep Quality Index)≧5, 6) whose residential address is within the greater Taichung area. Patients were randomly grouped into either experimental group or control group. Intervention measures for experimental group were undergone for 11 weeks, including the integrated sleep support program. Study tools include both subjective and objective data collection, subjective data: Chinese version of the Pittsburgh Sleep Quality Index, Chinese version of the Center for Epidemiological Studies Depression Scale, Chinese version of the State-Trait Anxiety Inventory, measurement was conducted once every 2 weeks; objective data: physiologically measured wrist actigraphy recording sleep-related data for participants. The GEE (generalized estimating equations) method was used as the primary statistical approach, with p>.005 as significant difference. Result: After intervention of integrated sleep support program, caregivers in experimental group exhibit significantly lower scores than that of control group caregivers in PSQI average (β=-2.74,p=0.01), sleep disturbance (β=-33.3, p=0.01) and sleep latency (β=-4.88, p=0.01). Nevertheless, there is no any significant difference for total sleep time, sleep efficiency and percentage in each sleep stage. Relevant factors predicting sleep problems used in GEE demonstrate that caregivers with higher depression tendency, offering much assistance in patients’ everyday life and without alcohol addiction exhibit relatively poor sleep quality. Conclusion: 6 weeks of intervention using integrated sleep support program may effectively improve sleep status for caregivers, as well as shorten sleep latency to help falling asleep and reduce sleep disturbance. It is recommended to establish individualized care guidance to assist caregivers in developing efficient care strategies, as which may further minimize time and effort in offering care and consequently improve sleep quality.