Sleep-wake disturbances in people with cancer part II: evaluating the evidence for clinical decision making.
OBJECTIVE
To evaluate the quality of evidence on sleep-wake disturbances in people with cancer as a basis for clinical decision making and to discuss implications of the evidence for oncology clinicians, educators, and researchers.


METHODS
Published, peer-reviewed articles.


RESULTS
Members of the 2001 Oncology Nursing Society (ONS) Advanced Practice Nurse Retreat Evidence-Based Practice Sleep Working Group selected and evaluated data sources using criteria and processes outlined by ONS.


CONCLUSIONS
The development of nursing science related to sleep-wake disturbances among people with cancer and the application of research findings to clinical decision making are limited by the quantity and quality of published evidence.


CONCLUSIONS
Clinicians are challenged to develop a plan of care that includes the assessment of sleep-wake disturbances and interventions to address them. Nurse educators are challenged to include sleep-wake content and skills to evaluate empirical data and interventions for sleep-wake disturbances in degree and continuing education curricula. Nurse researchers are challenged to specify consistent conceptual and operational definitions of key variables in sleep-wake models, use measurement instruments with evidence of reliability and validity, and design clinical trials to test interventions for sleep-wake disturbances among people with cancer.
Clark
Jane
J
Emory University Hospital, Atlanta, GA, USA. ark1jc2jc@aol.com
Cunningham
Mary
M
McMillan
Susan
S
Vena
Catherine
C
Parker
Kathy
K
D000328:Adult; D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D003863:Depression / Q000150:complications; D019317:Evidence-Based Medicine; D005260:Female; D006760:Hospitalization; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000523:psychology / Q000628:therapy; D010146:Pain / Q000150:complications; D015995:Prevalence; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012064:Relaxation Therapy; D012737:Sex Factors; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology* / Q000451:nursing / Q000628:therapy
D000970:Antineoplastic Agents; D006993:Hypnotics and Sedatives