title: Relationships among pain, sleep disturbances, and depressive symptoms in outpatients from a comprehensive cancer center.
abstract: OBJECTIVE
  To describe the pain experience of outpatients with cancer and explore the relationships with sleep disturbance, depression, and patient functioning.
  
  
  METHODS
  Descriptive, cross-sectional study.
  
  
  METHODS
  Outpatient clinics at a large comprehensive cancer center in the southeastern United States.
  
  
  METHODS
  85 patients with a pain intensity level of at least 3.
  
  
  METHODS
  Secondary analysis of baseline data.
  
  
  METHODS
  Pain intensity and distress, pain interference, sleep disturbance intensity, and distress and depression.
  
  
  RESULTS
  The sample included men and women with a mean age of 54 years and 13 years of education. Mean present pain intensity on the Brief Pain Inventory scale was 4.6; mean pain at its worst was 8.3. Mean pain intensity measured with the Memorial Symptom Assessment Scale was 2.4 and pain distress was 2.2. Pain intensity and pain distress had a strong, positive correlation. The mean interference score for the group was 42.8. More than 63% of patients reported a problem with sleep disturbance. Distress from sleep disturbance was significantly correlated with pain intensity and pain distress. Pain interference also was correlated with sleep disturbance intensity and sleep disturbance distress. Pain severity, pain distress, pain right now, and pain interference total scores all were significantly correlated with depression scores.
  
  
  CONCLUSIONS
  Patients with cancer continue to experience pain during outpatient treatment and report sleep and depressive symptoms related to it.
  
  
  CONCLUSIONS
  Improvements continue to be needed in assessment and treatment of pain.
authors.affiliation: College of Nursing, University of South Florida, Tampa, FL, USA. smcmilla@hsc.usf.edu
authors.forename: Susan C
authors.initials: SC
authors.lastname: McMillan
authors.forename: Cindy
authors.initials: C
authors.lastname: Tofthagen
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Morgan
mesh_terms: D001294:Attitude to Health; D002173:Cancer Care Facilities; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D005163:Factor Analysis, Statistical; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D024802:Nurse's Role; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D009859:Oncology Nursing; D010045:Outpatients / Q000523:psychology* / Q000706:statistics & numerical data; D010146:Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D010147:Pain Measurement; D012307:Risk Factors; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D015144:Southeastern United States / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology / Q000523:psychology