title: Modeling hot flushes and quality of life in breast cancer survivors.
abstract: OBJECTIVE
  To evaluate the relationships among measures of hot flushes, perceived hot flush interference, sleep disturbance, and measures of quality of life while controlling for potential covariates (patient and treatment variables).
  
  
  METHODS
  Breast cancer survivors (n = 395) due to receive aromatase inhibitor therapy provided demographic information, physiological hot flush data via sternal skin conductance monitoring, hot flush frequency via written diary and electronic event marker, hot flush severity and bother via written diary, and questionnaire data via the Hot Flash Related Daily Interference Scale, Pittsburgh Sleep Quality Index, the EuroQOL, Hospital Anxiety and Depression Scale and the Center for Epidemiologic Studies Depression Scale.
  
  
  RESULTS
  Confirmatory factor analysis supported a two-factor model for hot flush symptoms (frequency and severity). Although there was strong convergence among self-reported hot flush measures, there was a high degree of unexplained variance associated with physiological measures. This suggests that self-report and physiological measures do not overlap substantially. The structural model showed that greater hot flush frequency and severity were directly related to greater perceived interference with daily life activities. Greater perceived interference, in turn, directly predicted greater sleep disruption, which predicted lower perceived health state and more symptoms of anxiety and depression.
  
  
  CONCLUSIONS
  Findings suggest hot flush interference may be the most appropriate single measure to include in clinical trials of vasomotor symptom therapies. Measuring and ameliorating patients' perceptions of hot flush interference with life activities and subjective sleep quality may be the most direct routes to improving quality of life.
authors.affiliation: Department of Psychology, Indiana University-Purdue University, Indianapolis.
authors.forename: K L
authors.initials: KL
authors.lastname: Rand
authors.forename: J L
authors.initials: JL
authors.lastname: Otte
authors.forename: D
authors.initials: D
authors.lastname: Flockhart
authors.forename: D
authors.initials: D
authors.lastname: Hayes
authors.forename: A M
authors.initials: AM
authors.lastname: Storniolo
authors.forename: V
authors.initials: V
authors.lastname: Stearns
authors.forename: N L
authors.initials: NL
authors.lastname: Henry
authors.forename: A
authors.initials: A
authors.lastname: Nguyen
authors.forename: S
authors.initials: S
authors.lastname: Lemler
authors.forename: J
authors.initials: J
authors.lastname: Hayden
authors.forename: S
authors.initials: S
authors.lastname: Jeter
authors.forename: J S
authors.initials: JS
authors.lastname: Carpenter
mesh_terms: D001007:Anxiety / Q000523:psychology; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005163:Factor Analysis, Statistical; D005260:Female; D005712:Galvanic Skin Response; D006304:Health Status; D019584:Hot Flashes / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D008954:Models, Biological; D018670:Monitoring, Ambulatory; D011788:Quality of Life; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors
chemical_list: D047072:Aromatase Inhibitors
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