Comparison of differences and determinants between presence and absence of sleep disturbance in hepatocellular carcinoma patients.
BACKGROUND
Hepatocellular carcinoma patients often experience sleep disturbance after undergoing transcatheter arterial chemoembolization (TACE).


OBJECTIVE
The objectives of this study were to (1) examine and compare symptom distress, depression, and sleep quality in hepatocellular carcinoma patients undergoing TACE with sleep disturbance versus without sleep disturbance and (2) examine the determinants of sleep disturbance in these patients.


METHODS
Hepatocellular carcinoma patients undergoing TACE were recruited. The patients were evaluated 1 week (T1) and 1 month (T2) after receiving TACE in terms of performance status, symptom distress, depression (T1), and sleep disturbance (T2). Logistic regression was used to determine the predictive factors of sleep disturbance.


RESULTS
Patients with sleep disturbance reported significantly higher overall symptom distress and depression and lower sleep quality than patients without sleep disturbance. The 5 leading causes of symptom distress in both groups were fatigue, pain, poor appetite, chest tightness, and fever. Older age, greater symptom distress, and higher levels of depression were significantly associated with sleep disturbance.


CONCLUSIONS
The results of this study show significant associations among symptom distress, depression at baseline, and sleep problems 1 month after undergoing TACE. Clinicians should be aware of the possibility of lasting sleep disturbance in hepatocellular carcinoma patients undergoing TACE.


CONCLUSIONS
In clinical care, symptom management, psychological consultation, and relaxation training may promote sleep quality.
Department of Nursing, Chang Gung Medical Foundation, Chang Gung Memorial Hospital at Lin-Kou, Taiwan.
Tsung-Lan
TL
Chu
Wen-Pin
WP
Yu
Shu-Ching
SC
Chen
Hsi-Ling
HL
Peng
Ming-Ju
MJ
Wu
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000523:psychology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000523:psychology / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D013315:Stress, Psychological / Q000209:etiology; D013997:Time Factors