title: Experiences of Patients With Advanced Lung Cancer: Being Resigned to Sleep-Wake Disturbances While Maintaining Hope for Optimal Treatment Outcomes.
abstract: BACKGROUND
  Sleep-wake disturbances are prevalent in patients with lung cancer yet are infrequently studied over time. This article reports on the qualitative results of a mixed-methods study of newly diagnosed patients' narratives over 6 months.
  
  
  OBJECTIVE
  The objective of this study was to gain an understanding of the treatment and illness trajectory related to sleep-wake disturbances as well as the beliefs and practices of patients while seeking optimal treatment outcomes.
  
  
  METHODS
  Longitudinal interview narratives of 26 patients' experiences with advanced lung cancer diagnosis (at baseline, pre-second and third treatment, and 6 months) were obtained from participants recruited from Veterans Administration Hospital Center and a Comprehensive Cancer Center in Northeast United States. Analysis of illness narratives used interpretive phenomenology based on Heideggarian hermeneutic traditions.
  
  
  RESULTS
  At diagnosis, participants described poor sleep such as trouble falling asleep and frequent awakenings. Over time, as the treatment worsened their sleep symptoms, these participants still maintained hope for more time with treatment. This focus enabled them to tolerate the sleep-wake disturbances and treatment adverse effects. As the treatment effectiveness declined, their focus changed to spiritual meanings for the future and to keep living life with a purpose.
  
  
  CONCLUSIONS
  By explicating lung cancer patients' experiences with sleep-wake disturbances, nurses will gain insight into potential interventions to improve sleep and support effective outcomes as well as open a dialogue about hope.
  
  
  CONCLUSIONS
  Findings offer insight for oncology nurses to provide opportunities for dialogue about treatment options and techniques to improve sleep, which will facilitate patients living their lives.
authors.affiliation: Author Affiliations: School of Nursing, University at Buffalo, the State University of New York (Drs Dickerson and Dean and Mss Abbu Sabbah and Gothard); VA Western New York Health System (Dr Steinbrenner and Ms Zeigler); and Department of Medicine at Roswell Park Cancer Institute and School of Medicine, Buffalo, New York, and Biomedical Sciences at the University at Buffalo, the State University of New York (Dr Chen).
authors.forename: Suzanne S
authors.initials: SS
authors.lastname: Dickerson
authors.forename: Eman
authors.initials: E
authors.lastname: Abbu Sabbah
authors.forename: Sandra
authors.initials: S
authors.lastname: Gothard
authors.forename: Patricia
authors.initials: P
authors.lastname: Zeigler
authors.forename: Hongbin
authors.initials: H
authors.lastname: Chen
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Steinbrenner
authors.forename: Grace E
authors.initials: GE
authors.lastname: Dean
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D066297:Hermeneutics; D065026:Hope; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D033262:Narration; D009367:Neoplasm Staging; D009859:Oncology Nursing; D036301:Qualitative Research; D012893:Sleep Wake Disorders / Q000523:psychology*; D016896:Treatment Outcome