title: Patterns and Predictors of Sleep Quality Within the First Year After Lung Transplantation.
abstract: BACKGROUND
  Sleep quality affects health and self-management in chronic illness. Limited research has examined patterns and predictors of sleep quality and its impact on self-management and health-related quality of life (HRQOL) among lung transplant recipients (LTRs).
  
  
  OBJECTIVE
  The aims of this study were to identify the patterns, predictors, and impact of poor sleep quality on self-management behaviors and HRQOL the first year after lung transplantation.
  
  
  METHODS
  Secondary analysis of 75 LTRs who participated in a randomized controlled trial. Pittsburgh Sleep Quality Index (PSQI) was administered at baseline, 2, 6, and 12 months after transplant; 12-month PSQI was dichotomized categorizing good versus poor sleepers. Predictors were measured at the time of transplant; self-management and HRQOL were measured at 12 months. Logistic regression identified predictors of poor sleep. Correlations examined poor sleep quality, self-management behaviors, and HRQOL.
  
  
  RESULTS
  Sleep quality was relatively stable during the first year, and 24 of the 75 (32%) of the sample met criteria for poor sleep quality at 12 months. The only multivariate predictor of poor sleep was female gender (odds ratio = 3.421; P = .026); the mental component of HRQOL was the only outcome associated with poor sleep (r = -.348; P < .01).
  
  
  CONCLUSIONS
  Nearly one-third of LTRs reported persistent poor sleep through year 1. More females reported poor sleep quality, and sleep quality was inversely related to mental HRQOL by 12 months. Knowledge of these relationships may help identify LTRs at the greatest risk for poor sleep and guide strategies to promote sleep and optimize HRQOL.
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA aff10@pitt.edu.
authors.forename: Angela
authors.initials: A
authors.lastname: Fatigati
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alrawashdeh
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Jenna
authors.initials: J
authors.lastname: Zaldonis
authors.affiliation: University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
authors.forename: Annette DeVito
authors.initials: AD
authors.lastname: Dabbs
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008171:Lung Diseases / Q000601:surgery*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D012648:Self Care; D012737:Sex Factors; D012890:Sleep; D016896:Treatment Outcome
keywords: lung transplantation; quality of life; self-care; sleep quality; the Pittsburgh Sleep Quality Index (PSQI); transplant recipients