BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article

BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article This assignment will be submitted to Turnitin! Be careful with plagiarism! Instruction! Critiquing Research Part 1 Answer all questions that apply to the quantitative and/or qualitative study that you selected.The paper should be in narrative form , use APA format, and include a title page and a reference page . Use your research textbook to help you answer the questions and explain/define the terms. When doing a research critique, it is acceptable to put the reference for the article on the bottom of the title page. Do not cite the article within the body of the paper. All other resources (such as the research textbook) must be cited and referenced as usual. Critiquing Research Part II IV. Research Design Is the research quantitative or qualitative? If quantitative is it experimental or non-experimental? If it is a mixed-method design, did this approach enhance the study? Is the design appropriate to answer the questions indicated by the problem and/or hypotheses? Is the target population identified? Are eligibility criteria specified? What type of sampling plan was used? What are the key characteristics of the sample? Is the setting appropriate for the study? V. Data Collection Is informed consent utilized? Who collected the data? How were the data collected? (survey, interview, etc.) Are the measurement instruments or tools clearly described? What statistical tests were utilized? Is reliability (consistency) and validity (accuracy and precision of measurement instruments) addressed? VI. Interpretation, Discussion, and Clinical Application Are all of the important results discussed? State author’s conclusion and recommendations. What are the author’s implications for practice? Identify 3 researchable questions for further study. State if and when/where you would put the research findings into practice. BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article References are required: One from the course textbook. Other references from a peer-reviewed NURSING journal less than 5 years old . National professional, governmental, or educational organizations (. org, .gov, or.edu) be used as supplemental references. Must use the textbook as Reference Here is the textbook! Polit, D. E & Beck, C. T. (2018). Essentials of Nursing Research: Appraising Evidence for nursing practice (9th ed.) Philadelphia: Wolters Kluwer Health ISBN: 9781496351296 (Book) research_article__cancer_patients_and_sleep__1_.pdf ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Copyright B 2016 Wolters Kluwer Health, Inc. All rights reserved. Jia-Ling Sun, PhD, RN Chia-Chin Lin, PhD, RN Relationships Among Daytime Napping and Fatigue, Sleep Quality, and Quality of Life in Cancer Patients K E Y W O R D S Background: The relationships among napping and sleep quality, fatigue, and Cancer quality of life (QOL) in cancer patients are not clearly understood. Objective: The Fatigue aim of the study was to determine whether daytime napping is associated with nighttime Napping sleep, fatigue, and QOL in cancer patients. Methods: In total, 187 cancer patients Quality of life (QOL) were recruited. Daytime napping, nighttime self-reported sleep, fatigue, and QOL Sleep quality were assessed using a questionnaire. Objective sleep parameters were collected using a wrist actigraph. Results: According to waking-after-sleep-onset measurements, patients who napped during the day experienced poorer nighttime sleep than did patients who did not (t = j2.44, P = .02). Daytime napping duration was significantly negatively correlated with QOL. Patients who napped after 4 PM had poorer sleep quality (t = j1.93, P = .05) and a poorer Short-Form Health Survey mental component score (t = 2.06, P = .04) than did patients who did not. Fatigue, daytime napping duration, and sleep quality were significant predictors of the mental component score and physical component score, accounting for 45.7% and 39.3% of the variance, respectively. Conclusions: Daytime napping duration was negatively associated with QOL. Napping should be avoided after 4 PM. Implications for Practice: Daytime napping affects the QOL of cancer patients. Future research can determine the role of napping in the sleep hygiene of cancer patients. C ancer diagnosis and treatment cause patients to experience symptom distress, particularly sleep disturbance, fatigue, and poor quality of life (QOL). Fatigue and sleep disturbance are 2 of the most prevalent and distressing symptoms experienced by cancer patients.1 Studies have reported that poor sleep quality negatively influences health-related QOL.2,3 Sleep Author Affiliations: Department of Nursing, Yuanpei University of Medical Technology, Hsinchu (Dr Sun); and School of Nursing, College of Nursing, Taipei Medical University, Taipei (Dr Lin), Taiwan. This study was supported by the Ministry of Science and Technology (97-2314B-038-044-MY3). The authors have no conflicts of interest to disclose. Correspondence: Chia-Chin Lin, PhD, RN, School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing St, Taipei 11031, Taiwan, Republic of China ([email protected]). Accepted for publication June 3, 2015. DOI: 10.1097/NCC.0000000000000299 Napping, Fatigue, Sleep Quality, QOL in Cancer Patients Cancer NursingTM, Vol. 39, No. 5, 2016 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. n 383 disturbances are a series of sleep problems, such as difficulty initiating and maintaining sleep, nonrestorative sleep, short duration of sleep, and impairment of daytime functioning.4 Sleep is crucial in the health-related QOL of cancer patients. A previous study revealed that the sleep quality of cancer patients is associated with the mental component score (MCS) of the 36-item Short-Form Health Survey (SF-36) used to measure QOL and that sleep quality and daytime napping are associated with the physical component score (PCS). BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article 3 Moreover, another study indicated that fatigue may be associated with total nap time in cancer patients undergoing chemotherapy.1 Numerous people habitually take naps, which help maintain energy levels. The prevalence of daytime napping in the British population was 29.8%, 90% of whom napped for less than 1 h/d.5 The prevalence rates of napping are high among elderly people (56.34%), retired people (53%), and people older than 50 years (42%).6,7 A previous study reported that 25% of the world population engages in regular daytime napping and that the median nap duration is 60 minutes.8 People typically nap for 20 to 30 minutes, and 30 and 60 minutes are the 2 most common total daytime napping durations.7 A short nap less than 30 minutes helps prevent afternoon sleepiness.9 An electroencephalogram study revealed that longer naps cannot improve the daytime performance in elderly people.10 However, 60- to 90-minute naps lead to slow-wave sleep and rapid eye movement.11 People with inadequate nighttime sleep can experience daytime sleepiness and may require daytime napping, particularly in the early afternoon.12 Napping compensates for sleep lost the previous night and improves the immune system.13 A short nap (e20 minutes) is effective in maintaining alertness throughout the rest of the day and compensates for a poor night of sleep.13 Although naps are effective in managing fatigue,14 prolonged daytime napping has harmful outcomes. In addition, afternoon napping was associated with increased daytime sleepiness in patients with chronic fatigue syndrome.15 Fatigue severely peaks between 2 and 4 PM,16 and daytime sleepiness typically occurs during this time interval17; afternoon napping is recommended in such a scenario. Napping for less than 30 minutes between 1 and 3 PM has been indicated to enhance QOL and sleep quality in elderly people.16,18 By contrast, elderly people who nap in the evening or before going to bed have poor nighttime sleep quality and daily function.18 Sleep is a crucial component of the circadian rhythm in humans. Circadian-rhythm sleep disorders arise from internal desynchronization. The National Comprehensive Cancer Network defines cancerrelated fatigue as a distressing and persistent subjective sense of physical, emotional, and/or cognitive tiredness or exhaustion related to cancer or cancer treatment that is not proportional to recent activity and interferes with usual functioning.19,20 Fatigue can be relieved by identifying the cause and providing mitigating interventions. The National Comprehensive Cancer Network21 and a previous study20 have reported that fatigue arises from pain, emotional distress, sleep disturbance, anemia, poor nutrition, deconditioning because of reduced activity, and comorbidities. Previous studies have shown that awareness and counseling, increased activity, exercise and sports therapy, and psychosocial interventions are effective strategies for preventing and managing fatigue.22,23 Fatigue and sleepiness are overlapping phenomena with similar manifestations, and distinguishing the two is difficult.24,25 Daytime sleepiness is a disorder characterized by the inability to stay awake and the tendency to fall asleep during daytime.26 Patients with fatigue or sleepiness experience poor sleep quality and desire sleep during daytime. In a previous study, patients with chronic fatigue syndrome experienced adequate sleep, and insufficient sleep was not a factor that caused fatigue.25 This finding explains why fatigue patients could not resolve their fatigue by sleeping. Few studies have examined the relationships among daytime napping, fatigue, sleep quality, and QOL in cancer patients. BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article The relationships among napping and sleep quality, fatigue, and QOL in cancer patients are not clearly understood; therefore, we explored these relationships. In addition, we examined whether daytime napping after 4 PM is a significant factor affecting fatigue, nighttime sleep quality, and QOL and whether daytime napping, fatigue, and sleep quality are predictors of QOL. n Methods Study Design A cross-sectional research design and consecutive sampling were used for recruiting participants. Participants were recruited from the oncology outpatient clinic of a teaching hospital in northern Taiwan. To ensure inclusion of all of the accessible subjects, the researcher invited the patients to join the research after explaining the research purposes, procedure, and design when each patient completed the clinic visit. n Participants The selection criteria were as follows. Patients should (a) have a confirmed pathological diagnosis of cancer, (b) be at least 18 years old, and (c) be able to communicate in Mandarin or Taiwanese. Patients with a history of (a) mental impairment, including depression, psychologically ill health, schizophrenia, or psychosis (determined through chart history review), or (b) any form of impairment of the upper extremities were excluded from the study because participants were required to wear Actiwatch, a wrist actigraph. Consecutive sampling was used in this study, and the researchers approached patients who satisfied the selection criteria. All recruited participants provided written informed consent. Among the 269 recruited cancer patients, 74 were excluded because of deficiencies in the actigraph data, and 8 were excluded because of incomplete questionnaires. In total, 187 patients completed all procedures. Instruments Napping. The researcher developed a self-report napping questionnaire with 3 items to collect daytime napping habits, namely, daytime napping habits, daytime napping duration, and napping duration after 4 PM. Napping after 4 PM was recorded separately because such late napping affects the circadian rhythm.16,17,26 384 n Cancer NursingTM, Vol. 39, No. 5, 2016 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Sun and Lin Napping habits were recorded using the item ‘‘Do you engage in daytime sleep?’’ (yes or no) and ‘‘Do you take a nap after 4 PM?’’ (yes or no). Daytime napping duration, defined as the total duration of all naps per day, was recorded in minutes (>60 and e60 minutes), with participants recalling the past month; the threshold of 60 minutes was obtained from a previous study.27 Sleep. Subjective sleep quality was assessed using the Taiwanese version of the Pittsburgh Sleep Quality Index (PSQI-T). The PSQI-T was proven as a valid and reliable instrument for assessing sleep quality and has been applied in several studies to measure sleep quality in Taiwanese cancer patients.28,29 The PSQI-T is a 19-item questionnaire comprising 7 dimensions: subjective sleep quality, sleep latency, sleep duration, sleep efficiency (SE), sleep disturbances, sleep medications, and daytime dysfunction. Each dimension is rated on a scale of 0 to 3, with the total score ranging from 0 to 21. A total score higher than 5 indicates poor sleep quality. Objective Sleep Quality. Objective sleep quality was measured using an Actiwatch (MiniMitter-Respironics Co, Inc, Bend, Oregon) ambulatory device; this device measures arm movements and collects activity data in 1-minute epochs. BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article The data were uploaded to a computer and manually marked sleep duration according to the participants’ night-sleep bedtimes and wakingtime recordings. The data for sleep onset latency (SOL), SE, waking after sleep onset (WASO), and total sleep time (TST) were obtained. The data were used as physiological parameters in analyzing sleep variability. Sleep onset latency is the time elapsed from attempting to fall asleep to the onset of sleep, SE is the percentage of the scored TST against total duration of bedtime, WASO is the total number of epochs between the start and end times of a given sleep interval, and TST is the duration of sleep between the start and end times of a given interval. Actiwatch is as effective as polysomnography and exhibits high specificity and sensitivity.30,31 Fatigue. Fatigue was assessed using the Taiwanese version of the Brief Fatigue Inventory (BFI-T), which was developed at the University of Texas M. D. Anderson Cancer Center for measuring fatigue in cancer patients.32 In the BFI-T, fatigue severity and interference with life activities in the preceding 24 hours are measured on a scale of 0 to 10. The first section of the BFI-T entails measuring the most severe fatigue during the preceding 24 hours, typical fatigue during the preceding 24 hours, and current fatigue. Each item is rated from 0 (no fatigue) to 10 (fatigue as bad as you can imagine); the average score of these was adopted. The second section entails assessing the extent to which fatigue interferes with general activities, mood, walking, normal work, interpersonal relationships, and the QOL enjoyment. Each item is rated on a scale of 0 (does not interfere with activity) to 10 (completely interferes with activity), and the average score of the 6 items was adopted. Higher scores indicate higher fatigue severity. The fatigue interference score is the average of the 6 interference items and has been shown to be a valid and reliable tool for assessing cancer-related fatigue.32,33 Quality of Life. The Taiwanese version of the SF-36 (SF-36YT) was adopted as the measure of QOL in this study. The SF-36, developed in a Medical Outcomes Study,34 contains 36 variable Napping, Fatigue, Sleep Quality, QOL in Cancer Patients items from 8 dimensions, namely, physical functioning (10 items), role limitations caused by physical health problems (RP, 4 items), bodily pain (2 items), general health (5 items), vitality (4 items), social functioning (2 items), role limitations caused by emotional problems (RE, 3 items), and mental health (5 items). These 8 measurement dimensions are used to calculate the PCS and MCS. The PCS is determined by averaging the physical functioning, RP, bodily pain, and general health scores, and the MCS is calculated by averaging the vitality, social functioning, RE, and mental health scores. This generic QOL instrument has been widely used across different disease populations. SF-36YT has been validated in a sample of healthy adults.35,36 Scores of each variable item are coded and summed. For comparing the results of this study with those of other studies and disease populations, all raw scale scores were transformed to standardized scores ranging from 0 (worst possible health state measured by the questionnaire) to 100 (best possible health state). Demographic and Disease Information. We administered a self-report demographic and disease information questionnaire to collect information on age, sex, education level, and marital status. We collected the diagnosis, staging, current cancer treatment, and time since diagnosis from chart records. Study Procedure The institutional review board of the teaching hospital approved this study. Data were collected from the outpatient department. When patients finished the clinic visit, the researcher approached the eligible patients. The researcher invited patients to participate in the study after the study objectives were explained. BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article The patients were recruited if they passed the screening selection criteria. Participants signed a written consent form and completed a paperpencil questionnaire. All data in this study were collected by the same researchers. Diagnosis, staging, and treatment data were collected from chart records, and the remaining demographic data were obtained through a self-rated questionnaire. Patients completed the questionnaire. The participants recalled their sleep quality and disturbances, QOL, and fatigue for the past 1 month. The researchers reviewed the data for missing items. After the procedure of complete questionnaire, the researchers demonstrated how to the use the Actiwatch on the dominant wrist. The participants were then requested to wear it for 3 consecutive nights while sleeping and to record their bedtimes and waking times in a sleep recording. When the Actiwatch data were collected, the research procedure was completed. Data Analyses Data were analyzed using SPSS Statistics (version 19.0; IBM, USA). We used descriptive statistics to present the questionnaire data. One-way analysis of variance and a # 2 test were performed to compare the differences between nappers and nonnappers groups. The t test was used to assess differences between 2 groups, including the nappers and nonnappers groups, napping after 4 PM and not napping after 4 PM groups, nap duration of 60 minutes or less and more than 60 minutes groups, and the follow-up and consulting group and undergoing treatment group. The relationships Cancer NursingTM, Vol. 39, No. 5, 2016 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. n 385 among the objective sleep parameters, sleep quality, fatigue, napping habits, daytime napping duration, and napping duration after 4 PM based on the MCS or PCS were investigated using Pearson correlation coefficients. These significance variables were used as predictors of MCS or PCS; therefore, stepwise regression was used. Statistical significance was defined as P e .05. n Results Demographic and Disease-Related Characteristics We collected data from 187 participants, whose average age was 54.97 (SD, 12.83) years. The participants had received a diagnosis of breast (37.4%), gastrointestinal (26.2%), head and neck (12.3%), genitourinary (8.0%), lung (6.4%), and other cancers (9.7%). At the time of the study, 81.3% of the participants were undergoing cancer treatments, and the remaining 18.7% were in the follow-up and consulting stage. Furthermore, Of the participants currently undergoing treatment, 19.7% were undergoing chemotherapy, 33.6% radiotherapy, 27.6% both chemotherapy and radiotherapy, 5.9% hormone therapy, 2.0% target therapy, 3.3% both radiotherapy and hormone therapy, 4.0% both radio- therapy and target therapy, 3.3% both chemotherapy and hormone, and 0.6% were undergoing both chemotherapy and target therapy. Table 1 lists the demographic and disease-related characteristics of the participants. The mean time since the completion of treatment was 24.51 (SD, 28.97) months for participants in the follow-up and consulting group. No significant differences were observed in nap habits, sleep quality, fatigue, objective sleep parameters, MCS, and PCS (t = j0.32, j0.38, j1.16, j0.85 to 0.13, 1.9, and 1.49, respectively, all P > .05) between the follow-up and consulting group and undergoing treatment group. Sleep Quality, Fatigue, and Quality of Life The global sleep quality score of the participants, measured using the PSQI-T, was 7.16 (SD, 4.25). The PSQI-T scores of subjective sleep quality, sleep latency, and sleep duration were 1.50 (SD, 0.91), 1.29 (SD, 1.06), and 1.19 (SD, 1.01), respectively. BCC Relationships Among Daytime Napping and Fatigue in Cancer Patients Article The subjective sleep parameters were obtained from the Actiwatch. The average SE was 76.20% (SD, 10.75%), the average SOL was 22.28 (SD, 29.58) minutes, the WASO was 72.48 (SD, 31.55) minutes, and the TST was 355.75 (SD, 76.26) minutes. Fatigue severity and interference were 3.52 (SD, 2.40) and 1.50 (SD, 1.98), respectively. The PCS and MCS, measured Table 1 & Patient Demographics and Cancer-Related Information (N = 187) All (N = 187) Characteristics Sex Female Male Marital status Married Other Diagnosis Lung Gastrointestinal Head and neck Genitourinary Breast Other Stage of cancer I II III IV Unknown Treatment Chemotherapy Radiotherapy Chemotherapy + radiotherapy Other treatments Follow-up + consulting Age, y Education, y a Nappers (n = 106) Nonnappers (n = 81) n % n % n % 115 72 61.5 38.5 62 44 58.5 41.5 53 28 65.4 34.6 152 35 81.3 18.7 92 14 86.8 13.2 60 21 74.1 25.9 12 49 23 15 70 18 6.4 26.2 12.3 8.0 37.4 9.7 9 32 13 11 32 9 8.5 30.2 12.3 10.4 30.2 8.5 3 17 10 4 38 9 3.7 21.0 12.3 4.9 46.9 11.1 44 35 45 54 9 24.7 19.7 25.3 30.3 20 19 25 33 9 20.6 1967 25.8 34.0 24 16 20 21 29.6 19.8 24.7 25.9 30 51 42 29 35 16.0 27.3 22.5 15.5 18.7 16 29 22 20 19 15.1 27.4 20.8 18.9 17.8 14 22 20 9 16 17.3 27.2 24.7 11.1 19.7 Mean SD Mean SD Mean SD 54.97 11.60 12.83 3.62 57.35 11.16 12.41 3.64 51.86 12.18 12.79 3.55 t/F/# 2 P 0.93 .36 4.88 .03a 8.57 .13 2.42 .48 2.31 .68 j2.96 j1.93 .003a .06 P e .05. 386 n Cancer NursingTM, Vol. 39, No. 5, 2016 Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. Sun and Lin using the SF-36YT, were 59.51 (SD, 19.99) and 60.32 (SD, 22.16), respectively. Bodily pain was the highest PCS dimensi … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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