| BACKGROUNDBreast cancer(BC)is still the most common malignant tumor among women in China and the world,and a leading cause of cancer-related deaths among women worldwide.Recent epidemiological studies in China have shown that breast cancer accounts for 15%of all new cancer-related cases in women,and the incidence rate is on the rise.According to a research,breast cancer is the leading cause of cancer death in women under 45.In recent years,although the incidence of breast cancer is rising rapidly in China,the mortality rate of breast cancer is decreasing year by year with the continuous improvement of the early diagnosis level of breast cancer and the wide application of effective treatment methods.With the increasing awareness of the importance of quality of life in cancer patients,reducing symptoms and improving sleep quality have become the focus of cancer research.Sleep is the key to maintaining optimal immune,endocrine and cellular functions.Sleep disorders are a common problem in cancer patients.However,along with other symptoms,sleep disorders were largely ignored in the treatment of one patient.The prevalence of all cancers/disorders remains high.However,compared with patients with other types of cancer,sleep disorders are not only associated with reduced quality of life in breast cancer patients,but are also risk factors for breast cancer progression,metastasis and prognosis.At present,there have been studies on the factors affecting sleep quality in breast cancer patients at home and abroad.However,there are few studies on the relationship between sleep quality and breast cancer disease itself or the factors related to treatment,such as cancer stage,hormone receptor status,surgical methods,chemotherapy and so on.Sleep quality is associated with increased levels of pro-inflammatory cytokines,and breast cancer itself or treatment can also increase in inflammation levels in the body.Therefore,we hypothesized that sleep quality in breast cancer patients is related to the disease itself and treatment factors.In conclusion,this study by comparing the differences in sleep quality between breast cancer patients and healthy controls,explore the relationship between breast cancer itself or treatment related factors and sleep quality of breast cancer patients,and design intervention program for clinical practice,help patients to improve sleep quality and provide policy guidance to improve the quality of life.Objective1.A questionaire survey was conducted to compare the sleep quality of breast cancer patients and healthy women with Pittsburgy Sleep Quality Index(PSQI)to describe the sleep stasus of breast cancer patients.2.Analyze the influencing factors of sleep quality in breast cancer patients,and discuss the relationship between breast cancer disease itself or treatment related factors and sleep disorders in breast cancer patients.Research Methods1.Case control studyFemale breast cancer patients admitted to the department of breast surgery of the Second hospital of Shandong University from July 2018 to November 2018 were selected as the case group,and women who anderwent physical examination in the same period were selected as the control group.Patients were collected on the spot after filling in the questionnaire.Pathological data such as clinical stage of breast cancer,estrogen receptor status,progesterone receptor status and treatment status of patients were obtained from the medical record system.2.Statistical analysis methodsSPSS20.0 software was used for statistical analysis,numerical variables were expressed by x±s,categorical variables were described by cases and percentages,and general data between breast cancer case group and healthy control group were compared by independent sample T test(numerical variable)or chi-square test(categorical variable).Independent samples were used to examine and compare the differences in sleep quality between the two groups.Pearson correlation analysis,independent sample T test and one-way anova were used to analyze the correlation between demographic characteristics and disease characteristics and sleep quality(one-way analysis).General linear regression analysis was used to investigate the influence of disease-related factors on sleep quality of breast cancer patients:the statistically significant demographic characteristics in the univariate analysis were used as the control variable,the disease characteristics as the independent variable,and the sleep quality score as the dependent variable.P<0.05 was considered to be statistically significant(bilateral).Results1.Basic characteristics of the research objectA total of 100 pathologiacally confirmed breast cancer patients were included in this study,with an average age of 52.69± 10.04 years,and an average body mass index of 24.95 ± 3.54.There were 200 healthy women,with an average age of 54.56 ±10.04,and an average BMI of 25.33±3.65.Clinicopathological features of the case group:45%of breast cancer patients were in stage 1,41%were in stage 11,73%were estrogen receptor-positive and 66%were progesterone receptor-positive,Eighty-four percent had undergone surgery,of which 22(26 percent)had undergone mastectomy,and 62(74 percent)had undergone mastectomy:64 percent had undergone chemotherapy.2.Comparison of sleep quality scores of the subjectsThe sleep quality of breast cancer patients was worse than that of healthy controls(6.46±3.58 vs4.99±3.06,t=3.512,P<0.001).According to the demarcation score,67.0%of the patients were judged to have poor sleep quality,higher than 44.5%of the healthy control group(?2=13.522,P<0.001).The scores of total sleep quality,subjective sleep quality factor,sleep latency factor,habitual sleep efficiency factor and hypnotic drug use factor in breast cancer patients were all higher than those in the healthy control group.3.Analysis of factors related to sleep disorders in breast cancer patientsCorrelation analysis showed that sleep quality was positively correlated with age,which was statistically significant(r=0.23,P=0.023).The correlation between sleep quality and BMI was not statistically significant(r=0.12 P =0.238).In addition,the sleep quality of patients with monthly family income of 2000 yuan or less was worse than that of patients with monthly income of 200uan or more,and the sleep quality of postmenopausal patients was worse than that of patients without menopause(P<0.05).The sleep quality of patients who had received surgical treatment was worse than those who had not received surgical treatment.Among the patients who received surgical treatment,those who underwent mastectomy were worse than those who underwent breast conserving surgery,and the sleep quality of the chemotherapy patients was worse than those who did not receive chemotherapy(P<0.05).It is Further confirmed that patients who have undergone mastectomy have worse sleep quality than those who have undergone breast conserving surgery(B=2.92,Beta=0.40,95%CI=1.40?4.45,P<0.001).Conclusion1.The sleep quality of breast cancer patients is significantly lower than that of normal people,and 67.0%of patients have sleep problems.2.The surgery way is an important factor affecting poor sleep quality of patients,and patients undergoing mastectomy have poorer sleep quality than those undergoing breast conserving surgery. |
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