Background Sleep disorders are highly prevalent among breast cancer patients and have a detrimental impact on their quality of life. This study aims to investigate the serial multiple mediating roles of social support and hope in the relationship between anxiety, depression, and sleep quality in breast cancer patients. Methods A cross-sectional study was conducted in China from October 2021 to February 2022. A total of 315 breast cancer patients were assessed using self-reported questionnaires, including the Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Social Support Survey (MOS-SSS), Herth Hope Index (HHI), and Hospital Anxiety and Depression Scale (HADS). Mediation analysis was performed using the R Statistical Software. Results Sleep quality exhibited a negative correlation with hope and medical social support (P < 0.01), and a positive correlation with anxiety and depression (P < 0.01). Anxiety and depression accounted for 18.8% and 12.8% of the variance in sleep quality, respectively. Bootstrap analyses of the anxiety-medical social support-hope-sleep quality pathway indicated the presence of direct effects [B = 0.331, 95%CI (0.215, 0.493)] and indirect effects of anxiety on sleep quality mediated solely by medical social support [B = 0.054, 95%CI (0.015, 0.108)] and hope [B = 0.041, 95%CI (0.018, 0.073)], as well as combined effects [B = 0.012, 95%CI (0.004, 0.025)]. Similarly, the depression-medical social support-hope-sleep quality pathway revealed direct effects [B = 0.235, 95%CI (0.104, 0.372)] and indirect effects of depression on sleep quality mediated solely by medical social support [B = 0.078, 95%CI (0.016, 0.150)] and hope [B = 0.049, 95%CI (0.018, 0.086)], as well as combined effects [B = 0.017, 95%CI (0.004, 0.034)]. Conclusions This research validates the hypothesis that medical social support and hope serve as mediators between anxiety, depression, and sleep quality in breast cancer patients. Interventions targeting anxiety, depression, medical social support, and hope have the potential to effectively enhance sleep quality.
Aim:The aim of the study was to investigate the incidence of sleep disturbance and its relationship with anxiety and depression symptoms, social support and hope in breast cancer patients in China during chemotherapy.Design: A single-centre cross-sectional study.Methods: A total of 329 breast cancer patients were selected via convenience sampling method before they began chemotherapy (n = 115), before the 5th week of chemotherapy (n = 117) or 1 month after chemotherapy ended (n = 97) and administered paper-and-pencil questionnaires to evaluate sleep quality, depression and anxiety symptoms, social support and hope. Risk factors significantly associated with sleep disturbance during bivariate were incorporated in the multivariate analysis. Bivariate analyses showed that age, menopausal status, depression and anxiety symptoms, emotional/informational support, tangible support, affectionate support, positive social interaction and total support were predictors of sleep disturbance.Results: Sleep disturbance was prevalent in breast cancer patients before (27.0%), during (32.5%) and after (39.2%) chemotherapy, with 37.4%, 41.9% and 52.6% of participants, respectively, reporting sleeping below the recommended 7 h. Only 8.6%-15.5% of patients reported taking sedative-hypnotic drugs during the chemotherapy.Multivariate analyses found that participants reporting clinically significant anxiety (HADS > 8) were 3.5 times more likely to report sleep disturbance (PSQI > 8) than participants without clinically significant anxiety, and each increment in emotional/ informational support was associated with a 9.04% reduced risk of sleep disturbance.Moreover, age was an independent predictor of sleep disturbance during multivariate modelling.
Background:Chemotherapy has side effects on breast cancer patients, and sleep disturbance is one of the common psychological symptoms. Purpose: This study aimed to examine the incidence of sleep disorders and investigate the relationship between anxiety and depression, hope, social support and sleep disorders in breast cancer patients with chemotherapy in China.Results:Total 350 patients were administered questionnaires, and 329 patients completed the questionnaires. The recovery rate was 94%. The majority of participants reported clinically significant sleep disturbance prior to chemotherapy (67.8%), during chemotherapy (71.8%), and after chemotherapy (72.2%). Pearson correlation analysis showed that the higher the direct support, emotional support, social interaction support, informational support and total social support score, the lower the total PSQI score of breast cancer patients (r = -0.212, -0.292, -0.236, -0.271, and -0.195 p< 0.01, respectively). Multifactorial model analysis showed that direct support, anxiety and age were the three main factors that affected sleep quality in breast cancer patients. Conclusions:social support may provide a powerful tool to reduce anxiety and improve sleep quality in breast cancer patients with chemotherapy. Citation Format: Wenjuan Zhu, Wanling Li, Hui Yang, Linying Wang, Jun Guo, Jinnan Gao. The association of sleep quality with anxiety, depression and social support in breast cancer patients with chemotherapy [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-14.
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