乳腺癌患者睡眠障碍发生率和影响因素的系统评价

Systematic evaluation of the incidence and the influencing factors of sleep disorders in breast cancer patients

目的 探究乳腺癌(breast cancer, BC)患者睡眠障碍情况及其影响因素。方法 检索综合数据库:知网、万方、维普、sinomed、PubMed、Web of Science、Cochrane Library、Embase、EBSCO。检索时间均为建库至2023年12月,获取关于BC患者睡眠障碍的影响因素研究。提取资料并使用美国卫生保健质量和研究机构标准、纽卡斯尔-渥太华量表进行评价。结果 共纳入文献20篇,总样本量为4 409例;共涉及29种影响因素。系统评价结果显示,BC患者睡眠障碍检出率为67%;主要影响因素为化疗、年龄、手术、肿瘤分型、抑郁、焦虑、疼痛、疲乏及锻炼次数;次要影响因素为放疗、基因、收入、家庭状况、激素水平、潮热、应对方式、环境改变及生活质量;其他影响因素为种族、住院次数、生理功能、居住地、体质类型、高血脂、宗教信仰、既往呼吸系统病史、自我形象、社会支持及医保支付形式。结论 BC患者睡眠障碍发生率高,医务人员可针对其影响因素识别高危因素并及早对患者进行干预,以期减少睡眠障碍对患者造成的危害。

Objective To determine the incidence and the influencing factors of sleep disorders in breast cancer(BC)patients through a systematic evaluation.Methods Articles reporting the influencing factors of sleep disorders in BC patients published before December 2023 were searched in comprehensive databases,such as China National Knowledge Infrastructure(CNKI),Wanfang,VIP,sinomed,PubMed,Web of Science,Cochrane Library,Embase,EBSCO.The eligible data were evaluated using the Agency for Healthcare Research and Quality(AHRQ)and Newcastle-Ottawa scale(NOS).Results Twenty papers representing a total of 4409 cases sample size and 29 influencing factors were included.The results of the systematic evaluation showed that the detection rate of sleep disorders in BC patients was 67%,the main influencing factors were chemotherapy,age,surgery,tumour classification,depression,anxiety,pain,fatigue,and exercise frequency,the secondary influencing factors were radiotherapy,genetics,income,family status,hormone levels,hot flushes,coping styles,environmental changes,and quality of life,and the other influencing factors included ethnicity,number of hospitalisations,physiological function,place of residence,constitutional type,hyperlipidaemia,religious beliefs,previous respiratory disease,self-image,social support and form of medical insurance payment.Conclusion The prevalence of sleep disorders in BC patients is high,and healthcare professionals can identify high-risk factors and intervene early for reducing the risk of sleep disorders in BC patients.