Analysis of sleep quality,disease uncertainty,and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies

BACKGROUND Colorectal cancer is the second leading cause of cancer-related deaths among digestive tract malignancies,following gastric cancer.Sleep is of great significance for maintaining human health.The incidence of sleep disorders in patients with cancer is approximately twice that observed in the general population.Lack of sleep can prolong hospital stays,increase the likelihood of infection,and increase mortality rates.Therefore,studying the factors related to sleep quality is significant for improving the quality of life of patients with malignant tumors of the digestive tract.AIM To investigate the relationships among sleep quality,disease uncertainty,and psychological resilience in patients undergoing chemotherapy for digestive tract malignancies.METHODS A total of 131 patients with malignant digestive tract tumors who were treated at Hefei BOE Hospital between April 2021 and September 2022 were selected as research participants.Based on their Pittsburgh Sleep Quality Index(PSQI)scores,participants were divided into either the sleep disorder group(PSQI score>7)or the normal sleep group(PSQI score≤7).The clinical data—together with the Mishel Uncertainty in Illness Scale for Adults(MUIS-A)and Connor-Davidson Resilience Scale(CD-RISC)scores—were compared.RESULTS In this study,78(59.54%)patients with digestive tract malignancies developed sleep disorders after chemotherapy.Sleep disorder incidence was higher in patients with colorectal cancer than in those with gastric and esophageal cancers(P<0.05).The total MUIS-A score and those for each item in the sleep disorder group were higher than those in the normal sleep group.The total CD-RISC score and those for each item in the sleep disorder group were lower than those in the normal sleep group(P<0.05).The PSQI scores of patients with malignant digestive tract tumors were positively correlated with the scores for lack of disease information,disease uncertainty,and unpredictability in the MUIS-A and negatively correlated with the scores for tenacity,self-improvement,and optimism in the CD-RISC(P<0.05).CONCLUSION Patients undergoing chemotherapy for digestive tract malignancies are prone to sleep problems related to disease uncertainty and psychological resilience.Therefore,interventions can be implemented to improve their sleep quality.

The impacts of resilience on the association between illness uncertainty and sleep quality among patients with type 2 diabetes mellitus

Objective:The objective was to investigate the relationship between resilience,illness uncertainty,and sleep quality in patients with type 2 diabetes mellitus(T2DM).Methods:This cross‑sectional study was conducted from September 2019 to August 2020 from a tertiary hospital in Guangzhou,China.Totally,205 participants completed questionnaires concerning demographic characteristics,Pittsburgh sleep quality index,Mishel uncertainty in illness scale(MUIS),and Connor–Davidson Resilience Scale(CD‑RISR)were collected by convenience sampling.Multiple hierarchical regression analysis was used to evaluate the interaction of illness uncertainty,resilience,and sleep quality.The mediating role of resilience was also tested.Results:The total score of illness uncertainty was 94.68±11.19 in T2DM patients,which was proved in the medium level.There was a significant negative correlation between the total CD‑RISR score and total MUIS score(r=−0.716,P<0.01);there was a significant negative correlation between the total CD‑RISR score and total PISQ score(r=−0.806,P<0.01);total MUIS score was positively correlated with PISQ score(r=0.872,P<0.01).Psychological resilience could partially mediate the association between sleep quality and the level of illness uncertainty,and the mediating effect was 0.293,accounting for 34.20%of the total effect.Conclusion:Patients with T2DM have a moderate level of illness uncertainty,and it was negatively correlated with mental resilience level and positively associated with sleep quality.Medical staff should strengthen psychological intervention for T2DM patients to reduce the sense of uncertainty.