Berger, A. M., VonEssen, S., Khun, B. R., Piper, B. F., Farr, L., Agrawal, S., . . . & Higginbotham, P. (2002). Feasibility of a sleep intervention during adjuvant breast cancer chemotherapy. Oncology Nursing Forum, 29, 1431–1441.
DOI Link
Intervention Characteristics/Basic Study Process
Patients received multicomponent cognitive-behavioral therapy (CBT). Individual sleep promotion plans (ISPPs) included
- Sleep hygiene
- Relaxation prescription
- Stimulus control
- Sleep restriction delivered by a registered nurse (RN).
Each plan started two days before the first prescription, was revised before each prescription, and was and reinforced seven days after each prescription. There were four doses and reinforcements.
Sample Characteristics
- Twenty-five Caucasian patients (100% female) were included.
- Mean age was 54.3 years (range 40–65).
- Patients had stage I or II breast cancer and were receiving adjuvant chemotherapy.
Setting
- Midwestern United States
- Urban oncology clinics
- Patient homes
Phase of Care and Clinical Applications
Patients were undergoing the active treatment phase of care.
Study Design
This was a prospective, repeated measures, feasibility study with a single group and no control.
Measurement Instruments/Methods
- Piper’s Integrated Fatigue Model (IFM)
- Piper Fatigue Scale (PFS) and single fatigue intensity item
- Adherence
- Sleep
Results
- There was moderate to high adherence (46%–80%) to the components of the sleep plan.
- Fatigue on the PFS two days postchemotherapy was stable over time.
- Fatigue intensity was lower (not significant) postchemotherapy three but rebounded after chemotherapy four.
Limitations
- The pilot study was not designed to test the effectiveness of the intervention.
- The study had a small sample size.
- Research RN training was needed.
- The actigraphs had costs.