Berger, A. M., VonEssen, S., Kuhn, B. R., Piper, B. F., Farr, L., Agrawal, S., & ... Higginbotham, P. (2002). Feasibilty of a sleep intervention during adjuvant breast cancer chemotherapy. Oncology Nursing Forum, 29, 1431–1441.

DOI Link

Study Purpose

To evaluate the feasibility of an intervention designed to promote sleep and modify fatigue during four cycles of adjuvant breast cancer chemotherapy.

 

Intervention Characteristics/Basic Study Process

A multicomponent cognitive-behavioral therapy in the form of a four-part intervention consisting of sleep hygiene counseling, relaxation therapy, sleep restriction, and an individualized sleep promotion plan (ISPP) stimulus control was used. It began two days before the first chemotherapy treatment, was revised before each treatment, and was reinforced seven days after each treatment. Restrictions were delivered by RNs. Sleep and fatigue were the outcomes measured.

Sample Characteristics

  • The study was comprised of 25 female Caucasian patients with stage I or II breast cancer during adjuvant chemotherapy.
  • Mean patient age was 54.3 years (range 40–65).

Setting

The study was conducted in the Midwestern United States, in urban oncology clinics and the patients’ homes.

Phase of Care and Clinical Applications

Patients were undergoing the active treatment phase of care.

Study Design

This was a prospective, repeated measures, quasiexperimental, feasibility study.

Measurement Instruments/Methods

  • Pittsburgh Sleep Quality Index (PSQI)
  • Daily diary
  • Wrist actigraph

Results

Sleep latency, sleep efficiency, total rest, and ratings of feeling refreshed on awakening were stable. Time awake after sleep onset and nighttime awakenings exceeded desired levels.

Limitations

  • The pilot study was not designed to test the effectiveness of the intervention.
  • Research RN training was required.
  • Actigraphs incurred a cost.