Vargas, S., Antoni, M.H., Carver, C.S., Lechner, S.C., Wohlgemuth, W., Llabre, M., . . . Derhagopian, R.P. (2013). Sleep quality and fatigue after a stress management intervention for women with early-stage breast cancer in Southern Florida. International Journal of Behavioral Medicine. Retrieved from http://link.springer.com/article/10.1007%2Fs12529-013-9374-2

DOI Link

Study Purpose

To conduct a secondary data analysis of outcomes of a cognitive behavioral stress management (CBSM) intervention study on improvement in sleep quality and fatigue among women with early-stage breast cancer in Southern Florida

Intervention Characteristics/Basic Study Process

10-week CBSM

Sample Characteristics

  • N = 240
  • MEAN AGE = 50.99 years for CBSM and 49.69 years for psychoeducational control group 
  • FEMALE: 100%
  • KEY DISEASE CHARACTERISTICS: Patients with early-stage breast cancer (stage III and below) who had completed surgery (lumpectomy or mastectomy) prior to randomization

Setting

  • SITE: Not stated or unknown  
  • SETTING TYPE: Not specified  
  • LOCATION: Southern Florida

Phase of Care and Clinical Applications

  • PHASE OF CARE: Active anti-tumor treatment

Study Design

  • Experimental (random assignment)

Measurement Instruments/Methods

  • Pittsburgh Sleep Quality Index (PSQI)
  • Fatigue Symptom Inventory (FSI)

Results

No statistical differences in PSQI total scores or changes in fatigue intensity between groups. Changes in sleep quality were associated with change in fatigue.

Conclusions

CBSM may have some positive effects on elements of sleep quality and fatigue. Data support an association between sleep quality and fatigue (fatigue-related daytime interference).

Limitations

  • Risk of bias (no appropriate attentional control condition)
  • Risk of bias (sample characteristics)
  • Key sample group differences that could influence results
  • Intervention expensive, impractical, or training needs
  • Questionable protocol fidelity
  • Subject withdrawals were 10% or greater

Nursing Implications

Consider evaluation of sleep disturbance in patients experiencing fatigue.