Emotional well-being is most typically studied in trait or trait-like terms, yet a growing literature indicates that daily (within-person) fluctuations in emotional well-being may be equally important. The present research explored the hypothesis that daily variations may be understood in terms of the degree to which three basic needs—autonomy, competence, and relatedness—are satisfied in daily activity. Hierarchical linear models were used to examine this hypothesis across 2 weeks of daily activity and well-being reports controlling for trait-level individual differences. Results strongly supported the hypothesis. The authors also examined the social activities that contribute to satisfaction of relatedness needs. The best predictors were meaningful talk and feeling understood and appreciated by interaction partners. Finally, the authors found systematic day-of-the-week variations in emotional well-being and need satisfaction. These results are discussed in terms of the importance of daily activities and the need to consider both trait and day-level determinants of well-being.
A B S T R A C T PurposeSleep disruption is prevalent in patients with cancer and survivors, but the prevalence of insomnia, a distressing sleep disorder, in these populations has yet to be determined in large-scale studies.
Patients and MethodsA total of 823 patients with cancer receiving chemotherapy (mean age, 58 years; 597 female patients) reported on sleep difficulties in a prospective study.
ResultsDuring day 7 of cycle 1 of chemotherapy, 36.6% (n ϭ 301) of the patients with cancer reported insomnia symptoms, and 43% (n ϭ 362) met the diagnostic criteria for insomnia syndrome. Patients with cancer younger than 58 years were significantly more likely to experience either symptoms of insomnia or insomnia syndrome ( 2 ϭ 13.6; P ϭ .0002). Patients with breast cancer had the highest number of overall insomnia complaints. A significant positive association was found between symptoms of insomnia during cycles 1 and 2 of chemotherapy ( ϭ .62, P Ͻ .0001), showing persistence of insomnia during the first two cycles of chemotherapy. Sixty percent of the patient sample reported that their insomnia symptoms remained unchanged from cycle 1 to cycle 2. Those with insomnia complaints had significantly more depression and fatigue than good sleepers (all P Ͻ .0001).
ConclusionThe proportions of patients with cancer in this sample reporting symptoms of insomnia and meeting diagnostic criteria for insomnia syndrome during chemotherapy are approximately three times higher than the proportions reported in the general population. Insomnia complaints persist throughout the second chemotherapy cycle for the majority of patients with cancer in this study. Insomnia is prevalent, underrecognized, undermanaged, and understudied among patients with cancer receiving chemotherapy.
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