Exploration of the Relationships Between Stress and Distinct Pain and Sleep Disturbance Profiles in Patients Undergoing Chemotherapy

Abstract

Posttraumatic stress disorder Sleep disturbanceBackground: Unrelieved pain and sleep disturbance are common symptoms in oncology patients. Increased stress may be an underlying cause for both symptoms. Objectives:The purposes of this study were to identify subgroups of outpatients with distinct pain and sleep disturbance profiles and to evaluate differences among these subgroups in demographic and clinical characteristics. Differences in global stress, cancer-specific stress, and cumulative life stress, as well as resilience and coping, were evaluated.Methods: Patients (N = 1343) completed self-report questionnaires for demographic and clinical characteristics and stress, resilience, and coping. Latent profile analysis was used to identify subgroups of patients with distinct pain and sleep disturbance profiles.Differences among the subgroups were determined using parametric and nonparametric tests. Results: Three distinct profiles were identified (ie, No Pain + Moderate Sleep Disturbance (SD) (27.6%), Moderate Pain + Moderate SD (38.6%), Severe Pain + High SD (33.8%)). Compared with the other 2 classes, Severe Pain + High SD class was younger, had fewer years of education, was more likely to be female, more likely to live alone, less likely to be employed, and had a higher level of comorbidity. This class had the highest stress scores and was more likely to report higher rates of adverse childhood experiences. Conclusion: Over 70% of our sample reported clinically meaningful levels

Adverse childhood events and mental health problems in cancer survivors: a systematic review

“…Moreover, survivors who suffered from severe pain and high sleep disturbance reported the highest rates for family violence in childhood, forced touching, and forced sex at an age younger than 16 compared to people who did not suffer from pain and reported moderate sleep disturbance, or moderate pain and moderate sleep disturbance [31]. Regarding physical abuse, the difference was only significant between the severe and the no pain group [31].…”

“…The majority of the 25 studies were conducted in the USA (n = 19, 76.0%) (see Table 2) [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. The other studies were conducted in the UK [34,35], Brazil [36], Turkey [37],…”

“…and China [38,39]. The number of participants in these studies ranged from 20 [21] to 1343 [31]. Median sample size was 110 (Q1 = 64, Q3 = 271, IQR = 207).…”

“…The CTQ is a 28-item inventory that provides a reliable and valid screening for a history of abuse and neglect [41]. Four studies [17,[25][26][27] used the Risky Families Questionnaire (RFQ) [42], one study [22] used the Traumatic Events Survey (TES) [43], two studies [15,23] used the Childhood Traumatic Events Scale (CTES) [44], one study [38] used the Adverse Childhood Experience Questionnaire (ACEQ) [45], one; [28] the ACE Questionnaire by the Center of Disease Control (CDC) [46], and one [31] the Life Stressor Checklist-Revised (LSC-R) [47]. Furthermore, the semi-structured interview Life events and difficulties schedule (LEDS) [48] was used [15], and one study used non-validated self-report Non-validated questions 30 participants (5.0%) experienced at least one ACE questions regarding ACEs [35].…”