Paper
Thursday, July 22, 2004
Daytime Activity/Nap Patterns and Their Relationship to Fatigue During Adjuvant Chemotherapy for Breast Cancer
Ann M. Berger, RN, PhD, AOCN, Lynne A. Farr, PhD, and Brett R. Kuhn, PhD. College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| Learning Objective #1: Describe the patterns and length of naps taken by women receiving adjuvant chemotherapy for breast cancer |
| Learning Objective #2: Discuss the relationships among daytime activity/nap patterns, nighttime awakenings, sleep efficiency, and cancer-related fatigue |
Objective: A strong inverse relationship has been reported between daytime activity and fatigue levels in women receiving adjuvant breast cancer chemotherapy, but little is known about the role of day naps on day activity in modifying cancer-related fatigue. This study’s purpose is to describe the relationships between daytime activity/nap patterns and cancer-related fatigue during adjuvant chemotherapy for breast cancer. Design: Prospective, repeated measures, feasibility design Sample/Setting: 25 Caucasian post-op women with Stage I or II breast cancer, Mean age 54.3, most married, employed. Concepts: Sleep, fatigue, activity/nap patterns. Subjects received a behavioral sleep intervention. Methods: During first week of four cycles of Adriamycin-based chemotherapy, Morin Sleep Diary (daily), wrist actigraphy (continuous); Piper Fatigue Scale (day 3) Findings: The pattern of daily naps during the first week after chemotherapy followed a bell curve, ranging from 14% to a peak of 25% and back to 10% per actigraph. Mean daily minutes spent napping after the treatment ranged from a high of 48.7 (0-135) to a low of 31.6 (0-131) per diary. No significant correlation was found between total nap time and fatigue. There were no significant differences in fatigue levels or wake after sleep onset (WASO) when comparing shorter vs longer nap duration. Higher daily activity per actigraph was correlated with lower fatigue at treatments 3 & 4 (r=-.48-.58, p<.0.01-.03). Higher daily awakenings per actigraph were correlated with higher fatigue at treatments 3 & 4 (r=.47-.62, p<0.04-.005). Conclusions: Patterns of napping followed a bell curve during the first week after chemotherapy. Total daily nap time varied widely. Nap duration was not related to fatigue or WASO. The previous relationship between activity and fatigue was supported. Implications: Findings need to be replicated in a larger study to clarify the relationship between daytime activity/nap patterns and fatigue during chemotherapy treatments.
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Sigma Theta Tau International
July 22-24, 2004