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Sleep Quality in Adults with Cancer: Associations with Symptom Burden and Psychological Resilience
Ryan Hae Park1,2, Su Jung Lee3
1Graduate School of Nursing Science, Hallym University, Gangwon-Do, Chuncheon-Si, Republic of Korea.
Background:
Sleep disturbance is prevalent among adults with cancer and often co-occurs with multiple physical and psychological symptoms. Although resilience has been associated with better sleep outcomes, evidence integrating overall symptom burden and resilience remains limited.
Objective:
To identify factors associated with sleep quality in adults with cancer, focusing on co-occurring symptom burden and resilience.
Methods:
This cross-sectional study included 159 adults with cancer recruited from a tertiary hospital and online patient communities in the Republic of Korea. Sleep quality was assessed using the Pittsburgh Sleep Quality Index. Symptom burden was measured with the Patient-Reported Outcomes Measurement Information System 29-Item Profile, and resilience with the Korean version of the Connor-Davidson Resilience Scale. Multivariable logistic regression was used to identify factors associated with poor sleep quality, and hierarchical multiple linear regression examined factors associated with sleep quality scores.
Results:
The mean sleep quality score was 6.99 ± 3.84, and 42.1% of participants were classified as poor sleepers. Being 1-3 years postdiagnosis and having received radiotherapy were independently associated with higher odds of poor sleep. Higher mental health summary scores and higher resilience were associated with lower odds of poor sleep after adjustment for sociodemographic and clinical factors. The final regression model explained 34.1% of the variance in sleep quality.
Conclusions:
Poor sleep was common among adults with cancer. Mental health and resilience were independently associated with sleep quality beyond clinical characteristics. These findings highlight the relevance of considering psychosocial factors alongside clinical characteristics when assessing sleep problems in supportive oncology care.
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