Date of Award
Summer 2024
Document Type
Open Access Dissertation
Department
College of Nursing
First Advisor
Karen McDonnell
Abstract
Introduction: Improving the quality of life of survivors of early-stage lung cancer (NSCLC, Stages I - IIIa) requires attention to persistent, burdensome symptoms, including sleep disturbances. While research exists regarding sleep quality, sleep quantity, and sleep disturbances in cancer survivors, minimal research targets this minority survivor population. The purpose of this study was to measure and assess sleep quality, sleep quantity, and sleep disturbances among African American survivors of lung cancer. Based on the Symptom Management Theory, our comprehensive assessment focuses on a racial minority group and multiple diagnostic groups (COPD vs. No COPD). Methods: This two-group, cross-sectional, descriptive study utilized cancer registry data to recruit survivors from a private medical and radiation oncology practice. Sixteen lung cancer survivors (N = 16) consented to participate. Measurement tools included sleep and symptom-focused questionnaires, accelerometry, a sleep diary and an in-person interview. After consent was obtained, participants answered study specific questionnaires, wore a waist accelerometer for 7 days, kept a 7-day sleep diary, and completed an interview. Descriptive statistics were computed on all variables as appropriate including range of distribution, means, medians, and frequencies for each group. Baseline measures to include demographic information and information gained from medical record review were compared between the group with COPD and the group without COPD. Inferential statistics included independent t-tests performed to assess for subset differences between the group with COPD and the group without COPD. Interview data was recorded, professionally transcribed, and analyzed using thematic analysis. Results: Most participants were female (68.8%, n = 11), with a mean age of 68.9 years (range 45 - 84), average time since diagnosis of 6.5 years (range 1 - 13), 56.3% had Stage I lung cancer (n = 9), and 50% (n = 8) of the participants had COPD with a mean of 4.3 comorbidities (range 0 - 9). Quantitative results reveal the mean global PSQI score was 11.4 (range 8 - 16) for participants with COPD and was 8.1 (range 1 – 12) for participants without COPD. Most participants (93.8%, n = 15) scored 5 or higher, indicating poor sleep quality. Self-reported sleep was inadequate ( < 7hours/night) and self-reported sleep efficiency was inadequate ( < 85%). Accelerometer data indicated adequate sleep, adequate sleep efficiency, but a high level of sleep disturbances. Qualitative analysis resulted in 5 themes: : 1) perceived sleep quality varied from “terrible” to “good,” 2) multiple wakes occur after sleep onset, 3) upon final awakening do not feel well rested, 4) following a sleep time routine is improves sleep quality, 5) health providers are inattentive to sleep presenting a potential clinical problem. Implications: This study provides insight into a historically understudied minority group. Survivors of early-stage lung cancer experience poor sleep. Our assessment study provides new evidence that sleep is an important clinical problem among this population, providing support for effective assessment and intervention strategies to understand and improve sleep. Elucidating a thorough understanding of sleep will help vulnerable survivors recover from their cancer treatments, lower their risk of cancer recurrence, and manage the additional burden of co-morbidities.
Rights
© 2024, Amanda Rae Myhren Dyer
Recommended Citation
Dyer, A. R.(2024). Sleep Quality and Quantity Assessment Among African American Survivors of Lung Cancer with and Without Chronic Obstructive Pulmonary Disease (COPD). (Doctoral dissertation). Retrieved from https://scholarcommons.sc.edu/etd/7945