Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy

Dennis E McChargue, Jayashri Sankaranarayanan, Constance G. Visovsky, Ellyn E. Matthews, Krista B. Highland, Ann Malone Berger

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. Methods: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. Results: Total adherence rates to the BT plan were 51-52% at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). Conclusions: Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.

Original languageEnglish (US)
Pages (from-to)245-252
Number of pages8
JournalSupportive Care in Cancer
Volume20
Issue number2
DOIs
StatePublished - Feb 1 2012

Fingerprint

Sleep
Breast Neoplasms
Drug Therapy
Therapeutics
Depression
Relaxation Therapy
Psychology
Counseling
Anxiety
Randomized Controlled Trials
Nurses
Pain
Research

Keywords

  • Adherence
  • Behavioral intervention
  • Breast cancer
  • Depression
  • Oncology
  • Sleep disturbance

ASJC Scopus subject areas

  • Oncology

Cite this

Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy. / McChargue, Dennis E; Sankaranarayanan, Jayashri; Visovsky, Constance G.; Matthews, Ellyn E.; Highland, Krista B.; Berger, Ann Malone.

In: Supportive Care in Cancer, Vol. 20, No. 2, 01.02.2012, p. 245-252.

Research output: Contribution to journalArticle

McChargue, Dennis E ; Sankaranarayanan, Jayashri ; Visovsky, Constance G. ; Matthews, Ellyn E. ; Highland, Krista B. ; Berger, Ann Malone. / Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy. In: Supportive Care in Cancer. 2012 ; Vol. 20, No. 2. pp. 245-252.
@article{6b6de9417b9148ae97cca2757c969677,
title = "Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy",
abstract = "Background: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. Methods: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. Results: Total adherence rates to the BT plan were 51-52{\%} at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). Conclusions: Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.",
keywords = "Adherence, Behavioral intervention, Breast cancer, Depression, Oncology, Sleep disturbance",
author = "McChargue, {Dennis E} and Jayashri Sankaranarayanan and Visovsky, {Constance G.} and Matthews, {Ellyn E.} and Highland, {Krista B.} and Berger, {Ann Malone}",
year = "2012",
month = "2",
day = "1",
doi = "10.1007/s00520-010-1060-1",
language = "English (US)",
volume = "20",
pages = "245--252",
journal = "Supportive Care in Cancer",
issn = "0941-4355",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Predictors of adherence to a behavioral therapy sleep intervention during breast cancer chemotherapy

AU - McChargue, Dennis E

AU - Sankaranarayanan, Jayashri

AU - Visovsky, Constance G.

AU - Matthews, Ellyn E.

AU - Highland, Krista B.

AU - Berger, Ann Malone

PY - 2012/2/1

Y1 - 2012/2/1

N2 - Background: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. Methods: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. Results: Total adherence rates to the BT plan were 51-52% at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). Conclusions: Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.

AB - Background: This study's purpose was twofold: (1) to establish adherence rates to a behavioral therapy (BT) sleep intervention and (2) to identify psychological and physical symptom predictors of adherence to the intervention in women undergoing breast cancer chemotherapy. Methods: A randomized controlled trial began 48 h before the first of four chemotherapy treatments. Women with stages I-IIIA breast cancer (n = 113) received a BT sleep intervention composed of stimulus control, modified sleep restriction (MSR), relaxation therapy (RT), and sleep hygiene counseling components. A BT plan was developed by a research nurse and each participant, reinforced on day 8, and repeated for chemotherapy cycles 2, 3, and 4. Adherence to the BT plan was measured daily; total adherence score was computed at each chemotherapy cycle by combining adherence estimates of all BT plan components. Psychological and physical symptoms over the past 7 days were measured 2 days prior to and 7 days after each chemotherapy treatment. Results: Total adherence rates to the BT plan were 51-52% at all four treatments but adherence varied by component. Sleep disturbance, pain, and anxiety significantly decreased whereas depression significantly increased across chemotherapy. Structural equation modeling revealed a good model fit with decreasing sleep disturbances (0.409) and increasing depression (-0.711) contributing to lower total adherence rates. Increasing depression predicted lower MSR adherence (-0.203) and decreasing sleep disturbances predicted lower RT adherence (1.220). Conclusions: Sleep disturbance and depression significantly impacted adherence rates during chemotherapy. Results warrant attention when promoting adherence to BT sleep interventions during chemotherapy treatment.

KW - Adherence

KW - Behavioral intervention

KW - Breast cancer

KW - Depression

KW - Oncology

KW - Sleep disturbance

UR - http://www.scopus.com/inward/record.url?scp=84855196859&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84855196859&partnerID=8YFLogxK

U2 - 10.1007/s00520-010-1060-1

DO - 10.1007/s00520-010-1060-1

M3 - Article

C2 - 21174129

AN - SCOPUS:84855196859

VL - 20

SP - 245

EP - 252

JO - Supportive Care in Cancer

JF - Supportive Care in Cancer

SN - 0941-4355

IS - 2

ER -