Insomnia and Related Symptom Severity in Women with Breast Cancer and Pain Receiving Treatment in Medically Underserved Areas

Résumé fourni par la source

OBJECTIVES: Insomnia is common for women with breast cancer, and related to fatigue, depression, and pain. Research exploring these symptoms among breast cancer patients in medically underserved areas is lacking. This study aimed to characterize symptom severity, and examine how fatigue, depression, and pain vary based on categories of insomnia severity. METHODS: = 127) with Stage 0-IV breast cancer receiving care at clinics in mostly rural, medically underserved areas completed self-report measures of insomnia (Insomnia Severity Index), fatigue (PROMIS-Fatigue), depression (Center for Epidemiological Studies Depression Scale), and pain (Brief Pain Inventory). ANOVA or Kruskal-Wallis tests compared differences in fatigue, depression, and pain across insomnia severity categories. Post-hoc tests determined pairwise significant differences. Analyses were conducted using SAS software. RESULTS: Median [IQR] insomnia symptom severity fell within the Subthreshold/Mild range (12.00 [6.00, 16.00]). Thirty-four percent of women endorsed insomnia symptoms in the Moderate range or higher. Median fatigue was moderate (60.80 [55.60, 64.85]), and median depressive symptoms (17.00 [10.50, 23.50]) indicated risk for clinical depression. Mean pain severity (4.59 [1.85]) and median pain interference (4.29 [2.57, 6.46]) were moderate. Women endorsing Subthreshold/Mild and Moderate/Severe insomnia symptoms exhibited significantly worse fatigue, depressive symptoms, and pain. CONCLUSIONS: Results highlight a multi-symptom burden for women with breast cancer receiving care at clinics in medically underserved areas with a largely rural population. Behavioral symptom management is critically needed. Intervening on insomnia may, in turn, improve fatigue, depression, and pain. Behavioral interventions targeting insomnia and related symptoms should be adapted for, and tested, in this population.

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