Cancer symptom management is a National Cancer Institute and National Institute of Nursing Researchpriority for improving quality of life. Few studies have addressed sleep in children with cancer, and sourcesof sleep disturbances in children with cancer in inpatient settings are not well understood. Studies of acutelyill children indicate that hospital environmental stimuli impair sleep quantity and quality. Other cancer symp-toms also can contribute to disturbed sleep. Temperament characteristics can impact children's response tohospital stimuli and impair sleep. Common genetic polymorphisms associated with variations in tempera-ment may influence response to physiologic and environmental stimuli and impact symptom burden.Design: The proposed study will utilize a multiple-case study design to describe biobehavioral and environ-mental influences on sleep-wake patterns among children with cancer receiving inpatient chemotherapy.
Specific aims are:1. Describe nighttime sleep-wake patterns among children with cancer receiving inpatient chemotherapy.2. Describe nighttime patterns of variation in environmental factors (room sound, light, and temperaturelevels), and relationships with clinical variables (pain, nausea/vomiting, and medication administration).3. Describe relationships between nighttime sleep-wake patterns in children with cancer, environmentalvariables, biobehavioral variables (temperament and behavioral genotype), and fatigue.Methods: Fifteen children with cancer ages 5 to 12 years receiving inpatient chemotherapy will be included.Actigraphs will measure sleep variables. Data loggers will measure environmental variables. Carey Temper-ament Scales and behavioral genotyping using polymerase chain reaction will measure biobehavioralvariables. Fatigue will be measured using the Fatigue Scales for 7- to 12-Year Olds and for Parents.Analysis:
(Aim 1) Descriptive time series plots of sleep variables will be generated for individual and groupdata. Repeated measures ANOVA will evaluate change in sleep.
(Aim 2) Graphical plots will be generatedfor environmental variables and superimposed with clinical variables. Autocorrelation functions will evaluateenvironmental variable trends.
(Aim 3) Individual time-series plots will compare sleep, environment, and fati-gue data. Correlation coefficients will evaluate associations between temperament, sleep, and fatigue.Kruskall-Wallis statistics will evaluate differences in sleep and fatigue based on behavioral genotype.Public Health: The study will promote quality of life for children with cancer through identification of factorscontributing to disturbed sleep in the hospital and the development of interventions to improve sleep.
| Linder, Lauri A; Christian, Becky J (2013) Nighttime sleep characteristics of hospitalized school-age children with cancer. J Spec Pediatr Nurs 18:13-24 |
| Linder, Lauri A; Christian, Becky J (2012) Nighttime sleep disruptions, the hospital care environment, and symptoms in elementary school-age children with cancer. Oncol Nurs Forum 39:553-61 |
| Linder, Lauri A; Christian, Becky J (2011) Characteristics of the nighttime hospital bedside care environment (sound, light, and temperature) for children with cancer. Cancer Nurs 34:176-84 |
| Linder, Lauri (2010) Analysis of the UCSF Symptom Management Theory: implications for pediatric oncology nursing. J Pediatr Oncol Nurs 27:316-24 |
