This application for a Mentored Patient-Oriented Research Career Development Award (K23) is designed to support a period of training to the candidate, a doctorally-prepared nurse who is an Assistant Professor in the School of Nursing at The University at Colorado. The majority of the award will .be devoted to the supervised implementation of a randomized, controlled study. The primary goal of the proposed study is to examine a cognitive behavioral intervention for insomnia (CBTI) in women after breast cancer treatment. Chronic insomnia is a highly prevalent and distressing symptom in cancer patients. CBTI is considered the treatment of choice for chronic primary insomnia. Few studies have been conducted in cancer survivors to evaluate the effect of CBTI on sleep and clinically relevant outcomes. The overall goals of this feasibility study are to: 1) test standards-component CBTI in patients with breast cancer post-treatment, 2) gather data on the feasibility of the methods, and 3) determine effects of the intervention on quality of life (QOL) and daily functioning. Sixty women after completion of primary breast cancer treatment, 21-65 years of age, who meet the criteria for chronic insomnia, will be recruited from two Western US. Cancer Centers. Participants will be randomized to one of two treatment conditions (CBTI or behavioral placebo treatment). Both groups. Will receive six in-office and phone sessions. The control group will receive the same amount of individualized attention. Sleep efficiency and component measures (e.g., sleep onset latency, minutes awake after sleep onset) and quality of life and component measures of daily functioning will be assess pre and post-intervention, and at 3- and 6-month follow up visits. It is hypothesized that women receiving CBTi .treatment will demonstrate greater increase in sleep efficiency (time in bed compared with time asleep) and will self-report greater improvements in QOL and daily functioning compared to those receiving a behavioral placebo treatment at the conclusion of the intervention and at 3- to 6-month follow-ups. Established instruments include the Insomnia Severity Index. Morin Sleep Diary, Dysfunctional Beliefs and Attitudes about Sleep-16, EORTC Quality of Life Questionnaire C30, Attentional Function Index, Revised Piper Fatigue Scale, and Hospital Anxiety and Depression Scale. Subjective data will be corroborated with actigraphy. ANOOVA will be used to compare groups on each subjective dependent variable. Results may inform development of clinical guidelines for insomnia management after cancer treatment. The proposed study associated with this K23 award relates to the Health People 2010 goal of improving quality of life of individuals of all ages, and the cancer focus area goal of reducing illness and disability caused by cancer.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23NR010587-03
Application #
7622089
Study Section
National Institute of Nursing Research Initial Review Group (NRRC)
Program Officer
Marden, Susan F
Project Start
2007-09-28
Project End
2011-05-31
Budget Start
2009-06-05
Budget End
2011-05-31
Support Year
3
Fiscal Year
2009
Total Cost
$132,300
Indirect Cost
Name
University of Colorado Denver
Department
Type
Schools of Nursing
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Moore, Camille M; Schmiege, Sarah J; Matthews, Ellyn E (2015) Actigraphy and Sleep Diary Measurements in Breast Cancer Survivors: Discrepancy in Selected Sleep Parameters. Behav Sleep Med 13:472-90
Matthews, Ellyn E; Berger, Ann M; Schmiege, Sarah J et al. (2014) Cognitive behavioral therapy for insomnia outcomes in women after primary breast cancer treatment: a randomized, controlled trial. Oncol Nurs Forum 41:241-53
Matthews, Ellyn E; Arnedt, J Todd; McCarthy, Michaela S et al. (2013) Adherence to cognitive behavioral therapy for insomnia: a systematic review. Sleep Med Rev 17:453-64
Matthews, Ellyn E; Schmiege, Sarah J; Cook, Paul F et al. (2012) Adherence to cognitive behavioral therapy for insomnia (CBTI) among women following primary breast cancer treatment: a pilot study. Behav Sleep Med 10:217-29
Matthews, Ellyn E (2011) Sleep disturbances and fatigue in critically ill patients. AACN Adv Crit Care 22:204-24
Matthews, Ellyn E; Cook, Paul F; Terada, Masaka et al. (2010) Randomizing research participants: promoting balance and concealment in small samples. Res Nurs Health 33:243-53
Matthews, Ellyn E; Cook, Paul F (2009) Relationships among optimism, well-being, self-transcendence, coping, and social support in women during treatment for breast cancer. Psychooncology 18:716-26
Matthews, Ellyn; Armstrong, Gail; Spencer, Tammy (2008) Pertussis infection in a baccalaureate nursing program: clinical implications, emerging issues, and recommendations. J Contin Educ Nurs 39:419-26