Sleeping-related distress in a palliative care population: A national, prospective, consecutive cohort.
Autor: | Currow, David C, Davis, Walter, Connolly, Alanna, Krishnan, Anu, Wong, Aaron, Webster, Andrew, Barnes-Harris, Matilda MM, Daveson, Barb, Ekström, Magnus |
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Předmět: |
WELL-being
RESPIRATORY diseases CONFIDENCE intervals PAIN HEALTH outcome assessment SLEEP disorders SEX distribution RISK assessment SYMPTOMS KARNOFSKY Performance Status DISEASE prevalence ODDS ratio FATIGUE (Physiology) PSYCHOLOGICAL distress PALLIATIVE treatment LONGITUDINAL method COMORBIDITY EVALUATION |
Zdroj: | Palliative Medicine; Oct2021, Vol. 35 Issue 9, p1663-1670, 8p |
Abstrakt: | Background: Sleep, a multi-dimensional experience, is essential for optimal physical and mental wellbeing. Poor sleep is associated with worse wellbeing but data are scarce from multi-site studies on sleeping-related distress in palliative care populations. Aim: To evaluate patient-reported distress related to sleep and explore key demographic and symptom distress related to pain, breathing or fatigue. Design: Australian national, consecutive cohort study with prospectively collected point-of-care data using symptoms from the Symptom Assessment Scale (SAS). Setting/Participants: People (n = 118,117; 475,298 phases of care) who died while being seen by specialist palliative care services (n = 152) 2013–2019. Settings: inpatient (direct care, consultative); community (outpatient clinics, home, residential aged care). Results: Moderate/severe levels of sleeping-related distress were reported in 11.9% of assessments, more frequently by males (12.7% vs 10.9% females); people aged <50 years (16.2% vs 11.5%); and people with cancer (12.3% vs 10.0% for other diagnoses). Sleeping-related distress peaked with mid-range Australia-modified Karnofsky Performance Status scores (40–60). Strong associations existed between pain-, breathing- and fatigue-related distress in people who identified moderate/severe sleeping-related distress, adjusted for age, sex and functional status. Those reporting moderate/severe sleeping-related distress were also more likely to experience severe pain-related distress (adjusted odds ratios [OR] 6.6; 95% confidence interval (CI) 6.3, 6.9); breathing-related distress (OR 6.2; 95% CI 5.8, 6.6); and fatigue-related distress (OR 10.4; 95% CI 9.99–10.8). Conclusions: This large, representative study of palliative care patients shows high prevalence of sleeping-related distress, with strong associations shown to distress from other symptoms including pain, breathlessness and fatigue. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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