Perioperative Sleep Disturbance,Sleep Beliefs And Coping Modes In Patients With Esophageal Cancer

Objectives: To investigate the dynamic changes and influencing factors of patients’ sleep quality during the whole perioperative period,and to provide innovative interventions for managing sleep in cancer patients.Methods:It was a longitudinal,observational study.A convenience sample was selected from patients with esophageal cancer hospitalized for surgery in the thoracic surgery ward of a hospital in Sichuan Province from December 2020 to November 2021.Collected data included demographic and clinical characteristics,sleep beliefs,coping modes and sleep quality before surgery,7 days after surgery and before discharge.Among them,sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep Scale,coping modes were evaluated by the Medical Coping Modes Questionnaire,and sleep quality was measured by the Pittsburgh Sleep Quality Scale.Analyses were performed using the software of the IBM SPSS.Comparisons of means between two groups were conducted using the independent Student’s t-test.Comparisons of means among three and more groups were performed by the One-way ANOVA.Post-hoc comparisons for significant variables were conducted using the Least Significant Difference test.Pearson’s correlation coefficient was used to investigate the relationship between sleep quality,sleep beliefs,and coping modes.Repeated measures ANOVA was used to compare the changes of perioperative sleep quality in patients with esophageal cancer.Multivariate linear regression analysis was used to find significant influencing factors of sleep quality at different stages.Results:The incidences of sleep disturbance before surgery,7 days after surgery,and before discharge in patients with esophageal cancer were 53.5%,90.9%,and 65.1%.The total score of sleep beliefs in esophageal cancer patients was 56.84±6.53.The scores of confrontation,avoidance and acceptance modes were 19.63±1.40,14.57±1.89,11.01±1.60.Multivariate linear regression analysis showed that the influencing factors of preoperative sleep quality included type of caregivers,smoking,hypnotics,sleep beliefs,and acceptance coping mode;the influencing factors of sleep quality 7 days after surgery were the application of patient-controlled analgesia;and the influencing factors of sleep quality before discharge were coronary heart disease（other diseases）,per capita family monthly income,the application of patient-controlled analgesia and avoidance coping mode.Conclusions:The incidence of sleep disturbance was high in patients with esophageal cancer patient across the perioperative period,with the highest occurring 7days after surgery.The study confirmed that the influencing factors of sleep quality varied with different periods of surgery,and sleep beliefs and negative coping modes significantly affected sleep quality.The results are helpful for medical staff to comprehensively understand perioperative sleep of patients and provide evidence for sleep management of patients at different periods of surgery.