Analysis of sleep quality, disease uncertainty, and psychological tolerance in patients undergoing chemotherapy for digestive tract malignancies

Table 1 Sleep quality survey results of gastrointestinal malignant tumor chemotherapy patients

Cancer types	n	PSQI score (points)	Number of sleep disorders				Incidence of sleep disorders (%)
			Mild	Moderate	Severe	Total
Gastrointestinal malignant tumor	131	10.52 ± 1.07	41	26	11	78	59.54
Rectal cancer	22	9.31 ± 0.96	9	7	3	19	86.36
Colon cancer	13	9.19 ± 0.94	6	4	1	11	84.62
Gastric cancer	33	11.18 ± 1.46a,b	8	5	3	16	48.48a,b
Esophageal cancer	63	10.87 ± 1.72a,b	18	10	4	32	50.79a,b
F/χ2		11.621				13.639
P value		< 0.001				0.003

^aP < 0.05, compared with rectal cancer.

^bP < 0.05, compared with colon cancer.

PSQI: Pittsburgh Sleep Quality Index.

Table 2 Comparison of data between the sleep disorder group and the normal sleep group

Variables	Group	Sleep disorders group (n = 78)	Normal sleep group (n = 53)	χ2/t	P value
Sex	Male	62 (79.49)	38 (71.70)	1.060	0.303
	Female	16 (20.51)	15 (28.30)
Age	-	68.74 ± 6.95	64.82 ± 6.56	3.241	< 0.001
Educational level	Junior high school and below	36 (46.15)	25 (47.17)	0.013	0.909
	High school and above	42 (53.85)	28 (52.83)
Residence	Town	48 (61.54)	33 (62.26)	0.007	0.933
	Rural	30 (38.46)	20 (37.74)
Chemotherapy regimen	FOLFOXIRI	45 (57.69)	32 (60.38)	0.094	0.759
	FOLFOX	33 (42.31)	21 (39.62)
Chemotherapy frequency	≤ 6	68 (87.18)	52 (98.11)	4.905	0.027
	> 6	10 (12.82)	1 (1.89)
Pain level	Mild	68 (85.90)	52 (98.11)	-	0.0361
	Moderate	9 (12.82)	1 (1.89)
	Severe	1 (1.28)	0 (0)
SAS score	-	57.43 ± 5.86	46.62 ± 4.58	11.286	< 0.001
SDS score	-	58.17 ± 5.69	44.23 ± 4.75	14.689	< 0.001
Ward noise	Yes	30 (38.46)	10 (18.87)	5.712	0.017
	No	48 (61.54)	43 (81.13)

¹Indicates using Fisher's exact probability method. SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.

Table 3 Comparison of Mishel Uncertainty in Illness Scale for Adults scores between sleep disorder group and normal sleep group (mean ± SD)

Group	Lack of disease information	Disease uncertainty	Complexity	Unpredictability	Total score
Sleep disorders group (n = 78)	16.57 ± 1.68	46.25 ± 4.72	24.75 ± 2.54	10.13 ± 1.16	97.76 ± 9.82
Normal sleep group (n = 53)	13.26 ± 1.57	30.57 ± 3.26	16.54 ± 1.79	8.15 ± 0.83	68.53 ± 6.90
t	11.362	21.007	20.338	10.699	18.743
P value	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001

Table 4 Comparison of Connor-Davidson Resilience Scale scores between sleep disorder group and normal sleep group (mean ± SD)

Group	Resilience	Self-improvement	Optimistic	Total score
Sleep disorders group (n = 78)	25.48 ± 2.63	17.15 ± 1.78	5.71 ± 0.61	48.32 ± 4.96
Normal sleep group (n = 53)	28.63 ± 2.97	18.96 ± 1.93	6.34 ± 0.65	53.93 ± 5.46
t	6.383	5.520	5.650	6.099
P value	< 0.001	< 0.001	< 0.001	< 0.001

Table 5 Correlation between Pittsburgh Sleep Quality Index score and Mishel Uncertainty in Illness Scale for Adults and Connor-Davidson Resilience Scale scores in chemotherapy patients with gastrointestinal malignant tumors

Variables		PSQI
		r	P value
MUIS-A score	Lack of disease information	0.583	< 0.001
	Disease uncertainty	0.422	0.008
	Complexity	0.169	0.114
	Unpredictability	0.426	0.006
CD-RISC score	Resilience	-0.579	< 0.001
	Self-improvement	-0.613	< 0.001
	Optimistic	-0.281	0.021

PSQI: Pittsburgh Sleep Quality Index; MUIS-A: Mishel Uncertainty in Illness Scale for Adults; CD-RISC: Connor-Davidson Resilience Scale.

Table 6 Analysis of Factors Influencing Sleep Disorders in Chemotherapy Patients with Gastrointestinal Malignant Tumors

Factors	β	SE	Wald χ2	OR	P value	95%CI
Age	0.353	0.276	1.636	1.423	0.202	0.829-2.445
Chemotherapy frequency	0.255	0.184	1.921	1.290	0.167	0.900-1.851
Pain level	0.457	0.273	2.802	1.579	0.095	0.925-2.697
SAS score	0.291	0.115	6.403	1.338	0.012	1.068-1.676
SDS score	0.284	0.118	5.793	1.328	0.017	1.054-1.674
Ward noise	0.365	0.176	4.301	1.441	0.039	1.020-2.034
MUIS-A score	0.357	0.148	5.819	1.429	0.016	1.069-1.910
CD-RISC score	-0.426	0.106	16.151	0.653	< 0.001	0.531-0.804

MUIS-A: Mishel Uncertainty in Illness Scale for Adults; CD-RISC: Connor-Davidson Resilience Scale; SAS: Self-rating anxiety scale; SDS: Self-rating depression scale.