외래 항암화학요법 중인 유방암 환자의 수면의 질
Sleep Quality of Breast Cancer Patients Receiving Chemotherapy in the Outpatients Setting
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초록
연구배경: 유방암은 한국 여성에서 두 번째로 가장 흔한 암이며, 환자의 생존율과 생존 시간이 점차 증가하여 유방암 환자의 삶의 질에 대한 관심이 높아지고 있다. 수면장애는 유방암환자에서 흔하며 삶의 질과 큰 연관이 있지만 이에 대해 거의연구된 바 없다. 이 연구는 항암화학요법 중인 유방암 환자의수면의 질을 연구하여 낮은 수면의 질의 유병률과 연관 요인들을 평가하고자 수행하였다. 방법: 2009년 2월부터 7월까지 한 3차 병원 외래 항암 치료실에 항암화학요법을 목적으로 내원한 129명의 환자에게 자기 기입식 설문조사를 시행하였고, 최종 94명(72.8%)이 연구 대상에 포함되었다. 수면의 질은 피츠버그 수면 질 지수(Pi sburg Sleep Quality Index, PSQI)로 조사하여 5점 보다 클 때수면의 질이 낮은 것으로 정의하였다. 기타 관련 요인은 설문지와 의무 기록 자료를 이용하여 조사하였으며, 단변량 분석및 다중 로짓 회귀 분석을 시행하였다. 결과: 외래에서 항암화학요법을 받고 있는 유방암 환자 94명중 72명(76.6%)에서 수면의 질이 낮았다. PSQI 평균 점수는 8.8점(±4.1)이었으며, 수면의 질이 낮았던 환자 중에서 수면 문제에 대해 의사와 상담을 한 환자는 11명(15.3%)에 불과하였다. 직업이 없는 것과 불안척도점수가 높은 것이 수면의 질과독립적인 연관성이 있었고, 교육, 항암화학요법 기간, 우울, 운동, 운동 수행 능력 등은 유의한 연관성이 없었다. 결론: 항암화학요법을 받고 있는 유방암 환자 중 상당한 수가수면의 질이 낮았지만, 실제로는 환자들 대부분이 이 문제에대해 의사와 상담을 하지 않았다. 수면 문제는 중요하지만 간과되는 문제로 이에 대한 관심과 치료가 필요하다.
Abstract
Background: Breast cancer is the second most common cancer in Korean women. As survival years increase, healthrelated quality of life has become an important issue in breast cancer patients. Sleep problems are common and cause significant disruption in quality of life in breast cancer patients. However, cancer-related sleep disturbance has received little attention. The purpose of this study was to determine the prevalence of poor sleep quality and factors which are associated with poor sleep quality in the breast cancer patients receiving chemotherapy in the outpatients setting. Methods: One hundred and twenty-seven breast cancer patients receiving chemotherapy in a tertiary hospital outpatient were surveyed between February 2009 and July 2009. Among them, 94 (72.8%) patients were finally included in the study. The sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI). PSQI > 5 indicates clinically significant poor sleep quality. Also the independent factors of sleep quality were assessed using univariable analysis and multiple logistic regression analysis. Results: Seventy-two (76.6%) patients of 94 breast cancer patients undergoing chemotherapy have poor sleep quality. Among of them, 11 (15.3%) patients were actually consulted with doctors. Average PSQI score was 8.8 (± 4.1). Anxiety and employment status were associated with poor sleep quality. Conclusion: A high proportion of breast cancer patients receiving chemotherapy even in the outpatient settings had poor sleep quality. But only small proportion of them consulted doctor. Poor sleep quality during chemotherapy in breast cancer patient was associated with anxiety and employment status. Considering the high prevalence of sleep problem and inadequate management, more adequate attention is needed to manage the sleep problem of breast cancer patients receiving chemotherapy.
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