European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2025
Demoralization and sleep in breast cancer: A casual and computer-simulated network analysis.
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Li Hongman, Xiong Ying, Zhang Qihan, Lu Yufei, Chen Qiaoling, Wu Siqi, Deng Yiguo, Wu Jiahua, Knobf M Tish, Ye Zengjie
Аннотация
PURPOSE: There is evidence in studies with patients diagnosed with breast cancer that suggests demoralization, which is described as a sense of hopelessness and inability to cope, is associated with a decline in sleep. However, there are limited studies that fully explain the association. The purpose of this study was to further explore demoralization and sleep in patients.
METHODS: In the "Be Resilient to Breast Cancer" study, self-report data were collected on sleep and demoralization. Sleep was measured with the Pittsburgh Sleep Quality Index for a total sleep quality score and 7 sleep domains. The Demoralization Scale provides 16 items. Gaussian network analysis was employed to identify core symptoms and bridge symptoms. A Bayesian network was used to examine how these symptoms are causally related to each other. Computer-simulated interventions were used to identify targets for intervention.
RESULTS: The distress item of the Demoralization Scale was the core symptom (Str = 1.17, Bet = 52, Clo = 0.003), while the daytime dysfunction domain of sleep was considered the bridge symptom. Sleep quality was the key parent node. Computer-simulated intervention suggests targeting distress and loss of emotional control.
CONCLUSIONS: Sleep may contribute to demoralization from the findings of casual networking analysis. Distress and loss of emotional control should be targeted to decrease the adverse interaction with sleep.
METHODS: In the "Be Resilient to Breast Cancer" study, self-report data were collected on sleep and demoralization. Sleep was measured with the Pittsburgh Sleep Quality Index for a total sleep quality score and 7 sleep domains. The Demoralization Scale provides 16 items. Gaussian network analysis was employed to identify core symptoms and bridge symptoms. A Bayesian network was used to examine how these symptoms are causally related to each other. Computer-simulated interventions were used to identify targets for intervention.
RESULTS: The distress item of the Demoralization Scale was the core symptom (Str = 1.17, Bet = 52, Clo = 0.003), while the daytime dysfunction domain of sleep was considered the bridge symptom. Sleep quality was the key parent node. Computer-simulated intervention suggests targeting distress and loss of emotional control.
CONCLUSIONS: Sleep may contribute to demoralization from the findings of casual networking analysis. Distress and loss of emotional control should be targeted to decrease the adverse interaction with sleep.