BACKGROUND: Hepatocellular carcinoma patients often experience sleep disturbance after undergoing transcatheter arterial chemoembolization (TACE).
OBJECTIVE: The purposes of this study were to (1) examine and compare symptom distress, depression, and sleep quality in hepatocellular carcinoma patients undergoing TACE with versus without sleep disturbance and (2) examine the determinants of sleep disturbance in these patients.
METHODS: Hepatocellular carcinoma patients undergoing TACE were recruited. The patients were evaluated 1 week (T1) and 1 month (T2) after receiving TACE in terms of performance status, symptom distress, depression (T1), and sleep disturbance (T2). Logistic regression was used to determine the predictive factors of sleep disturbance.
RESULTS: Significantly higher overall symptom distress and depression and lower sleep quality were reported in patients with sleep disturbance than in patients without sleep disturbance. The 5 leading causes of symptom distress in both groups were fatigue, pain, poor appetite, chest tightness, and fever. Older age, greater symptom distress, and higher levels of depression were significantly associated with sleep disturbance.
CONCLUSIONS: The results of this study show significant associations among symptom distress, depression at baseline, and sleep problems 1 month after undergoing TACE. Clinicians should be aware of the possibility of lasting sleep disturbance in hepatocellular carcinoma patients undergoing TACE.
IMPLICATIONS FOR PRACTICE: In clinical care, symptom management, psychological consultation, and relaxation training may promote sleep quality.