Relationships Among Pain, Sleep Disturbances, and Depressive Symptoms in Outpatients From a Comprehensive Cancer Center

Susan C. McMillan

Cindy S. Tofthagen

Mary Ann Morgan

outpatient setting, cancer pain, qualitative research
ONF 2008, 35(4), 603-611. DOI: 10.1188/08.ONF.603-611

Purpose/Objectives: To describe the pain experience of outpatients with cancer and explore the relationships with sleep disturbance, depression, and patient functioning.

Design: Descriptive, cross-sectional study.

Setting: Outpatient clinics at a large comprehensive cancer center in the southeastern United States.

Sample: 85 patients with a pain intensity level of at least 3.

Methods: Secondary analysis of baseline data.

Main Research Variables: Pain intensity and distress, pain interference, sleep disturbance intensity, and distress and depression.

Findings: The sample included men and women with a mean age of 54 years and 13 years of education. Mean present pain intensity on the Brief Pain Inventory scale was 4.6; mean pain at its worst was 8.3. Mean pain intensity measured with the Memorial Symptom Assessment Scale was 2.4 and pain distress was 2.2. Pain intensity and pain distress had a strong, positive correlation. The mean interference score for the group was 42.8. More than 63% of patients reported a problem with sleep disturbance. Distress from sleep disturbance was significantly correlated with pain intensity and pain distress. Pain interference also was correlated with sleep disturbance intensity and sleep disturbance distress. Pain severity, pain distress, pain right now, and pain interference total scores all were significantly correlated with depression scores.

Conclusions: Patients with cancer continue to experience pain during outpatient treatment and report sleep and depressive symptoms related to it.

Implications for Nursing: Improvements continue to be needed in assessment and treatment of pain.

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