Logo image
Back
Biobehavioral predictors of mood, pain, fatigue, and insomnia in endometrial cancer survivors
Journal article   Peer reviewed

Biobehavioral predictors of mood, pain, fatigue, and insomnia in endometrial cancer survivors

Elizabeth S. Ver Hoeve, Meredith E. Rumble, Jessica S. Gorzelitz, Stephen L. Rose, Ashley M. Nelson, Keayra E. Morris and Erin S. Costanzo
Gynecologic oncology, Vol.191, pp.265-274
10/30/2024
DOI: 10.1016/j.ygyno.2024.10.024
PMCID: PMC11658135
PMID: 39481346
url
https://pmc.ncbi.nlm.nih.gov/articles/PMC11658135/pdf/nihms-2032969.pdfView
Open Access

Abstract

Endometrial cancer survivors experience persistent health-related quality of life concerns, including pain, fatigue, and disrupted emotional and social functioning. The purpose of this longitudinal study was to evaluate associations between biobehavioral factors, including daytime physical activity, nighttime sleep, and 24-h circadian rest-activity rhythms, with psychological and physical symptoms following endometrial cancer surgery. This study included 69 adult female patients undergoing surgery for endometrial cancer. At each of three assessment points (1, 4, and 16 weeks post-surgery), participants wore a wrist actigraph for 3 days and completed a sleep log and self-report measures of depression and anxiety (Inventory of Depression and Anxiety Symptoms), pain (Brief Pain Inventory), fatigue (Fatigue Symptom Inventory), and insomnia (Insomnia Severity Index). Physical activity, sleep, and 24-h rest-activity indices were derived from actigraphy. Mixed- and fixed-effects linear regression models were utilized to evaluate relationships between actigraphy indices and patient-reported outcomes. Clinically elevated fatigue persisted for a majority of participants (64 %), while a sizeable minority continued to report clinically elevated insomnia (41 %) and pain (19 %) at 16-weeks post-surgery. Participants who recorded less daytime activity, more disrupted sleep, and less consistent 24-h rest-activity rhythms by actigraphy reported more depression and anxiety symptoms and greater pain and fatigue. Within individual participants, at time points when activity was lowest, sleep most disrupted, and 24-h rest-activity rhythms least consistent, participants experienced more psychological and physical symptoms. Findings suggest that disruptions in daytime physical activity, nighttime sleep, and 24-h rest-activity patterns contribute to patient-reported outcomes in the weeks and months after endometrial cancer treatment. Findings support modifiable intervention targets to address co-occurring physical and psychological symptoms and optimize health and recovery after endometrial cancer surgery. •At 16-weeks post-surgery, 64.2 % of participants continued to report elevated fatigue and 41.4 % continued to report insomnia.•Daytime physical activity (PA), nighttime sleep, and 24-h rest-activity patterns were associated with multiple patient-reported symptoms.•Less physical activity, more disrupted sleep, and less consistent 24-h rest-activity rhythms were associated with greater symptom burden.•Within participants, at time points when PA was lowest, sleep most disrupted, and rest-activity rhythms least consistent, participants reported more symptoms.
 Circadian Rhythms Endometrial Cancer Fatigue Insomnia Physical activity Sleep

Details

Metrics

21 Record Views
4 Times Cited - Web of Science
Logo image