Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies

Carol M. Baldwin, Marcia Grant, Christopher S Wendel, Mark C. Hornbrook, Lisa J. Herrinton, Carmit McMullen, Robert S Krouse

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Study Objectives: The aim of this study is to examine differences in sleep disruption and fatigue of men and women colorectal cancer (CRC) survivors with intestinal ostomies and associated health-related quality of life (HR-QOL). Methods: Participants in this cross-sectional study of long-term (> 5 years) CRC survivors received care at Kaiser Permanente. Measures included the City of Hope QOL Ostomy questionnaire with narrative comments for ostomy-related "greatest challenges." The Short Form-36 Version 2 (SF-36v2) health survey provided physical (PCS) and mental composite scale (MCS) scores to examine generic HR-QOL. The "sleep disruption" and "fatigue" items from the ostomy questionnaire (scale from 0 to 10 with higher scores indicating better HR-QOL) were dependent variables, while independent variables included age, ethnicity, education, partnered status, body mass index, and time since surgery. Data were analyzed using chi-square for nominal variables, Student t-tests for continuous variables, and logistic regression with significance set at p < 0.05. Results: On the ostomy-specific measure, women (n = 118) compared to men (n = 168) reported more sleep disruption (p < 0.01), adjusted for age, and greater levels of fatigue (p < 0.01), adjusted for time since surgery. Women's PCS and MCS scores indicated poorer HR-QOL compared to men, and differences were clinically meaningful. Qualitative narrative comments suggested that sleep disruption could stem from ostomy-associated fear of or actual leakage during sleep. Conclusion: Although women CRC survivors with ostomies report more sleep disruption and fatigue, which is reflected in their reduced physical and mental health scores on the SF-36v2 compared to men with ostomies, their stated reasons for disrupted sleep are similar to their male counterparts. These findings can provide a foundation for gender-relevant ostomy interventions to improve sleep and HR-QOL in this patient population.

Original languageEnglish (US)
Pages (from-to)335-343
Number of pages9
JournalJournal of Clinical Sleep Medicine
Volume5
Issue number4
StatePublished - Aug 15 2009

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Ostomy
Fatigue
Sleep
Quality of Life
Survivors
Colorectal Neoplasms
Hope
Health Surveys
Fear
Mental Health
Body Mass Index
Cross-Sectional Studies
Logistic Models
Students
Education

Keywords

  • Gender differences
  • Intestinal ostomies
  • Mixed-methods
  • Quality of life
  • Sleep disruption

ASJC Scopus subject areas

  • Clinical Neurology
  • Pulmonary and Respiratory Medicine
  • Neurology

Cite this

Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies. / Baldwin, Carol M.; Grant, Marcia; Wendel, Christopher S; Hornbrook, Mark C.; Herrinton, Lisa J.; McMullen, Carmit; Krouse, Robert S.

In: Journal of Clinical Sleep Medicine, Vol. 5, No. 4, 15.08.2009, p. 335-343.

Research output: Contribution to journalArticle

Baldwin, CM, Grant, M, Wendel, CS, Hornbrook, MC, Herrinton, LJ, McMullen, C & Krouse, RS 2009, 'Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies', Journal of Clinical Sleep Medicine, vol. 5, no. 4, pp. 335-343.
Baldwin CM, Grant M, Wendel CS, Hornbrook MC, Herrinton LJ, McMullen C et al. Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies. Journal of Clinical Sleep Medicine. 2009 Aug 15;5(4):335-343.
Baldwin, Carol M. ; Grant, Marcia ; Wendel, Christopher S ; Hornbrook, Mark C. ; Herrinton, Lisa J. ; McMullen, Carmit ; Krouse, Robert S. / Gender differences in sleep disruption and fatigue on quality of life among persons with ostomies. In: Journal of Clinical Sleep Medicine. 2009 ; Vol. 5, No. 4. pp. 335-343.
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abstract = "Study Objectives: The aim of this study is to examine differences in sleep disruption and fatigue of men and women colorectal cancer (CRC) survivors with intestinal ostomies and associated health-related quality of life (HR-QOL). Methods: Participants in this cross-sectional study of long-term (> 5 years) CRC survivors received care at Kaiser Permanente. Measures included the City of Hope QOL Ostomy questionnaire with narrative comments for ostomy-related {"}greatest challenges.{"} The Short Form-36 Version 2 (SF-36v2) health survey provided physical (PCS) and mental composite scale (MCS) scores to examine generic HR-QOL. The {"}sleep disruption{"} and {"}fatigue{"} items from the ostomy questionnaire (scale from 0 to 10 with higher scores indicating better HR-QOL) were dependent variables, while independent variables included age, ethnicity, education, partnered status, body mass index, and time since surgery. Data were analyzed using chi-square for nominal variables, Student t-tests for continuous variables, and logistic regression with significance set at p < 0.05. Results: On the ostomy-specific measure, women (n = 118) compared to men (n = 168) reported more sleep disruption (p < 0.01), adjusted for age, and greater levels of fatigue (p < 0.01), adjusted for time since surgery. Women's PCS and MCS scores indicated poorer HR-QOL compared to men, and differences were clinically meaningful. Qualitative narrative comments suggested that sleep disruption could stem from ostomy-associated fear of or actual leakage during sleep. Conclusion: Although women CRC survivors with ostomies report more sleep disruption and fatigue, which is reflected in their reduced physical and mental health scores on the SF-36v2 compared to men with ostomies, their stated reasons for disrupted sleep are similar to their male counterparts. These findings can provide a foundation for gender-relevant ostomy interventions to improve sleep and HR-QOL in this patient population.",
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