Risk factors of perioperative insomnia in young patients with breast masses undergoing ambulatory Mammotome minimally invasive surgery_West China Medical Journal

Authors：

CAI Yuting , ZHU Min , ZHANG Suqing , LONG Xiaoqing , MA Hongsheng ,  DAI Yan

Day Surgery Center, West China Hospital, Sichuan Univeristy, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

DAI Yan, Email: 1846703501@qq.com

Keywords：

Breast mass; Mammotome minimally invasive surgery; Insomnia Severity Index; Day surgery; Risk factors

DOI：

10.7507/1002-0179.201709093

Video：

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Objective To explore the risk factors of perioperative insomnia in young patients with breast masses undergoing ambulatory Mammotome (MMT) minimally invasive surgery. Methods A total of 166 young female patients who were ≤40 years old, diagnosed with breast masses, undergoing ambulatory MMT between June and December 2016 in West China Hospital of Sichuan University were included in this study. Questionnaire survey and data about general condition, preoperative and postoperative Insomnia Severity Index (ISI), Hospital Anxiety and Depression Scale, and postoperative pain Visual Analogue Scale were collected in the enrolled population. Univariate analysis was used to screen the factors that might cause insomnia, and then multiple logistic regression analysis was performed to identify possible risk factors of insomnia. Results In the 166 young female patients, the mean age was (30.90±5.96) years, and the mean perioperative ISI score was 8.83±4.97. Slight insomnia was found in 39.7% (66/166) of the patients, moderate insomnia was found in 12.7% (21/166), and severe insomnia was found in 2.4% (4/166). The results of multiple logistic regression suggested that the number of breast masses [taking the number=1 as the reference, when the number=4, odds ratio (OR)=2.269, 95% confidence interval (CI) (1.917, 13.818), P=0.001; when the number>4,OR=9.359, 95%CI (4.507, 19.433), P<0.001] and the maximum diameter of breast masses [taking 1–10 mm as the reference, when the maximum diameter was 26–30 mm,OR=6.989, 95%CI (1.488, 32.785), P=0.014; when the maximum diameter >30 mm, OR=17.290, 95%CI (4.664, 64.071), P<0.001] were independent risk factors of the severity of perioperative insomnia in these young women. Conclusion It is recommended that psychological nursing and comprehensive admission education should be enhanced for young patients who have >3 breast masses or the diameter of the mass is >25 mm, aiming to improve the postoperative recovery of patients with high risk of insomnia.

Citation： CAI Yuting, ZHU Min, ZHANG Suqing, LONG Xiaoqing, MA Hongsheng, DAI Yan. Risk factors of perioperative insomnia in young patients with breast masses undergoing ambulatory Mammotome minimally invasive surgery. West China Medical Journal, 2017, 32(11): 1661-1666. doi: 10.7507/1002-0179.201709093 Copy

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2.	Savard J, Simard S, Blanchet J, et al. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 2001, 24(5): 583-590.
3.	Luo HJ, Chen X, Tu G, et al. Therapeutic application of ultrasound-guided 8-gauge Mammotome system in presumed benign breast lesions. Breast J, 2011, 17(5): 490-497.
4.	Salem C, Sakr R, Chopier J, et al. Pain and complications of directional vacuum-assisted stereotactic biopsy: comparison of the Mammotome and Vacora techniques. Eur J Radiol, 2009, 72(2): 295-299.
5.	Fridfinnsdottir EB. Icelandic women’s identifications of stressors and social support during the diagnostic phase of breast cancer. J Adv Nurs, 1997, 25(3): 526-531.
6.	Northouse LL, Jeffs M, Cracchiolo-Caraway A, et al. Emotional distress reported by women and husbands prior to a breast biopsy. Nurs Res, 1995, 44(4): 196-201.
7.	Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatric Scand, 1983, 67: 361-370.
8.	Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 1983, 17: 45-56.
9.	Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med, 2001, 2(4): 297-307.
10.	Liao MN, Chen MF, Chen SC, et al. Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer. Cancer Nurs, 2008, 31(4): 274-283.
11.	Beliaev DG, Shestokov IP, Zadorozhnaia OA, et al. Insomnia and its treatment during the postoperative period. Anesteziol Reanimatol, 1994(1): 37-40.
12.	Beydon L, Rauss A, Lofaso F, et al. Survey of the quality of sleep during the perioperative period. Study of factors predisposing to insomnia. Ann Fr Anesth Reanim, 1994, 13(5): 669-674.
13.	Kj?lhede P, Langstr?m P, Nilsson P, et al. The impact of quality of sleep on recovery from fast-track abdominal hysterectomy. J Clin Sleep Med, 2012, 8(4): 395-402.
14.	Morin CM, Belleville G, Bélanger L, et al. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep, 2011, 34(5): 601-608.
15.	Gehrman PR, Garland SN, Matura LA, et al. Insomnia in breast cancer: independent symptom or symptom cluster?. Palliat Support Care, 2017, 15(3): 369-375.
16.	王春霞, 宋真. 健康教育對前列腺活檢穿刺患者焦慮抑郁情緒及疼痛的影響. 臨床護理雜志, 2017, 16(2): 32-34.
17.	鄭秀珍, 林曉江. 循證護理聯合健康教育對老年突發性耳聾患者焦慮抑郁情緒的影響. 中國現代醫生, 2017, 55(8): 161-164, 168.
18.	Jouve P, Bazin JE, Petit A, et al. Epidural versus continuous preperitoneal analgesia during fast-track open colorectal surgery: a randomized controlled trial. Anesthesiology, 2013, 118(3): 622-630.
19.	郭巧麗. 針對性護理在減輕腹部手術患者術后疼痛中的應用效果評價. 齊齊哈爾醫學院學報, 2016, 37(19): 2475-2476.
20.	Chang ET, Lai HL, Chen PW, et al. The effects of music on the sleep quality of adults with chronic insomnia using evidence from polysomnographic and self-reported analysis: a randomized control trial. Int J Nurs Stud, 2012, 49(8): 921-930.
21.	Quesnel C, Savard J, Simard S, et al. Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol, 2003, 71(1): 189-200.
22.	陳偉, 王鳳君. 麥默通微創旋切術治療乳腺多發良性腫物的臨床價值研究. 中國衛生標準管理, 2014, 20(20): 177-178.
23.	Apfelbaum JL, Chen C, Mehta SS, Gan TJ, et al. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg, 2003, 97(2): 534-540, table of contents.
24.	馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復（ERAS）規范. 中國胸心血管外科臨床雜志, 2016(2): 104-106.

1. Fiorentino L, Ancoli-Israel S. Insomnia and its treatment in women with breast cancer. Sleep Med Rev, 2006, 10(6): 419-429.
2. Savard J, Simard S, Blanchet J, et al. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 2001, 24(5): 583-590.
3. Luo HJ, Chen X, Tu G, et al. Therapeutic application of ultrasound-guided 8-gauge Mammotome system in presumed benign breast lesions. Breast J, 2011, 17(5): 490-497.
4. Salem C, Sakr R, Chopier J, et al. Pain and complications of directional vacuum-assisted stereotactic biopsy: comparison of the Mammotome and Vacora techniques. Eur J Radiol, 2009, 72(2): 295-299.
5. Fridfinnsdottir EB. Icelandic women’s identifications of stressors and social support during the diagnostic phase of breast cancer. J Adv Nurs, 1997, 25(3): 526-531.
6. Northouse LL, Jeffs M, Cracchiolo-Caraway A, et al. Emotional distress reported by women and husbands prior to a breast biopsy. Nurs Res, 1995, 44(4): 196-201.
7. Zigmond AS, Snaith RP. The Hospital Anxiety and Depression Scale. Acta Psychiatric Scand, 1983, 67: 361-370.
8. Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain, 1983, 17: 45-56.
9. Bastien CH, Vallières A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Med, 2001, 2(4): 297-307.
10. Liao MN, Chen MF, Chen SC, et al. Uncertainty and anxiety during the diagnostic period for women with suspected breast cancer. Cancer Nurs, 2008, 31(4): 274-283.
11. Beliaev DG, Shestokov IP, Zadorozhnaia OA, et al. Insomnia and its treatment during the postoperative period. Anesteziol Reanimatol, 1994(1): 37-40.
12. Beydon L, Rauss A, Lofaso F, et al. Survey of the quality of sleep during the perioperative period. Study of factors predisposing to insomnia. Ann Fr Anesth Reanim, 1994, 13(5): 669-674.
13. Kj?lhede P, Langstr?m P, Nilsson P, et al. The impact of quality of sleep on recovery from fast-track abdominal hysterectomy. J Clin Sleep Med, 2012, 8(4): 395-402.
14. Morin CM, Belleville G, Bélanger L, et al. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep, 2011, 34(5): 601-608.
15. Gehrman PR, Garland SN, Matura LA, et al. Insomnia in breast cancer: independent symptom or symptom cluster?. Palliat Support Care, 2017, 15(3): 369-375.
16. 王春霞, 宋真. 健康教育對前列腺活檢穿刺患者焦慮抑郁情緒及疼痛的影響. 臨床護理雜志, 2017, 16(2): 32-34.
17. 鄭秀珍, 林曉江. 循證護理聯合健康教育對老年突發性耳聾患者焦慮抑郁情緒的影響. 中國現代醫生, 2017, 55(8): 161-164, 168.
18. Jouve P, Bazin JE, Petit A, et al. Epidural versus continuous preperitoneal analgesia during fast-track open colorectal surgery: a randomized controlled trial. Anesthesiology, 2013, 118(3): 622-630.
19. 郭巧麗. 針對性護理在減輕腹部手術患者術后疼痛中的應用效果評價. 齊齊哈爾醫學院學報, 2016, 37(19): 2475-2476.
20. Chang ET, Lai HL, Chen PW, et al. The effects of music on the sleep quality of adults with chronic insomnia using evidence from polysomnographic and self-reported analysis: a randomized control trial. Int J Nurs Stud, 2012, 49(8): 921-930.
21. Quesnel C, Savard J, Simard S, et al. Efficacy of cognitive-behavioral therapy for insomnia in women treated for nonmetastatic breast cancer. J Consult Clin Psychol, 2003, 71(1): 189-200.
22. 陳偉, 王鳳君. 麥默通微創旋切術治療乳腺多發良性腫物的臨床價值研究. 中國衛生標準管理, 2014, 20(20): 177-178.
23. Apfelbaum JL, Chen C, Mehta SS, Gan TJ, et al. Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg, 2003, 97(2): 534-540, table of contents.
24. 馬洪升, 程南生, 朱濤, 等. 華西醫院日間手術快速康復（ERAS）規范. 中國胸心血管外科臨床雜志, 2016(2): 104-106.

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Risk factors of perioperative insomnia in young patients with breast masses undergoing ambulatory Mammotome minimally invasive surgery

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