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.	Kjølhede P, Langström 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. 健康教育对前列腺活检穿刺患者焦虑抑郁情绪及疼痛的影响. 临床护理杂志, 2017, 16(2): 32-34.
17.	郑秀珍, 林晓江. 循证护理联合健康教育对老年突发性耳聋患者焦虑抑郁情绪的影响. 中国现代医生, 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.	郭巧丽. 针对性护理在减轻腹部手术患者术后疼痛中的应用效果评价. 齐齐哈尔医学院学报, 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.	陈伟, 王凤君. 麦默通微创旋切术治疗乳腺多发良性肿物的临床价值研究. 中国卫生标准管理, 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.	马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复（ERAS）规范. 中国胸心血管外科临床杂志, 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. Kjølhede P, Langström 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. 健康教育对前列腺活检穿刺患者焦虑抑郁情绪及疼痛的影响. 临床护理杂志, 2017, 16(2): 32-34.
17. 郑秀珍, 林晓江. 循证护理联合健康教育对老年突发性耳聋患者焦虑抑郁情绪的影响. 中国现代医生, 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. 郭巧丽. 针对性护理在减轻腹部手术患者术后疼痛中的应用效果评价. 齐齐哈尔医学院学报, 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. 陈伟, 王凤君. 麦默通微创旋切术治疗乳腺多发良性肿物的临床价值研究. 中国卫生标准管理, 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. 马洪升, 程南生, 朱涛, 等. 华西医院日间手术快速康复（ERAS）规范. 中国胸心血管外科临床杂志, 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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