Hopelessness is associated with poor sleep quality after breast cancer surgery among Tunisian women

Abstract

Background: Sleep disorders are a common complaint in breast cancer patients. These women suffer from fear of death, fear of suffering, treatment complications as well as social devaluation; all leading to feelings of hopelessness. The objectives of this work were to evaluate the quality of sleep in a group of breast cancer women, and to analyze the association between sleep quality, depression, and hopelessness.

Methods: A cross-sectional study was carried out over a period of 3 months, including 50 women suffering from breast cancer and having received a surgical treatment of their disease. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The evaluation of depression was performed using the Beck Depression Inventory (BDI-II). Hopelessness was measured with the Beck hopelessness scale (BHS). All participants were screened using the Arab-language version of these scales.

Results: Of 66% of breast cancer patients were considered as poor sleepers (PSQI scores >5), 30% of our sample had a moderate to severe depression, and 24% had a high level of hopelessness. PQSI scores were negatively correlated with depression (P < 0.001) and hopelessness scores (P < 0.001). Multivariate analysis retained as main predictors of the sleep quality habitation and hopelessness scores. After controlling for demographic (age) and social (habitation) variables, hopelessness significantly contributed to sleep quality.

Conclusion: Hopelessness was positively associated to sleep disorders in women suffering from breast cancer. Hopelessness requires an appropriate management in order to prevent depression and suicide and to improve the quality of life of these patients.

Keywords: Breast cancer; Depression; Hopelessness; Sleep quality; Surgery.