Predisposing, Precipitating, and Perpetuating Factors of Insomnia in Cancer Survivors

Oncol Nurs Forum. 2024 Apr 18;51(3):210-222. doi: 10.1188/24.ONF.210-222.

Abstract

Objectives: To explore and characterize predisposing, precipitating, and perpetuating factors of subthreshold, moderate, and severe insomnia in cancer survivors.

Sample & setting: 135 cancer survivors who self-reported symptom severity on the Insomnia Severity Index during the baseline phase of a randomized clinical trial on insomnia treatment.

Methods & variables: Participants completed measures assessing predisposing factors (age, sex, race and ethnicity, body mass index), precipitating factors (number of years since cancer diagnosis, depression and anxiety symptoms, health-related quality of life), and perpetuating factors (frequency of consuming alcoholic and caffeinated beverages, napping behavior, dysfunctional beliefs about sleep).

Results: In the multivariate model, being female was protective against insomnia, and being a person of color, having higher anxiety, having more depression symptoms, and having stronger dysfunctional beliefs about sleep were significantly associated with greater insomnia severity.

Implications for nursing: By fostering interprofessional collaboration and implementing evidence-based interventions, nurses can contribute to the well-being of cancer survivors and address their sleep-related challenges. This study underscores the importance of regular insomnia screenings for cancer survivors, with nurses as essential facilitators.

Keywords: 3P model; Spielman model; assessment; cancer; insomnia; oncology; sleep; survivors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cancer Survivors* / psychology
  • Depression / etiology
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms* / complications
  • Neoplasms* / psychology
  • Quality of Life / psychology
  • Risk Factors
  • Severity of Illness Index
  • Sleep Initiation and Maintenance Disorders* / etiology
  • Sleep Initiation and Maintenance Disorders* / psychology
  • Surveys and Questionnaires