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Department of Nursing College of Medicine
National Taiwan University master thesis
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Mindfulness levels as the Mediator between Depression, Quality of life, and Sleep Disturbance
among primary caregivers of cancer patients.
Chiu Yu-Ying
Advisor: Hsiao Fei-Hsiu, Ph.D.
106 8
Aug, 2017
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Abstract
Background: More than half of the primary caregivers of the cancer patients
experience sleep disturbance which influences their body-mind health and care quality for their ill family members.. The previous studies found that depression and quality of life were the main factors associated with sleep disturbance. Up to date, there is a lack of the study examining the role of mindfulness levels as the mediator between
depression, quality of life and sleep disturbance.
Aims of the study: This study aims to examine 1. the sleep disturbances among the primary caregivers of the cancer patients, 2. the associations of sleep disturbances with depression, quality of life, and mindfulness levels (including five facets: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience), 3. mindfulness levels as the mediator between depression and sleep disturbances, and 4. mindfulness levels as the mediator between quality of life and sleep disturbances.
Methods: This study adopts cross sectional, descriptive correlation design. The study subjects are the primary caregivers of the cancer patients at the oncology department of the general hospital. The following structured questionnaires were used to collect data:
Taiwan version of Pittsburg Sleep Quality Index, Caregiver Oncology Quality of Life Questionnaire, Taiwan version of Five Facet Mindfulness Questionnaire, Patient Health Questionnaire and the basic information of the primary caregivers and cancer patients.
Results: Among 200 primary caregivers of the cancer patients, over 70 per cent experienced sleep disturbance. The primary caregivers appeared to experience higher sleep disturbance if they were being employed, also suffer from chronic illness, received antidepressant and sleep pills, and spent more time in caring for ill family members. After controlling the covariates such as sociodemographic data, depression and quality of life predicted sleep disturbance. Higher sleep disturbance was correlated with higher depressive symptoms and poorer quality of life. Overall mindfulness scores did not predict sleep disturbance. However, according to bootstrap regression analysis, among five facets of mindfulness, acting with awareness played as a partial mediator between depression, quality of life, and sleep disturbance. . The results indicated that the impacts of depression and poor quality of life on ability of acting with mindfulness were the part of the causes of sleep disturbance.
Conclusions: Sleep disturbance is the common distress among the primary caregivers of the cancer patients. Depression and quality of life are the direct factors associated with sleep disturbance. Acting with awareness of mindfulness plays the partial mediator between depression, quality of life and sleep disturbance. The negative thoughts and feelings due to depression and poor quality of life might influence primary caregivers’
ability of acting with awareness of mindfulness, as a result of sleep disturbance. The intervention aiming to increase the ability of acting with awareness might be helpful in improving sleep disturbance among among primary caregivers of cancer patients at inpatient oncology unit.
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匹茲堡睡眠品質量表
說明：下列問題是要調查您過去這一個月來的睡眠習慣，請您以平均狀況 回答以下每一個問題。
1. 過去一個月來，您晚上通常幾點上床睡覺？________點_________分 2. 過去一個月來，您在上床後，通常躺多久才能入睡？________分 3. 過去一個月來，您早上通常幾點起床？_________點____________分 4. 過去一個月來，您每天晚上真正睡著的時間約多少 (這可能和您躺在床
上所花的時間不同)？ ___________小時___________分
下列問題請選擇最適合您的答案，在適合的選項內打勾，並回答所有問題。
從未發生 每週少於 1 次
每週 1-2 次
每週 3 次 或以上 5.過去一個月來，您的睡眠有多少
次受到下列干擾
a.無法在 30 分鐘入睡 b.半夜或清晨醒來 c.需要起床上廁所 d.呼吸不順暢 e.咳嗽或大聲打鼾
從未發生 每週少於 1 次
每週 1-2 次
每週 3 次 或以上 f.感覺很冷
g.感覺很熱 h.作惡夢 i.疼痛
j.其他情況請說明：_______。
6.過去一個月來，您有多少次需要 藉助藥物(醫師處方或成藥)來幫 助睡眠？
7.過去一個月來，當你在開車、用 餐、從事日常社交活動時，有多 少次覺得難以保持清醒狀態？
完全沒有 困擾
只有很少
困擾 有些困擾 有很大的 困擾 8.過去一個月來，要打起精神來完
成您應該做的事情對您有多少 困擾？
非常好 好 不好 非常不好 9.過去一個月來，您對您自己的睡
眠品質整體評價如何？
