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

Misol Kwon

Miranda V. McPhillips

Fanghong Dong

Jingtao Zhu

Gregory E. Wilding

Suzanne S. Dickerson

insomnia, sleep, cancer, survivors, assessment, oncology, Spielman model, 3P model
ONF 2024, 51(3), 210-222. DOI: 10.1188/24.ONF.210-222

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.

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