Fatigue and sleep disturbance with Arabic cancer patients in Oman

Abstract

Background
People diagnosed with cancer frequently experience a range of complex symptoms include pain, weakness, sleep disturbance and fatigue. These may cause limited function in terms of active daily living. Fatigue and sleep disturbance are two of the most common and distressing cancer symptoms that negatively affect quality of life. However, in the Omani population, there are no published data on the prevalence of fatigue, sleep disturbance, or quality of life in cancer patients. Given this dearth of information, it is important to examine fatigue and sleep disturbance among specific groups of cancer survivors.

Objectives
This research was conducted in two phases. Phase one was comprised of three studies: Study I- examining the validity and reliability of the Arabic FACIT-F; study IIexamining the validity and reliability of the Arabic PSQI; and study III- using these outcome measures, examining the point prevalence and relationship between fatigue, sleep disturbance, and quality of life among post-treatment Arabic cancer patients. Phase two comprised study IV, the aim of which was to determine health professionals' perceptions of fatigue among cancer patients in Oman and to identify the current management and assessment of fatigue.
Methods Phase one employed a quantitative design incorporating a cross-sectional survey using a paper-based instrument. However, before conducting phase one, three systematic reviews were conducted to identify appropriate instruments to measure fatigue, sleep disturbance, and quality of life among Arabic cancer patients. For phase two, an electronic survey was employed. All questionnaires were entered into Qualtrics ® survey software for electronic distribution

Results
A total of 369 patients with cancer completed and returned valid questionnaire booklets, giving a response rate of 92.2%. Study I: The FACT-G 27 items and FACIT-Fatigue 13 items were valid for Arabic cancer patients (confirmed by demonstrated adequate construct and discriminant validity). Study II: The PSQI 19 items were valid for Arabicpatients with cancer (confirmed by discriminant, and factorial validity). Study III: Prevalence of fatigue and sleep disturbance; 286 (77.5%) reported clinically significant fatigue (FACIT-Fatigue ≥ 34) while 83 (22.5%) did not report any fatigue. The prevalence of poor sleep among the participants was 78% (n=288). Study IV: A total of 138 healthcare professionals (response rate 63.9%). participated in a survey exploring healthcare professionals’ knowledge of cancer-related fatigue. In general, the mean level of knowledge of cancer-related fatigue (16.63; SD=3.48) was considered to be good (above 12). However, 23% of participants admitted that they had no knowledge of CRF.

Conclusion
This thesis provides important evidence regarding the prevalence of cancer related fatigue, sleep disturbance and quality of life in Arabic cancer patients. This will aid understanding of fatigue and sleep quality among Arabic cancer patients. Furthermore, it provides a solid foundation for the next phase of research, which will involve identifying appropriate management strategies for CRF and sleep disturbance in Arabic cancer patients.

Date of Award	Mar 2020
Original language	English
Supervisor	Jackie Gracey (Supervisor), Lynn Dunwoody (Supervisor) & Ciara Hughes (Supervisor)