Background The factors associated with sleep disorder are controversial. This study aimed to evaluate the prevalence of sleep disorder and the factors associated with sleep disorder among Korean adult cancer survivors.
Methods In this cross-sectional study, we collected data on sleep problems as outcome variables, and sociodemographic and clinical information as predictor variables from cancer survivors at two university-affiliated hospitals. Sleep disorder was defined as “a difficulty in sleep initiation or sleep maintenance at least 3 times a week that started after a cancer diagnosis.” Multiple logistic regression analysis was performed with odds ratios (OR) and 95% confidence intervals (95% CI) to evaluate the factors associated with sleep disorder.
Results The participants were 1,893 Korean cancer survivors (mean age, 58.1 years; females 68.0%). The prevalence of sleep disorder among male and female cancer survivors were 16.5% and 20.3%, respectively. An increase of age by 1-year was associated with a 1.04 (95% CI, 1.01–1.07; P=0.011) times higher risk of sleep disorder in males, while an inverse association was found in females. In female survivors, high fear of cancer recurrence (FCR), high anxiety, menopause, and high EuroQol Visual Analog Scale were associated with 1.45 (95% CI, 1.06–1.98; P=0.020), 1.78 (95% CI, 1.25–2.55; P=0.002), 1.70 (95% CI, 1.08–2.67; P=0.022), and 0.59 (95% CI, 0.43–0.82; P=0.002) times higher risk of sleep disorder, respectively. In male survivors, living with a spouse/or partner was associated with 57% (95% CI, 0.20–0.95; P=0.036) lower risk of sleep disorder. Analyses of cancer sites showed that the factors associated with sleep disorder varied across cancer sites.
Conclusion One-fifth of adult cancer survivors had sleep disorder. Age, menopausal status, FCR, anxiety, living with a spouse or partner, and quality of life were independently associated with sleep disorder in Korean cancer survivors.
Citations
Citations to this article as recorded by
Social support, fear of cancer recurrence and sleep quality in breast cancer: A moderated network analysis Yingting Jiang, Xinyu Wu, Hongman Li, Ying Xiong, M. Tish Knobf, Zengjie Ye European Journal of Oncology Nursing.2025; 74: 102799. CrossRef
Subgroups of sleep quality and associated risk factors in patients with cancer undergoing radiotherapy: A cross-sectional study based on latent profile analysis Liuna Bi, Xian Zhang, Linlin Wang, Yanxiu Cai, Jing Han European Journal of Oncology Nursing.2024; 68: 102488. CrossRef
Background This study aimed to assess the benefits of associating rehabilitation with therapeutic patient education (TPE) to decrease fear-avoidance belief and pain and improve function in adults with chronic low back pain (CLBP).
Methods This randomized controlled study included 100 patients with CLBP according to the CONSORT (Consolidated Standards of Reporting Trials) guidelines. The patients were divided into two teams: group A that participated in the TPE in association with rehabilitation and group B that received rehabilitation only. Pain and functional amelioration were assessed initially (T0) and at the end of the program (T1) using a visual analog scale at rest, work, and activity, and the Echelle d’Incapacité Fonctionnelle pour l’Évaluation des Lombalgies scale. Psychological and apprehension and avoidance assessments were also conducted, including the evaluation of depression, anxiety, fear-avoidance belief, and kinesiophobia using the Hospital Anxiety and Depression Scale, Fear-Avoidance Beliefs Questionnaire, and Tampa scale of kinesiophobia scale.
Results The evaluation of progression initially (T0) and then at the end of the program (T1) revealed a significant reduction in pain at rest (P=0.00) and while working (P=0.00) and doing physical activity (P=0.03); a decrease in anxiety (P=0.03), fear-avoidance belief (P=0.03), and kinesiophobia (P=0.02); and an improvement in function (P=0.00) for patients in group A without amelioration of depression (P=0.15). Concerning group B, we identified a significant regression in pain at rest (P=0.001) and while working (P=0.03) and doing physical activity (P=0.00); depression (P=0.01); fear-avoidance beliefs (P=0.00); and kinesiophobia (P=0.002). Comparison between the groups revealed that associating TPE with rehabilitation resulted in a more significant improvement in function (P=0.00), anxiety (P=0.00), fear-avoidance belief (P=0.00), and kinesiophobia (P=0.00).
Conclusion Associating TPE with rehabilitation improved function and reduced fear, false beliefs, and kinesiophobia of movement in patients with CLBP.
Citations
Citations to this article as recorded by
Reassurance use and reassurance-related outcomes for low back pain in primary care: A scoping review Annie Young, Simon D. French, Adrian C. Traeger, Mark Hancock, Ben Darlow, Leticia Corrêa, Hazel J. Jenkins The Journal of Pain.2025; 29: 104753. CrossRef
Integration of Conventional and Virtual Reality Approaches in Augmented Reality for Theory-Based Psychoeducational Intervention Design for Chronic Low Back Pain: Scoping Review Robin Conen, Steffen Mueller, Ana Nanette Tibubos Interactive Journal of Medical Research.2025; 14: e59611. CrossRef
Individual Education for Patients With Chronic Low Back Pain: Likely a Clinically Relevant Effect for Long-term Disability Compared to Noneducational Interventions. A Systematic Review With Meta-Analysis Leonardo Piano, Paolo Audasso, Lorenzo Benzi, Adele Occhionero, Marco Trucco, Tiziano Innocenti, Raymond Ostelo, Alessandro Chiarotto Journal of Orthopaedic & Sports Physical Therapy.2025; 55(5): 331. CrossRef
Feasibility of Combined BFR, Education and Physiotherapy Program for Patellofemoral Pain: A pilot study Aslinda Fuhad, Zarina Zahari, Maria Justine, Suci Wahyu Ismiyasa Environment-Behaviour Proceedings Journal.2025; 10(32): 229. CrossRef
Comparative effectiveness of nonpharmacological interventions in reducing psychological symptoms among patients with chronic low back pain Lu-Ping Zhou, Ren-Jie Zhang, Jin Shang, Liang Kang, Zhi-Gang Zhang, Bo Zhang, Jia-Qi Wang, Chong-Yu Jia, Chen-Hao Zhao, Huang-Qing Zhang, Xian-Liang Zhang, Cai-Liang Shen International Journal of Surgery.2024; 110(1): 478. CrossRef
Pain Education and Virtual Reality Improves Pain, Pain-related Fear of Movement, and Trunk Kinematics in Individuals With Persistent Low Back Pain Peter Window, Michelle McGrath, Daniel S. Harvie, Esther Smits, Venerina Johnston, Megan Murdoch, Trevor Russell The Clinical Journal of Pain.2024; 40(8): 478. CrossRef
Ambulante Wirbelsäulenrehabilitation der Phase 3: Krankheitsinformation und Patientenschulung Michael Quittan, Günther F. Wiesinger Schmerz Nachrichten.2023; 23(3): 161. CrossRef
Background This study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing.
Methods We recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR.
Results CAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002).
Conclusion Breast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.
Citations
Citations to this article as recorded by
Associations between Fear of Cancer Recurrence and Health-Related Quality of Life, Psychological Distress, and Health Behaviors in Cancer Survivors Seo-Hee CHOI, Yeol KIM, Yu-Ri CHOE Korean Journal of Health Promotion.2025; 25(3): 99. CrossRef
Critical Considerations Regarding the Article “Association between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence among Breast Cancer Survivors” Niloufar Johari Varnoosfaderani, Ehsan Amiri-Ardekani Korean Journal of Family Medicine.2023; 44(1): 66. CrossRef
Use of complementary and alternative medicine for reducing fear of cancer recurrence among cancer survivors: Does it work? Heliang Wu, Adnan Rashid Aziz, Mahlagha Dehghan, Leyla Ahmadi Lari, Rasmieh Al-Amer, Mohammad Ali Zakeri Asia-Pacific Journal of Oncology Nursing.2023; 10(10): 100278. CrossRef
Adherence to lifestyle recommendations among Norwegian cancer survivors and the impact of traditional and complementary medicine use: the Tromsø Study 2015–2016 Kiwumulo Nakandi, Faith O. Benebo, Laila A. Hopstock, Trine Stub, Agnete E. Kristoffersen BMC Complementary Medicine and Therapies.2023;[Epub] CrossRef
Background The fear of falling (FOF) has been reported in a high percentage of elderly people. An excessive FOF is a major concern among the elderly because it can lead to permanent disability. However, the impact of FOF on mortality has been insufficiently studied. The aim of this study was to investigate the impact of FOF on mortality among the elderly in Korea.
Methods This was a prospective study carried out using the database of the Korean Longitudinal Study of Aging, a nationwide study of community-dwelling adults in Korea. Study participants included 3,421 adults, aged 65 years or older, without either severe cognitive impairment (Korean version of Mini-Mental Status Examination ≥10), or previous history of cancer. We used Cox proportional hazards models to investigate the association between FOF and all-cause mortality.
Results This study included 1,474 men and 1,947 women. Cox regression showed that participants with FOF had an increased risk of mortality (mild: hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.01−1.54; moderate: HR, 1.59; 95% CI, 1.23−2.05) after adjusting for confounding variables. In a subgroup analysis, FOF was still a significant risk factor of mortality for patients with no previous history of falling after adjusting for other risk factors, as in the full model, except for history of falling (HR, 1.65; 95% CI, 1.27−2.13).
Conclusion We found that FOF was a significant risk factor for mortality in the elderly in Korea. Further studies on the effects and mechanism of FOF on mortality are needed.
Citations
Citations to this article as recorded by
Development of a scale to measure fear of falling in older adults: a psychometric validation study Dayeon Lee, Sunghee H Tak Journal of Korean Academy of Nursing.2025; 55(3): 413. CrossRef
Association between fear of falling and mortality in middle-aged and older adults: A systematic review and meta-analysis Wenlian Ma, Xiaoli Liang, Hongyan Wang, Zhifei Wen, Linfeng Liu, Liangliang Fan, Xiangeng Zhang Geriatric Nursing.2024; 59: 113. CrossRef
Factors Associated with Fear of Falling by Fall Experience in the Community-dwelling Elderly Yeong Mi Seo, Eun Sook Lee Research in Community and Public Health Nursing.2023; 34: 12. CrossRef
Bidirectional relationship between fear of falling and frailty among community-dwelling older adults: A longitudinal study Cen Mo, Wenting Peng, Yuqian Luo, Siyuan Tang, Minhui Liu Geriatric Nursing.2023; 51: 286. CrossRef
Fear of falling and all-cause mortality among young-old community-dwelling adults: a 6-year prospective study Giulia Belloni, Christophe Büla, Brigitte Santos-Eggimann, Yves Henchoz, Sarah Fustinoni, Laurence Seematter-Bagnoud European Journal of Ageing.2022; 19(2): 293. CrossRef
A comparison of the prevalence of Fear of Falling between older patients with Lewy body dementia, Alzheimer's disease, and without dementia Pinar Soysal, Semen Gokce Tan, Lee Smith Experimental Gerontology.2021; 146: 111248. CrossRef
Background: This study was done to examine the impact of diabetes fear of self-injecting (FSI) and fear of self-testing (FST) on glycemic control and diabetes self-management. Methods: A questionnaire survey was performed in the form of one-on-one interviews with 100 insulin-treated diabetic patients. The questions included subject traits, FSI/FST, and confidence in diabetes self-care (CIDS). Glycemic control was determined by the measurement of glycated hemoglobin (Hemoglobin A1C). Results: The patients who did not have a spouse and were less well educated showed high FSI/FST scores and low CIDS scores. The patients who had taken high quantities of insulin, had diabetes related complications, and performed self-monitoring of blood glucose less frequently showed high FSI/FST scores. The patients who had received diabetes education, possessed glucometer and performed self-monitoring of blood glucose frequently had high CIDS scores. High FSI/FST scores were positively related to each other, negatively related to low CIDS scores and not significantly related to Hemoglobin A1C. On the other hand, a significant correlation was seen between CIDS scores and Hemoglobin A1C. Conclusion: High levels of FSI and/or FST were associated with high diabetes-related distress, poor general well-being, and psychologic comorbidity as well as poorer adherence to the diabetes treatment regimen. It is important in diabetes care to lower injection-related fears and improve diabetes self-management through systematic desensitization, relaxation therapy, the use of pen- type injection device, and proper education such as insulin injection amount adjustment, properties of insulin, and the risk of hypoglycemia for the patients and their families. (J Korean Acad Fam Med 2008;29:768-780)
Background : Falling in elderly persons can lead to disability, hospitalizations, and premature death. It may also result in a psychological trauma termed fear of falling. Although it has been reported in developed countries that such fear may lead to staying home or other self-restriction of activities with debilitating physical consequences, it has not been studied yet in Korea. So we conducted this study to examine relative frequency of fear of falling and its association with measures of falling, activities of daily-living, depression, frailty in elderly persons living in a home for the aged.
Methods : We conducted a cross-sectional study of a sample of 152 subjects among 163 elders living in a home for the aged in Seoul. Data on demographic and medical characteristics, and cognitive(MMSE-K), functional(ADL, Instrumental ADL), and psychological(GDS-K) functioning, and measures of fall and frailty were obtained during assessments. We asked the subjects whether they had fear of falling in a dichotomous manner.
Results : The incidence of falls in the prior year was 29.6%, and the relative frequency of fear of falling was 57.2%. The variables associated with fear of falling with a statistical significance were as follow; old age(≥80 years), no education, no alcohol drinking, no smoking, use of assistive device, experience with falls and fall with injury in the prior 12 months, any disability in ADL, 3 or more disability in IADL. In a stepwise logistic regression analysis, experience with falls(OR 2.80, 95% CI 1.12-6.97), 3 or more disability in IADL(OR 2.99, 95% CI 1.33-8.78), and no alcohol drinking(OR 3.23, 95% CI 1.36-7.95) were still associated independently with fear of falling.
Conclusion : Fear of falling is common in the institutionalized elderly persons in Korea, and is associated with decreased instrumental activities, recent experience with falls, and no alcohol drinking. Therefore it represents the need for effective intervention to prevent and limit the consequences of falls and fear of falling in elderly persons.
First
Prev
