Jinekolojik malignite tanılı hastalarda beslenme desteğinin uyku kalitesi üzerine etkisi

Abstract

Amaç: Jinekolojik kanserler, hastaların genel yaşam kalitesi üzerinde zararlı etkileri olan ciddi tıbbi durumlar arasındadır. Bu hastalar, hastalığın kendisinin yanı sıra tedavi sürecinin bir sonucu olarak uyku güçlükleri ve beslenme yetersizlikleri gibi sorunlar yaşayabilirler. Bu bağlamda, genel refahı optimize eden kapsamlı bakım stratejileri oluşturmak için enteral formül desteğinin bu hastaların uyku kalitesini nasıl etkilediğini araştırmak esastır. Bu çalışma, jinekolojik malignite tanılı hastalarda enteral beslenme desteğinin uyku kalitesi üzerindeki etkisini değerlendirmeyi ve kanser bakımına yönelik bütüncül yaklaşımlara yeni perspektifler sunmayı amaçlamıştır. Gereç ve Yöntemler: Selçuk Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı'nda 2023-2025 yılları arasında prospektif bir çalışma tasarlandı. Biri formül desteği alan, diğeri almayan iki grup oluşturuldu. Hastalar Pittsburgh Uyku Kalitesi İndeksi (PSQI) kullanılarak değerlendirildi. Formül aldıkları süre dikkate alındı. Gruplar öncelikle demografik özellikler, tanı ve cerrahi yöntem açısından değerlendirildi. Bulgular: Enteral beslenme desteği alan grupta, ortalama preoperatif PSQI skoru 7,10 ± 3,99 iken postoperatif 14. günde 5,52 ± 4,33'e gerileyerek uyku kalitesinde anlamlı bir iyileşme göstermiştir (p < 0,05). Enteral beslenme desteği almayan grupta ise preoperatif PSQI skoru postoperatif dönemde 8,10 ± 4,22'den 6,45 ± 3,80'e gerilemiş olsa da bu değişim istatistiksel olarak anlamlı bulunmamıştır (p > 0,05). Gruplar arası karşılaştırmada, postoperatif PSQI skorları enteral beslenme alan grupta daha düşük bulunmuş ancak fark istatistiksel anlamlılık düzeyine ulaşmamıştır (p > 0,05). Sonuç: Malign hastalığı olan hastaların yaşam standartlarını değerlendirmede uykunun önemi aşikardır, bu nedenle uyku kalitesini artıran bireysel desteklerin büyük önem taşıdığı düşünülmektedir.

Keywords

• jinekolojik onkoloji
• uyku bozukluğu
• beslenme desteği

Effect of nutritional support on sleep quality in patients diagnosed with gynecological malignancy

Abstract

Aim: Among the severe medical conditions that have a detrimental effect on patients' general quality of life are gynecological cancers. These patients may experience issues, including sleep difficulties and dietary inadequacies, as a result of the disease itself as well as the treatment procedure. In this regard, it is essential to investigate how enteral formula supplementation affects the sleep quality of these patients to establish comprehensive care strategies that optimize their overall well-being. This study aimed to evaluate the effect of enteral nutrition support on sleep quality in patients diagnosed with gynecological malignancies and to offer new perspectives on holistic approaches to cancer care. Materials and Methods: A prospective study was designed between 2023 and 2025 in the Department of Obstetrics and Gynecology at Selçuk University Faculty of Medicine. Two groups were formed: one with and one without formula supplementation. Patients were evaluated using the Pittsburgh Sleep Quality Index (PSQI).The period during which they received formula was taken into account. The groups were evaluated primarily in terms of demographics, diagnosis, and surgical method. Results: In the group receiving enteral nutrition support, the mean preoperative PSQI score decreased from 7.10 ± 3.99 to 5.52 ± 4.33 on the 14th postoperative day, showing a significant improvement in sleep quality (p < 0.05). In the group not receiving enteral nutrition support, although the preoperative PSQI score decreased from 8.10 ± 4.22 to 6.45 ± 3.80 in the postoperative period, this change was not statistically significant (p > 0.05). In the intergroup comparison, postoperative PSQI scores were found to be lower in the group receiving enteral nutrition, but the difference did not reach the level of statistical significance (p > 0.05). Conclusion: The importance of sleep in evaluating the living standards of patients with malignant diseases is evident; therefore, individual support that increases sleep quality is considered to be of great importance.

Keywords

• gynecologic oncology
• sleep disorder
• nutrition support

References

1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36: 11-48.
2. Palesh O, Aldridge-Gerry A, Zeitzer JM, Koopman C, Neri E, Giese-Davis J et al. Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep 2010; 33: 539-46.
3. Irwin MR. Why sleep is important for health: A psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143-72.
4. Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer—A systematic review of the epidemiological literature. Nutr J 2012; 11: 27.
5. Agargun MY, Kara H, Anlar O. Pittsburgh Uyku Kalitesi Indeksinin Gecerligi Ve Guvenirligi. Turk Psikiyatri Derg 1996; 7: 107-15.
6. Rampes S, Ma K, Divecha YA, Alam A, Ma D. Postoperative sleep disorders and their potential impacts on surgical outcomes. J Biomed Res. 2019; 34: 271-280.
7. Chung F, Liao P, Elsaid H, Shapiro CM, Kang W. Factors associated with postoperative exacerbation of sleep-disordered breathing. Anesthesiology 2014; 120: 299-311.
8. Calder PC. Omega-3 fatty acids and inflammatory processes: from molecules to man. Biochem Soc Trans 2017; 45: 1105-15.

9. Gianotti L, Braga M, Nespoli L, Radaelli G, Beneduce A, Di Carlo V. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 2002; 122: 1763-70.
10. Braga M, Gianotti L, Nespoli L, Radaelli G, Di Carlo V. Nutritional approach in malnourished surgical patients: a prospective randomized study. Arch Surg 2002; 137: 174-80.
11. Arends J, Bachmann P, Baracos V, arthelemy N, Bertz H, Bozzetti F et al. ESPEN guidelines on nutrition in cancer patients. Clin Nutr 2017; 36: 11-48.
12. Muscaritoli M, Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H et al. ESPEN practical guideline: Clinical Nutrition in Cancer. Clin Nutr 2021; 40: 2898-913.
13. St-Onge MP, Mikic A, Pietrolungo CE. Effects of diet on sleep quality. Adv Nutr 2016; 7: 938-49.
14. Palesh O, Aldridge-Gerry A, Zeitzer JM, Koopman C, Neri E, Giese-Davis J et al. Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep 2010; 33: 539-46.
15. Otte JL, Carpenter JS, Manchanda S, Rand KL, Skaar TC, Weaver M et al. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med. 2015; 4: 183-200
16. Irwin MR. Why sleep is important for health: A psychoneuroimmunology perspective. Annu Rev Psychol 2015; 66: 143-72.
17. Lis CG, Gupta D, Lammersfeld CA, Markman M, Vashi PG. Role of nutritional status in predicting quality of life outcomes in cancer: a systematic review. Nutr J 2012; 11: 27.
18. Baldwin C, Spiro A, Ahern R, Emery PW. Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst 2012; 104: 371-85.