RESUMEN
Compared to the general pediatric population, pediatric cancer patients are at increased risk of experiencing depressive symptoms during and after their treatment. Clinically, there exist few resources to guide health care professionals in the care of children with cancer who report depressive symptomatology. Pediatric cancer patients experience unique inflammatory changes secondary to their disease and accompanying treatments. It has been reported that inflammatory changes in the context of illness are related to cytokine dysregulation which in turn may influence the expression of depressive symptoms. In this review of current literature, we summarize the existing knowledge, relevant models and studies in progress with respect to this concept.
Asunto(s)
Citocinas/metabolismo , Depresión , Mediadores de Inflamación/metabolismo , Proteínas de Neoplasias/metabolismo , Neoplasias , Adolescente , Niño , Preescolar , Depresión/metabolismo , Depresión/psicología , Femenino , Humanos , Lactante , Masculino , Neoplasias/metabolismo , Neoplasias/psicologíaRESUMEN
OBJECTIVE: The purpose of this systematic review was to describe the occurrence of sleep disruptions in pediatric cancer patients and to identify and discuss the factors related to the hospital sleep environment that may be associated with disturbed sleep. METHODS: A total of 108 articles were located in five databases (PubMed, PsychINFO, Medline, CancerLit, and Google Scholar), and seven met our inclusion criteria and formed the basis of this review. RESULTS: Participants ranged from 1 to 18 years (n = 147). Data from objective and subjective assessments of sleep showed that child sleep was disrupted in the hospital when compared to previously established age-related norms. Noise, light levels, and staff room interruptions were associated with decreased total sleep minutes and increased nighttime awakenings. Methodological limitations of the current research as well as potential directions for future research are discussed. CONCLUSIONS: Investigations into the sources of increased sleep difficulties can be used to inform hospital procedures to create a more supportive sleep environment and more effective screening tools for patients who may be at greater risk for sleep difficulties. This may help to minimize the role that hospitalization plays in precipitating and perpetuating chronic sleep disturbances in pediatric cancer patients. Copyright © 2016 John Wiley & Sons, Ltd.