Sleep-Wake Disturbances in People With Cancer Part II: Evaluating the Evidence for Clinical Decision Making

Jane C. Clark

Mary Cunningham

Sandra W. McLeskey

Catherine Vena

Kathy P. Parker

ONF 2004, 31(4), 747-771. DOI: 10.1188/04.ONF.747-771

Purpose/Objectives: To evaluate the quality of evidence on sleep-wake disturbances in people with cancer as a basis for clinical decision making and to discuss implications of the evidence for oncology clinicians, educators, and researchers.

Data Sources: Published, peer-reviewed articles.

Data Synthesis: Members of the 2001 Oncology Nursing Society (ONS) Advanced Practice Nurse Retreat Evidence-Based Practice Sleep Working Group selected and evaluated data sources using criteria and processes outlined by ONS.

Conclusions: The development of nursing science related to sleep-wake disturbances among people with cancer and the application of research findings to clinical decision making are limited by the quantity and quality of published evidence.

Implications for Nursing: Clinicians are challenged to develop a plan of care that includes the assessment of sleep-wake disturbances and interventions to address them. Nurse educators are challenged to include sleep-wake content and skills to evaluate empirical data and interventions for sleep-wake disturbances in degree and continuing education curricula. Nurse researchers are challenged to specify consistent conceptual and operational definitions of key variables in sleep-wake models, use measurement instruments with evidence of reliability and validity, and design clinical trials to test interventions for sleep-wake disturbances among people with cancer.

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