Influences of Stress, Pain, and Nursing Care Activities on Sleep Quality in Children with Cancer Receiving Chemotherapy

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Prisana Wanich
Wantanee Wiroonpanich
Pissamai Wattanasit


This predictive study aimed to examine the predictive power of stress, pain, and nursing careThis predictive study aimed to examine the predictive power of stress, pain, and nursing careactivities on sleep quality in children receiving chemotherapy. Seventy-three children, aged 8-15 years were purposively selected while receiving chemotherapy. Data were obtained using the general data questionnaire, the Childhood Cancer Stressor Inventory, the Numeric Pain Rating Scale, the nursing care activities recording form, and the Children’s Sleep Habits Questionnaire. Descriptive statistics, Pearson’s product moment correlation, and stepwise multiple regression were used for data analyzis.

The results revealed that stress, pain, and nursing care activities could explain 53 percent of thevariance in sleep quality (R2= .53, F(3,69)= 25.91, p< .001). Nursing care activities had the greatest influenceon sleep quality followed by stress and pain (β=-51, p< .001, and β=-.30, β=-.23, p< .01, respectively).Therefore, nurses should have strategies to provide nursing care to reduce these factors, inturn enhancing the sleep quality of children receiving chemotherapy.


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Wanich, P., Wiroonpanich, W., & Wattanasit, P. (2019). Influences of Stress, Pain, and Nursing Care Activities on Sleep Quality in Children with Cancer Receiving Chemotherapy. Journal of Research in Nursing-Midwifery and Health Sciences, 39(1), 28–40. Retrieved from
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