Pain, stress, and sleep quality in chronic wound patients

Chronic wounds are one impact of cancer cell growth that may cause discomforts or pain. This study aimed to identify the relationship between pain, stress, and sleep quality in cancer patients with a chronic wound. We used a cross-sectional design with 76 patients from a cancer hospital in Jakarta, Indonesia. The instruments used were the Numeric Rating Scale, the Questionnaire on Stress in Cancer Patients, Revised 23, and the Pittsburgh Sleep Quality Index. The results of this study showed that moderate-severe pain produced a higher than average amount of stress (58.86), while patients with no pain or only mild pain had a lower than average stress level (52.3). The results indicated that there was a relationship between pain before analgesic usage, pain during bandage replacement, pain that occurred at night, and stress (p = 0.003, 0.007, and 0.002, respectively; α = 0.05). Patients who had poor sleep quality experienced above average stress (56.3), while those with good sleep quality reported below average stress levels (45.6). These results indicated that there was a relationship between stress and sleep quality (p = 0.033; α = 0.05). Poor quality sleep is more common in patients with a moderate to severe pain scale rating (93.1%). However, Fisher's exact test results found that there was no relationship between pain and sleep quality (p = 0.301; α = 0.05). The results of this study concluded that stress can affect pain and sleep quality, but the pain did not have a direct effect on sleep quality in chronic wound patients.