Study on the Profiles of Sleep Disorders, Associated Factors, and Pathways Among Gynecological Cancer Patients - A Latent Profile Analysis

Background: Gynecological cancer generally refers to malignant tumors in gynecology, commonly including cervical cancer, endometrial cancer, and ovarian cancer. Patients with gynecological cancer often suffer from sleep disorders after clinical treatment. Except for serious sleep disorders, female characteristics, family roles, and feudal beliefs make their self-stigma at a medium to high level, leading to huge pressure. This study aims to identify potential categories of sleep disorders, and analyze the relationship between self-stigma, perceived stress, and sleep disorders. Methods: A cross-sectional study was conducted in 2021-2022. Two hundred and two patients' data were collected from ShengJing Hospital Affiliated to China Medical University in Liaoning, Shenyang by using paper questionnaires for face-to-face surveys. The survey tools included the Pittsburgh Sleep Quality Index (PSQI), the Perceived Stress Scale (PSS), and the Social Impact Scale (SIS). Potential profile analysis (LPA), multiple logistic regression analysis, and structural equation modeling (SEM) were performed by Mplus 8.3, SPSS 26.0, and Amos 24.0 statistical tools, respectively. Results: Three latent patterns of sleep disorders were found: "Good Sleep group (42.5%)", "Sleep Deficiency group (32.4%)", and "Sleep Disturbance group (25.1%)". Patients with high perceived stress were more likely to report a moderate (OR=1.142, 95% CI: 1.061-1.230) or high (OR=1.455, 95% CI: 1.291-1.640) level of sleep disorders. Self-stigma did not have a direct effect on sleep disorders (0.055, P >0.05), but it could have indirect effect on sleep disorders through perceived stress (0.172, P <0.01). Conclusion: The perceptions of sleep disorders among gynecological cancer patients varies and exhibits individual differences. Gynecological cancer patients who feels alienated or discriminated may cause high pressure. This internal pressure can exacerbate sleep disorders.