Skip to main content
main-content
Top

Tip

Swipe om te navigeren naar een ander artikel

Gepubliceerd in: Quality of Life Research 10/2017

27-06-2017

Relationship between subjective and actigraphy-measured sleep in 237 patients with metastatic colorectal cancer

Auteurs: Oxana Palesh, Karyn Haitz, Francis Lévi, Georg A. Bjarnason, Carl Deguzman, Igbal Alizeh, Ayhan Ulusakarya, Mary Melissa Packer, Pasquale F. Innominato

Gepubliceerd in: Quality of Life Research | Uitgave 10/2017

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Objective

Patients with cancers frequently experience sleep and circadian dysfunction. To date, only a few studies have used both a questionnaire and actigraphy for concomitant evaluation of sleep and circadian function in patients with cancer. We sought to evaluate objective sleep and circadian parameters in metastatic colon cancer (MCC) patients and their associations with symptoms and quality of life (QOL).

Methods

Patients reported subjective sleep problems on the EORTC QLQ-C30. Sleep and circadian parameters were calculated using a wrist-actigraph that patients wore for 72 h.

Results

237 Patients with MCC (mean age: 60.4 years; range: 20.7–77.6; Male/Female ratio: 1.66) participated in this cross-sectional study. Subjective sleep problems were reported by 63.4% of patients (S+). No differences in any sleep parameters (sleep efficiency, sleep latency, total sleep time, total time in bed, wake after sleep onset, activity bathyphase) were observed between S+ and S− patients. However, S+ patients displayed a significantly worse circadian function than S− patients (96.4 vs 98.1%; p = 0.005). The presence of poor subjective sleep and objective circadian dysfunction negatively affected symptoms and QOL domains (p = 0.038).

Conclusions

Subjective report of sleep problems was not associated with worse objectively measured sleep parameters in patients with MCC although it was associated with disrupted circadian rest-activity rhythm and poorer QOL. These findings coincide with prior research in cancer patients in that an inconsistent relationship exists between subjective and objective sleep measurements on some sleep domains. This study supports the value of coupled evaluation of self-reported and objective measures of sleep and circadian function in cancer patients.
Literatuur
1.
go back to reference Siegel, R. L., Miller, K. D., & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66(1), 7–30. Siegel, R. L., Miller, K. D., & Jemal, A. (2016). Cancer statistics, 2016. CA: A Cancer Journal for Clinicians, 66(1), 7–30.
2.
go back to reference Mazzoccoli, G., Vinciguerra, M., Papa, G., & Piepoli, A. (2014). Circadian clock circuitry in colorectal cancer. World Journal of Gastroenterology, 20(15), 4197–4207. CrossRefPubMedPubMedCentral Mazzoccoli, G., Vinciguerra, M., Papa, G., & Piepoli, A. (2014). Circadian clock circuitry in colorectal cancer. World Journal of Gastroenterology, 20(15), 4197–4207. CrossRefPubMedPubMedCentral
3.
go back to reference Innominato, P. F., Roche, V. P., Palesh, O. G., Ulusakarya, A., Spiegel, D., & Levi, F. A. (2014). The circadian timing system in clinical oncology. Annals of Medicine, 46(4), 191–207. CrossRefPubMed Innominato, P. F., Roche, V. P., Palesh, O. G., Ulusakarya, A., Spiegel, D., & Levi, F. A. (2014). The circadian timing system in clinical oncology. Annals of Medicine, 46(4), 191–207. CrossRefPubMed
4.
go back to reference Reppert, S. M., & Weaver, D. R. (2002). Coordination of circadian timing in mammals. Nature, 418(6901), 935–941. CrossRefPubMed Reppert, S. M., & Weaver, D. R. (2002). Coordination of circadian timing in mammals. Nature, 418(6901), 935–941. CrossRefPubMed
5.
go back to reference Foster, R. G., & Wulff, K. (2005). The rhythm of rest and excess. Nature Reviews Neuroscience, 6(5), 407–414. CrossRefPubMed Foster, R. G., & Wulff, K. (2005). The rhythm of rest and excess. Nature Reviews Neuroscience, 6(5), 407–414. CrossRefPubMed
6.
7.
go back to reference Sack, R. L. (2010). Clinical practice. Jet lag. New England Journal of Medicine, 362(5), 440–447. CrossRefPubMed Sack, R. L. (2010). Clinical practice. Jet lag. New England Journal of Medicine, 362(5), 440–447. CrossRefPubMed
8.
go back to reference Innominato, P. F., Mormont, M. C., Rich, T. A., Waterhouse, J., Levi, F. A., & Bjarnason, G. A. (2009). Circadian disruption, fatigue, and anorexia clustering in advanced cancer patients: Implications for innovative therapeutic approaches. Integrative Cancer Therapy, 8(4), 361–370. CrossRef Innominato, P. F., Mormont, M. C., Rich, T. A., Waterhouse, J., Levi, F. A., & Bjarnason, G. A. (2009). Circadian disruption, fatigue, and anorexia clustering in advanced cancer patients: Implications for innovative therapeutic approaches. Integrative Cancer Therapy, 8(4), 361–370. CrossRef
9.
go back to reference Molassiotis, A., Wengstrom, Y., & Kearney, N. (2010). Symptom cluster patterns during the first year after diagnosis with cancer. Journal of Pain and Symptom Management, 39(5), 847–858. CrossRefPubMed Molassiotis, A., Wengstrom, Y., & Kearney, N. (2010). Symptom cluster patterns during the first year after diagnosis with cancer. Journal of Pain and Symptom Management, 39(5), 847–858. CrossRefPubMed
10.
go back to reference Miller, A. H., Ancoli-Israel, S., Bower, J. E., Capuron, L., & Irwin, M. R. (2008). Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. Journal of Clinical Oncology, 26(6), 971–982. CrossRefPubMedPubMedCentral Miller, A. H., Ancoli-Israel, S., Bower, J. E., Capuron, L., & Irwin, M. R. (2008). Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. Journal of Clinical Oncology, 26(6), 971–982. CrossRefPubMedPubMedCentral
11.
go back to reference Morgenthaler, T. I., Lee-Chiong, T., Alessi, C., Friedman, L., Aurora, R. N., Boehlecke, B., et al. (2007). Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep, 30(11), 1445–1459. CrossRefPubMedPubMedCentral Morgenthaler, T. I., Lee-Chiong, T., Alessi, C., Friedman, L., Aurora, R. N., Boehlecke, B., et al. (2007). Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep, 30(11), 1445–1459. CrossRefPubMedPubMedCentral
12.
go back to reference Palesh, O., Aldridge-Gerry, A., Ulusakarya, A., Ortiz-Tudela, E., Capuron, L., & Innominato, P. F. (2013). Sleep disruption in breast cancer patients and survivors. Journal of the National Comprehensive Cancer Network, 11(12), 1523–1530. CrossRefPubMed Palesh, O., Aldridge-Gerry, A., Ulusakarya, A., Ortiz-Tudela, E., Capuron, L., & Innominato, P. F. (2013). Sleep disruption in breast cancer patients and survivors. Journal of the National Comprehensive Cancer Network, 11(12), 1523–1530. CrossRefPubMed
13.
go back to reference Palesh, O. G., Roscoe, J. A., Mustian, K. M., Roth, T., Savard, J., Ancoli-Israel, S., et al. (2010). Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. Journal of Clinical Oncology, 28(2), 292–298. CrossRefPubMed Palesh, O. G., Roscoe, J. A., Mustian, K. M., Roth, T., Savard, J., Ancoli-Israel, S., et al. (2010). Prevalence, demographics, and psychological associations of sleep disruption in patients with cancer: University of Rochester Cancer Center-Community Clinical Oncology Program. Journal of Clinical Oncology, 28(2), 292–298. CrossRefPubMed
14.
go back to reference Palesh, O., Peppone, L., Innominato, P. F., Janelsins, M., Jeong, M., Sprod, L., et al. (2012). Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nature and Science of Sleep, 4, 151–162. CrossRefPubMedPubMedCentral Palesh, O., Peppone, L., Innominato, P. F., Janelsins, M., Jeong, M., Sprod, L., et al. (2012). Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nature and Science of Sleep, 4, 151–162. CrossRefPubMedPubMedCentral
15.
go back to reference Dhruva, A., Paul, S. M., Cooper, B. A., Lee, K., West, C., Aouizerat, B. E., et al. (2012). A longitudinal study of measures of objective and subjective sleep disturbance in patients with breast cancer before, during, and after radiation therapy. Journal of Pain and Symptom Management, 44(2), 215–228. CrossRefPubMedPubMedCentral Dhruva, A., Paul, S. M., Cooper, B. A., Lee, K., West, C., Aouizerat, B. E., et al. (2012). A longitudinal study of measures of objective and subjective sleep disturbance in patients with breast cancer before, during, and after radiation therapy. Journal of Pain and Symptom Management, 44(2), 215–228. CrossRefPubMedPubMedCentral
16.
go back to reference Erren, T. C., Morfeld, P., Foster, R. G., Reiter, R. J., Gross, J. V., & Westermann, I. K. (2016). Sleep and cancer: Synthesis of experimental data and meta-analyses of cancer incidence among some 1 500 000 study individuals in 13 countries. Chronobiology International, 33, 1–26. CrossRef Erren, T. C., Morfeld, P., Foster, R. G., Reiter, R. J., Gross, J. V., & Westermann, I. K. (2016). Sleep and cancer: Synthesis of experimental data and meta-analyses of cancer incidence among some 1 500 000 study individuals in 13 countries. Chronobiology International, 33, 1–26. CrossRef
18.
go back to reference Innominato, P. F., Giacchetti, S., Bjarnason, G. A., Focan, C., Garufi, C., Coudert, B., et al. (2012). Prediction of overall survival through circadian rest-activity monitoring during chemotherapy for metastatic colorectal cancer. International Journal of Cancer, 131(11), 2684–2692. CrossRefPubMed Innominato, P. F., Giacchetti, S., Bjarnason, G. A., Focan, C., Garufi, C., Coudert, B., et al. (2012). Prediction of overall survival through circadian rest-activity monitoring during chemotherapy for metastatic colorectal cancer. International Journal of Cancer, 131(11), 2684–2692. CrossRefPubMed
19.
go back to reference Levi, F., Dugue, P. A., Innominato, P., Karaboue, A., Dispersyn, G., Parganiha, A., et al. (2014). Wrist actimetry circadian rhythm as a robust predictor of colorectal cancer patients survival. Chronobiology International, 31(8), 891–900. CrossRefPubMed Levi, F., Dugue, P. A., Innominato, P., Karaboue, A., Dispersyn, G., Parganiha, A., et al. (2014). Wrist actimetry circadian rhythm as a robust predictor of colorectal cancer patients survival. Chronobiology International, 31(8), 891–900. CrossRefPubMed
20.
go back to reference Ancoli-Israel, S., Martin, J. L., Blackwell, T., Buenaver, L., Liu, L., Meltzer, L. J., et al. (2015). The SBSM guide to actigraphy monitoring: Clinical and research applications. Behavioral Sleep Medicine, 13(Suppl 1), S4–S38. CrossRefPubMed Ancoli-Israel, S., Martin, J. L., Blackwell, T., Buenaver, L., Liu, L., Meltzer, L. J., et al. (2015). The SBSM guide to actigraphy monitoring: Clinical and research applications. Behavioral Sleep Medicine, 13(Suppl 1), S4–S38. CrossRefPubMed
21.
go back to reference Minors, D., Akerstedt, T., Atkinson, G., Dahlitz, M., Folkard, S., Levi, F., et al. (1996). The difference between activity when in bed and out of bed. I. Healthy subjects and selected patients. Chronobiology International, 13(1), 27–34. CrossRefPubMed Minors, D., Akerstedt, T., Atkinson, G., Dahlitz, M., Folkard, S., Levi, F., et al. (1996). The difference between activity when in bed and out of bed. I. Healthy subjects and selected patients. Chronobiology International, 13(1), 27–34. CrossRefPubMed
22.
go back to reference Natale, V., Innominato, P. F., Boreggiani, M., Tonetti, L., Filardi, M., Parganiha, A., et al. (2015). The difference between in bed and out of bed activity as a behavioral marker of cancer patients: A comparative actigraphic study. Chronobiology International, 32(7), 925–933. CrossRefPubMed Natale, V., Innominato, P. F., Boreggiani, M., Tonetti, L., Filardi, M., Parganiha, A., et al. (2015). The difference between in bed and out of bed activity as a behavioral marker of cancer patients: A comparative actigraphic study. Chronobiology International, 32(7), 925–933. CrossRefPubMed
23.
go back to reference Innominato, P. F., Focan, C., Gorlia, T., Moreau, T., Garufi, C., Waterhouse, J., et al. (2009). Circadian rhythm in rest and activity: A biological correlate of quality of life and a predictor of survival in patients with metastatic colorectal cancer. Cancer Res, 69(11), 4700–4707. CrossRefPubMedPubMedCentral Innominato, P. F., Focan, C., Gorlia, T., Moreau, T., Garufi, C., Waterhouse, J., et al. (2009). Circadian rhythm in rest and activity: A biological correlate of quality of life and a predictor of survival in patients with metastatic colorectal cancer. Cancer Res, 69(11), 4700–4707. CrossRefPubMedPubMedCentral
24.
go back to reference Mormont, M. C., Waterhouse, J., Bleuzen, P., Giacchetti, S., Jami, A., Bogdan, A., et al. (2000). Marked 24-h rest/activity rhythms are associated with better quality of life, better response, and longer survival in patients with metastatic colorectal cancer and good performance status. Clinical Cancer Research, 6(8), 3038–3045. PubMed Mormont, M. C., Waterhouse, J., Bleuzen, P., Giacchetti, S., Jami, A., Bogdan, A., et al. (2000). Marked 24-h rest/activity rhythms are associated with better quality of life, better response, and longer survival in patients with metastatic colorectal cancer and good performance status. Clinical Cancer Research, 6(8), 3038–3045. PubMed
25.
go back to reference Mormont, M. C., & Waterhouse, J. (2002). Contribution of the rest-activity circadian rhythm to quality of life in cancer patients. Chronobiology International, 19(1), 313–323. CrossRefPubMed Mormont, M. C., & Waterhouse, J. (2002). Contribution of the rest-activity circadian rhythm to quality of life in cancer patients. Chronobiology International, 19(1), 313–323. CrossRefPubMed
26.
go back to reference Chen, H. M., Wu, Y. C., Tsai, C. M., Tzeng, J. I., & Lin, C. C. (2015). Relationships of circadian rhythms and physical activity with objective sleep parameters in lung cancer patients. Cancer Nursing, 38(3), 215–223. CrossRefPubMed Chen, H. M., Wu, Y. C., Tsai, C. M., Tzeng, J. I., & Lin, C. C. (2015). Relationships of circadian rhythms and physical activity with objective sleep parameters in lung cancer patients. Cancer Nursing, 38(3), 215–223. CrossRefPubMed
27.
go back to reference Giacchetti, S., Bjarnason, G., Garufi, C., Genet, D., Iacobelli, S., Tampellini, M., et al. (2006). Phase III trial comparing 4-day chronomodulated therapy versus 2-day conventional delivery of fluorouracil, leucovorin, and oxaliplatin as first-line chemotherapy of metastatic colorectal cancer: The European Organisation for Research and Treatment of Cancer Chronotherapy Group. Journal of Clinical Oncology, 24(22), 3562–3569. CrossRefPubMed Giacchetti, S., Bjarnason, G., Garufi, C., Genet, D., Iacobelli, S., Tampellini, M., et al. (2006). Phase III trial comparing 4-day chronomodulated therapy versus 2-day conventional delivery of fluorouracil, leucovorin, and oxaliplatin as first-line chemotherapy of metastatic colorectal cancer: The European Organisation for Research and Treatment of Cancer Chronotherapy Group. Journal of Clinical Oncology, 24(22), 3562–3569. CrossRefPubMed
28.
go back to reference Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376. CrossRefPubMed Aaronson, N. K., Ahmedzai, S., Bergman, B., Bullinger, M., Cull, A., Duez, N. J., et al. (1993). The European Organization for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute, 85(5), 365–376. CrossRefPubMed
29.
go back to reference Efficace, F., Innominato, P. F., Bjarnason, G., Coens, C., Humblet, Y., Tumolo, S., et al. (2008). Validation of patient’s self-reported social functioning as an independent prognostic factor for survival in metastatic colorectal cancer patients: Results of an international study by the Chronotherapy Group of the European Organisation for Research and Treatment of Cancer. Journal of Clinical Oncology, 26(12), 2020–2026. CrossRefPubMed Efficace, F., Innominato, P. F., Bjarnason, G., Coens, C., Humblet, Y., Tumolo, S., et al. (2008). Validation of patient’s self-reported social functioning as an independent prognostic factor for survival in metastatic colorectal cancer patients: Results of an international study by the Chronotherapy Group of the European Organisation for Research and Treatment of Cancer. Journal of Clinical Oncology, 26(12), 2020–2026. CrossRefPubMed
30.
go back to reference Fayers, P., Bottomley, A., EORTC Quality of Life Group, & Quality of Life Unit. (2002). Quality of life research within the EORTC-the EORTC QLQ-C30 European organisation for research and treatment of cancer. European Journal of Cancer, 38(Suppl 4), S125–S133. CrossRefPubMed Fayers, P., Bottomley, A., EORTC Quality of Life Group, & Quality of Life Unit. (2002). Quality of life research within the EORTC-the EORTC QLQ-C30 European organisation for research and treatment of cancer. European Journal of Cancer, 38(Suppl 4), S125–S133. CrossRefPubMed
31.
go back to reference Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003). The role of actigraphy in the study of sleep and circadian rhythms. Sleep, 26(3), 342–392. CrossRefPubMed Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003). The role of actigraphy in the study of sleep and circadian rhythms. Sleep, 26(3), 342–392. CrossRefPubMed
32.
go back to reference Palesh, O., Aldridge-Gerry, A., Zeitzer, J. M., Koopman, C., Neri, E., Giese-Davis, J., et al. (2014). Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep, 37(5), 837–842. CrossRefPubMedPubMedCentral Palesh, O., Aldridge-Gerry, A., Zeitzer, J. M., Koopman, C., Neri, E., Giese-Davis, J., et al. (2014). Actigraphy-measured sleep disruption as a predictor of survival among women with advanced breast cancer. Sleep, 37(5), 837–842. CrossRefPubMedPubMedCentral
33.
go back to reference American Academy of Sleep Medicine. (2005). International classification of sleep disorders: Diagnostic and coding manual (2nd ed.). Westchester, IL: American Academy of Sleep Medicine. American Academy of Sleep Medicine. (2005). International classification of sleep disorders: Diagnostic and coding manual (2nd ed.). Westchester, IL: American Academy of Sleep Medicine.
34.
go back to reference Littner, M., Kushida, C. A., Anderson, W. M., Bailey, D., Berry, R. B., Davila, D. G., et al. (2003). Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 26(3), 337–341. CrossRefPubMed Littner, M., Kushida, C. A., Anderson, W. M., Bailey, D., Berry, R. B., Davila, D. G., et al. (2003). Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 26(3), 337–341. CrossRefPubMed
35.
go back to reference Moore, C. M., Schmiege, S. J., & Matthews, E. E. (2015). Actigraphy and sleep diary measurements in breast cancer survivors: Discrepancy in selected sleep parameters. Behavioral Sleep Medicine, 13(6), 472–490. CrossRefPubMed Moore, C. M., Schmiege, S. J., & Matthews, E. E. (2015). Actigraphy and sleep diary measurements in breast cancer survivors: Discrepancy in selected sleep parameters. Behavioral Sleep Medicine, 13(6), 472–490. CrossRefPubMed
36.
go back to reference de Souza, L., Benedito-Silva, A. A., Pires, M. L., Poyares, D., Tufik, S., & Calil, H. M. (2003). Further validation of actigraphy for sleep studies. Sleep, 26(1), 81–85. CrossRefPubMed de Souza, L., Benedito-Silva, A. A., Pires, M. L., Poyares, D., Tufik, S., & Calil, H. M. (2003). Further validation of actigraphy for sleep studies. Sleep, 26(1), 81–85. CrossRefPubMed
37.
go back to reference Berger, A. M., Farr, L. A., Kuhn, B. R., Fischer, P., & Agrawal, S. (2007). Values of sleep/wake, activity/rest, circadian rhythms, and fatigue prior to adjuvant breast cancer chemotherapy. Journal of Pain and Symptom Management, 33(4), 398–409. CrossRefPubMedPubMedCentral Berger, A. M., Farr, L. A., Kuhn, B. R., Fischer, P., & Agrawal, S. (2007). Values of sleep/wake, activity/rest, circadian rhythms, and fatigue prior to adjuvant breast cancer chemotherapy. Journal of Pain and Symptom Management, 33(4), 398–409. CrossRefPubMedPubMedCentral
38.
go back to reference Tang, N. K., & Sanborn, A. N. (2014). Better quality sleep promotes daytime physical activity in patients with chronic pain? A multilevel analysis of the within-person relationship. PLoS ONE, 9(3), e92158. CrossRefPubMedPubMedCentral Tang, N. K., & Sanborn, A. N. (2014). Better quality sleep promotes daytime physical activity in patients with chronic pain? A multilevel analysis of the within-person relationship. PLoS ONE, 9(3), e92158. CrossRefPubMedPubMedCentral
39.
go back to reference Di Maio, M., Basch, E., Bryce, J., & Perrone, F. (2016). Patient-reported outcomes in the evaluation of toxicity of anticancer treatments. Nature Reviews Clinical Oncology, 13(5), 319–325. CrossRefPubMed Di Maio, M., Basch, E., Bryce, J., & Perrone, F. (2016). Patient-reported outcomes in the evaluation of toxicity of anticancer treatments. Nature Reviews Clinical Oncology, 13(5), 319–325. CrossRefPubMed
40.
go back to reference Kyte, D., Reeve, B. B., Efficace, F., Haywood, K., Mercieca-Bebber, R., King, M. T., et al. (2016). International society for quality of life research commentary on the draft European medicines agency reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies. Quality of Life Research, 25(2), 359–362. CrossRefPubMed Kyte, D., Reeve, B. B., Efficace, F., Haywood, K., Mercieca-Bebber, R., King, M. T., et al. (2016). International society for quality of life research commentary on the draft European medicines agency reflection paper on the use of patient-reported outcome (PRO) measures in oncology studies. Quality of Life Research, 25(2), 359–362. CrossRefPubMed
Metagegevens
Titel
Relationship between subjective and actigraphy-measured sleep in 237 patients with metastatic colorectal cancer
Auteurs
Oxana Palesh
Karyn Haitz
Francis Lévi
Georg A. Bjarnason
Carl Deguzman
Igbal Alizeh
Ayhan Ulusakarya
Mary Melissa Packer
Pasquale F. Innominato
Publicatiedatum
27-06-2017
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2017
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-017-1617-2