{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:08:46Z","timestamp":1780463326671,"version":"3.54.1"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To retrospectively evaluate the effects of hospice care combined with estazolam on sleep quality and psychological status in patients with advanced gastrointestinal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In accordance with our predefined inclusion and exclusion criteria, this study retrospectively enrolled 110 inpatients with advanced gastrointestinal cancer and sleep disturbances who received treatment at our hospital between January 2019 and January 2025. Participants were assigned to two groups based on the treatment documented in their medical records: the hospice care plus estazolam group (\n                      <jats:italic>n<\/jats:italic>\n                      = 59) and the routine nursing plus estazolam group (\n                      <jats:italic>n<\/jats:italic>\n                      = 51). The main evaluation indicators include changes in sleep quality, the degree of anxiety and depression, which were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS), respectively. The secondary evaluation indicators include quality of life and symptom burden, which were assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (QLQ-C30) and the Edmonton Symptom Assessment Scale (ESAS), respectively. Statistical analysis was performed using SPSS software. Relevant scoring indicators were compared between the two groups at baseline and 1 month after the initiation of treatment. The chi-square test and\n                      <jats:italic>t<\/jats:italic>\n                      -test were used to analyze intergroup differences. Adverse events were recorded and compared between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After 1 month of treatment, the hospice-care plus estazolam group showed greater improvements than the routine nursing plus estazolam group: PSQI (sleep quality) mean difference between groups was significant (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001, Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      = 1.043); anxiety (SAS)\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001,\n                      <jats:italic>d<\/jats:italic>\n                      = 1.10; depression (SDS)\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001,\n                      <jats:italic>d<\/jats:italic>\n                      = 1.15\u2014all reflecting large effect sizes. The ESAS appetite subscale yielded a Cohen\u2019s\n                      <jats:italic>d<\/jats:italic>\n                      of 0.758, indicating a moderate-to-large effect, while all other ESAS and QLQ-C30 subscales had Cohen\u2019s d values above 1.0, also indicating large effects. These findings suggest that the combined treatment was associated with substantial clinical improvements in sleep, psychological state, and overall quality of life.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This retrospective analysis suggests that hospice care combined with estazolam is associated with significantly better sleep quality, psychological wellbeing, and overall quality of life in patients with advanced gastrointestinal cancer compared to routine nursing with estazolam alone. However, due to the retrospective design and short 1-month follow-up, causality cannot be inferred, and the study has limitations including a relatively small sample size, single-center design, and short follow-up duration. Future prospective studies with larger samples and longer follow-up are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1827918","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:51:18Z","timestamp":1780462278000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of hospice care plus estazolam on sleep and psychological distress in advanced gastrointestinal cancer: a real-world observational study"],"prefix":"10.3389","volume":"13","author":[{"given":"Lihong","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Geriatrics and Specialized Medical Care, General Hospital of Ningxia Medical University, Ningxia Hui Autonomous Region","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghui","family":"Cao","sequence":"additional","affiliation":[{"name":"Department 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haifeng","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics and Specialized Medical Care, General Hospital of Ningxia Medical University, Ningxia Hui Autonomous Region","place":["Yinchuan, China"]},{"name":"Department of Spinal Orthopedics, General Hospital of Ningxia Medical University","place":["Yinchuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e70079","DOI":"10.1002\/pon.70079","article-title":"Insomnia prevalence and correlates in cancer patients undergoing treatment.","volume":"34","author":"Page","year":"2025","journal-title":"Psychooncology."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1309","DOI":"10.1016\/S0277-9536(01)00043-0","article-title":"Sleep disturbance in cancer 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