Pain, stress, and sleep quality in chronic wound patients
Faculty of Nursing, Universitas Indonesia, West Java, Indonesia
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"documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Enferm Clin. 2018;28 Supl 1:172-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1867 "formatos" => array:3 [ "EPUB" => 62 "HTML" => 1294 "PDF" => 511 ] ] "en" => array:10 [ "idiomaDefecto" => true "titulo" => "Mother-daugther communication about sexual and reproductive health issues in Singkawang, West Kalimantan, Indonesia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "172" "paginaFinal" => "175" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elly Nurachmah, Yati Afiyanti, Sri Yona, Rita Ismail, John Toding Padang, I Ketut Suardana, Yulia Irvan Dewit, Kelana Kusuma Dharma" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Elly" "apellidos" => "Nurachmah" ] 1 => array:2 [ "nombre" => "Yati" "apellidos" => "Afiyanti" ] 2 => array:2 [ "nombre" => "Sri" "apellidos" => "Yona" ] 3 => array:2 [ "nombre" => "Rita" "apellidos" => "Ismail" ] 4 => array:2 [ "nombre" => "John Toding" "apellidos" => "Padang" ] 5 => array:2 [ "nombre" => "I Ketut" "apellidos" => "Suardana" ] 6 => array:2 [ "nombre" => "Yulia Irvan" "apellidos" => "Dewit" ] 7 => array:2 [ "nombre" => "Kelana" "apellidos" => "Kusuma Dharma" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130862118300615?idApp=UINPBA00004N" "url" => "/11308621/00000028000000S1/v4_201810090949/S1130862118300615/v4_201810090949/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "titulo" => "Pain, stress, and sleep quality in chronic wound patients" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "176" "paginaFinal" => "179" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Hasna Fauziyah, Dewi Gayatri" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Hasna" "apellidos" => "Fauziyah" ] 1 => array:4 [ "nombre" => "Dewi" "apellidos" => "Gayatri" "email" => array:1 [ 0 => "ditya.b@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Faculty of Nursing, Universitas Indonesia, West Java, Indonesia" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">There were 300 of 100,000 new cancer cases around the world and 195 of 100,000 deaths due to cancer<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>. Ineffective cancer treatment often leads to complications, including wounds due to the rupture of a cancerous mass. Cancer wounds may produce physical complaints, such as pain, odors, inflammation, edema, and an irregular shape of the wound<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. Pain causes physical discomfort and psychological disorders, such as sleep disturbances, a decreased appetite; a lack of concentration, impaired interpersonal relationships, anxiety, depression, and decreased activities of daily living<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. Research that focuses on cancer wounds is still limited in Indonesia.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Therefore, this study set out to determine the association between physical and psychological discomfort: pain and stress with sleep quality in malignant wound patients at the Dharmais Cancer Hospital in Jakarta, Indonesia.<a name="p2"></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="par0015" class="elsevierStylePara elsevierViewall">This study used a cross-sectional design with a sample of 76 patients and was conducted at Dharmais Cancer Hospital. The respondents were chosen using a consecutive sampling method; the main inclusion criteria were people over the age of 20 who had a cancerous wound. The data collection procedure began with an explanation about the purpose of the study and a request for the respondent's participation in the study. This investigation used the Numeric Rating Scale (NRS) of pain intensity to determine the severity of their pain, the Questionnaire on Stress in Cancer Patients, Revised 23 (QSC-R23) to assess patients’ stress level, and the Pittsburgh Sleep Quality Index (PSQI) to measure their sleep quality.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="par0020" class="elsevierStylePara elsevierViewall">Our results (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 to 3</a>) revealed that the average stress score of respondents who suffered from moderate to severe pain was high at 58.86 (SD: 13.74). However, the analysis showed that there was no significant relationship between pain and stress (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.065; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">For participants with moderate to severe pain, the average stress score was higher during wound care activities (60.32; SD: 13:09). There was a significant relationship between pain during wound care and the patient's stress level (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.007; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0030" class="elsevierStylePara elsevierViewall">In regards to the relationship between pain following wound care and stress level, respondents reported a moderate to severe pain score (57.72, SD: 12.62). However, the analysis showed that there was no significant relationship between pain after wound care and stress level (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0243; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0035" class="elsevierStylePara elsevierViewall">The average stress score of respondents who reported moderate to severe pain was higher at night (60.22, SD: 14.06). The analysis showed that there was a significant relationship between pain at night and stress level (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.002; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0040" class="elsevierStylePara elsevierViewall">Our investigation revealed that the average stress score of respondents with poor sleep quality was high (56.3, SD: 14.9) here was a significant association between stress level and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.033; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0045" class="elsevierStylePara elsevierViewall">Poor sleep quality was more frequently experienced by the respondents who suffered from moderate to severe pain. The percentage of participants with poor sleep quality, who also reported moderate to severe pain, was 93.1%. Only 6.9% of the respondents reported moderate to severe pain but still experienced good sleep quality. There was no significant relationship between pain and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.301; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).<a name="p3"></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Before taking pain medication, 92.7% of the respondents who suffered from moderate to severe pain experienced poor sleep quality. Only 7.3% of the participants with moderate to severe pain still had good sleep quality. Our analysis indicated that there was no significant relationship between pain and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0172; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0055" class="elsevierStylePara elsevierViewall">Poor sleep quality was commonly experienced by respondents who suffered from moderate to severe pain and was as high as 90.3%. Only 9.7% of patients with moderate to severe pain had good sleep quality. There was no significant relationship between pain and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0514; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0060" class="elsevierStylePara elsevierViewall">After the wound dressings were changed, poor sleep quality was often experienced by the respondents who suffered from moderate to severe pain. Only 8% of participants, who reported moderate to severe pain, still had good sleep quality. The analysis showed that there was no significant relationship between pain and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.482; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0065" class="elsevierStylePara elsevierViewall">For the condition of pain at night, 91.7% of the respondents who reported poor sleep quality suffered from moderate to severe pain. Only 8.3% of the patients with moderate to severe pain experienced good sleep quality. The analysis showed that there was no significant relationship between pain with sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.317; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">The respondents with cancer wounds often suffered from physical discomfort symptoms, including pain. Pain induced by cancer sores is precipitated by the infiltration of tumor cells, the effects of treatment, and replacements of wound dressings that are not appropriate<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>. The questionnaire results revealed that respondents with cancer wounds suffered pain with an average score of 3.61 (SD: 2.472). Pain experiences can vary widely, so the perceived pain will often be different at night, during wound dressing procedures, after wound dressing procedures, and before taking pain medication. The experience of moderate to severe pain frequently occurred before the respondents took a pain killer and also at night.</p><p id="par0075" class="elsevierStylePara elsevierViewall">According to Desen's theory, stress may cause increased pain. Because people often think deeply about particular problems at night before going to bed, this increased stress at bedtime may also increase the pain intensity at night<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>. This factor affected the results of this study, where the average pain at night was quite high.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Respondents also experienced stress, with an average total stress score of 54.89; 30.3% experienced severe stress. Increased emotional reactions affect the immune and hormonal systems of the body and eventually lead to the development of cancer cells<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. This theory about stress from Desen was consistent with the results of studies that showed an association between the stress level and pain before taking pain medication, during wound dressing procedures, and at night (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003, 0.007, 0.002, respectively; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0085" class="elsevierStylePara elsevierViewall">Stress can cause physiological and psychological disturbances, including sleep disorders<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. The theory was supported by the results of this study, which found an association between stress and sleep quality (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.033; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05). Stress could be a trigger for anxiety, which stimulates the sympathetic nervous system and alters the stages of REM and NREM sleep by activating norepinephrine<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>.</p><p id="par0090" class="elsevierStylePara elsevierViewall">A study of 258 hospitalized patients found a relationship between depression and sleep quality (p < 0.001). Stressful conditions may be triggered by environmental factors, social support, and the coping strategies of each individual<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Pain may cause physical discomfort, which often produces a decline in the quality of sleep<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. Our results showed that 86.8% of respondents reported poor sleep quality. These patients suffered from a higher intensity of pain than the respondents who had good sleep quality. However, there was no significant relationship between sleep quality and pain before taking drugs, during wound dressing procedures, after wound dressing procedures, or at night (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.172, 0.514, 0.482, 0.317 respectively; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05).</p><p id="par0100" class="elsevierStylePara elsevierViewall">A previous study that included 2635 respondents showed that 62.6% of cancer patients who experienced pain had poor sleep quality (p <0.01)<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>. Another investigation of 214<a name="p4"></a> cancer patients who underwent treatment produced similar results; there was no relationship between pain and sleep disturbances (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>12:26; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.05)<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>. Sleep quality is not only influenced by the presence of pain; a decline in the quality of sleep may also be affected by increasing age, stress level, and environmentally induced inconveniences.</p><p id="par0105" class="elsevierStylePara elsevierViewall">The researchers concluded that an increased intensity of pain may lead to poor sleep quality in certain individuals. However, there was no significant correlation between pain and sleep quality in this study. These results may be influenced by a particular determinant, such as one's perception of and ability to express pain and also sleep disorders caused by various factors, such as the environment, waking at night to urinate, the effects of pain medications, and time shifting of the sleep-wake cycle, which all could lead to a decline in sleep quality.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The differences in perceived pain may also be influenced by cultural factors and an individual's adaptability to the pain experience. According to Roy's adaptation theory, each individual has a dissimilar capacity for adaptability. The ability of individuals to maintain their health depends on their ability to adapt to various stimuli. The adaptation rate is also influenced by a person's coping mechanisms. Therefore, individuals with good coping mechanisms, should also have the ability to adapt positively to pain stimuli.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Culture may also affect the way a person tolerates and interprets pain<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>. The Javanese culture tends to accept pain without much complaint. The results of this study indicated that the majority of respondents came from Java. As a result, the average pain intensity was not rated too high and was still classified as mild pain. However, although most respondents in this study experienced mild pain, the degree of pain was actually not relevant because the majority of respondents (86.8%) still reported poor sleep quality.</p><p id="par0120" class="elsevierStylePara elsevierViewall">In addition, our study was performed only in outpatient settings where the level of pain and sleep disorders will be perceived differently by patients in the wards. These results led to the absence of a significant correlation between pain and sleep quality in patients with cancer wounds at Dharmais Cancer Hospital in Jakarta, Indonesia.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="par0125" class="elsevierStylePara elsevierViewall">The results showed an absence of a relationship between pain and sleep quality in patients with a cancer wound. However, there was an association between pain and stressful conditions, as well as stressful conditions and sleep quality. These results indicated that pain impacts the psychological condition, producing stress that may lead to a decreased quality of sleep. However, the relationship between pain and sleep quality was not directly correlated because of the impact of stress; no correlation was identified between pain and quality of sleep.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Recommendation</span><p id="par0130" class="elsevierStylePara elsevierViewall">This study suggests that other researchers develop studies for inpatient and outpatient settings to compare certain variables, such as pain intensity, stress levels, the use of analgesic drugs, the environment, and sleep quality, patients in inpatient and outpatient facilities. The researchers also propose an investigation into stress and sleep quality in patients with cancer wounds.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres1092617" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1035489" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 3 => array:2 [ "identificador" => "sec0010" "titulo" => "Method" ] 4 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 5 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Recommendation" ] 8 => array:2 [ "identificador" => "xack371201" "titulo" => "Acknowledgement" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1035489" "palabras" => array:5 [ 0 => "Discomfort" 1 => "Sleep quality" 2 => "Pain" 3 => "Wound" 4 => "Cancer" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.003, 0.007, and 0.002, respectively; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.033; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.301; α<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>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.</p></span>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Stress \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No. \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MD (95%CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Pain</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−6.5 (−3.4 to 0.43) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.065 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.86 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Pain before medication</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−9.98 (−16.5 to −3.47) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.003* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Pain with wound dressing</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−9.256 (−15.9 to −2.59) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.007* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">13.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Pain after wound dressing</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">53.43 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−4.29 (−11.6 to 2.97) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.243 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">57.72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Pain at night</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−10.222 (−16.7 to −3.75) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.002* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868547.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Association between pain and stress.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sleep quality \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">No. \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">MD (95%CI) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p-value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="6" align="left" valign="top"><span class="elsevierStyleItalic">Stress</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Good \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">−10.7 (−20.5 to −0.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.033* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Poor \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">56.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="center" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868545.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Association between stress and sleep quality.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " rowspan="2" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable</th><th class="td" title="table-head " colspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Sleep quality</th><th class="td" title="table-head " rowspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Total</th><th class="td" title="table-head " rowspan="2" align="center" valign="top" scope="col" style="border-bottom: 2px solid black">p-value</th></tr><tr title="table-row"><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Good, no. (%) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="center" valign="top" scope="col" style="border-bottom: 2px solid black">Bad, no. (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (17) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (83) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">47 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.301 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (6.9) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27 (93.1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain before medication</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (20) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (80) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.172 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (7.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 (92.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain with wound dressing</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (15.6) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 (84.4) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.514 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (9.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (90.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain after wound dressing</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">8 (15.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43 (84.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">51 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.482 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (8) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23 (92) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " colspan="5" align="left" valign="top"><span class="elsevierStyleItalic">Pain at night</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">No-mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (17.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (82.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.317 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Moderate-severe \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">3 (8.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33 (91.7) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36 (100) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1868546.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Association between pain and sleep quality.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "World Health Organization, International Agency for Research on Cancer. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 0 | 3 |
| 2024 October | 31 | 7 | 38 |
| 2024 September | 31 | 6 | 37 |
| 2024 August | 41 | 13 | 54 |
| 2024 July | 26 | 6 | 32 |
| 2024 June | 28 | 8 | 36 |
| 2024 May | 21 | 2 | 23 |
| 2024 April | 29 | 7 | 36 |
| 2024 March | 23 | 7 | 30 |
| 2024 February | 32 | 3 | 35 |
| 2024 January | 27 | 13 | 40 |
| 2023 December | 38 | 3 | 41 |
| 2023 November | 38 | 14 | 52 |
| 2023 October | 40 | 10 | 50 |
| 2023 September | 27 | 1 | 28 |
| 2023 August | 33 | 0 | 33 |
| 2023 July | 38 | 1 | 39 |
| 2023 June | 34 | 18 | 52 |
| 2023 May | 37 | 4 | 41 |
| 2023 April | 26 | 4 | 30 |
| 2023 March | 34 | 15 | 49 |
| 2023 February | 12 | 7 | 19 |
| 2023 January | 38 | 7 | 45 |
| 2022 December | 33 | 3 | 36 |
| 2022 November | 37 | 13 | 50 |
| 2022 October | 37 | 21 | 58 |
| 2022 September | 31 | 15 | 46 |
| 2022 August | 30 | 18 | 48 |
| 2022 July | 21 | 10 | 31 |
| 2022 June | 20 | 9 | 29 |
| 2022 May | 21 | 24 | 45 |
| 2022 April | 40 | 8 | 48 |
| 2022 March | 28 | 8 | 36 |
| 2022 February | 17 | 6 | 23 |
| 2022 January | 22 | 9 | 31 |
| 2021 December | 28 | 21 | 49 |
| 2021 November | 20 | 9 | 29 |
| 2021 October | 22 | 16 | 38 |
| 2021 September | 30 | 18 | 48 |
| 2021 August | 19 | 5 | 24 |
| 2021 July | 19 | 11 | 30 |
| 2021 June | 22 | 12 | 34 |
| 2021 May | 25 | 9 | 34 |
| 2021 April | 68 | 20 | 88 |
| 2021 March | 75 | 11 | 86 |
| 2021 February | 36 | 12 | 48 |
| 2021 January | 54 | 14 | 68 |
| 2020 December | 56 | 15 | 71 |
| 2020 November | 24 | 12 | 36 |
| 2020 October | 18 | 9 | 27 |
| 2020 September | 33 | 12 | 45 |
| 2020 August | 38 | 6 | 44 |
| 2020 July | 22 | 9 | 31 |
| 2020 June | 14 | 6 | 20 |
| 2020 May | 18 | 12 | 30 |
| 2020 April | 19 | 9 | 28 |
| 2020 March | 29 | 15 | 44 |
| 2020 February | 32 | 18 | 50 |
| 2020 January | 30 | 9 | 39 |
| 2019 December | 22 | 14 | 36 |
| 2019 November | 35 | 16 | 51 |
| 2019 October | 26 | 19 | 45 |
| 2019 September | 23 | 14 | 37 |
| 2019 August | 15 | 14 | 29 |
| 2019 July | 17 | 11 | 28 |
| 2019 June | 20 | 23 | 43 |
| 2019 May | 83 | 46 | 129 |
| 2019 April | 41 | 9 | 50 |
| 2019 March | 4 | 4 | 8 |
| 2018 December | 6 | 8 | 14 |
| 2018 November | 1 | 0 | 1 |
| 2018 April | 1 | 0 | 1 |
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