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Background: Clinical trialists and clinicians have used a number of sleep quality measures to determine the outcomes of interventions to improve sleep and ameliorate the neurobehavioral consequences of sleep deprivation in critically ill patients, but findings have not always been consistent. To elucidate the source of these consistencies, an important consideration is responsiveness of existing sleep measures. The purpose of an evaluative measure is to describe a construct of interest in a specific population, and to measure the extent of change in the construct over time. This systematic literature review identified measures of sleep quality in critically ill adults hospitalized in the Intensive Care Unit (ICU), and assessed their measurement properties, strengths and weaknesses, clinical usefulness, and responsiveness. We also recommended modifications, including new technology, that may improve clinical usefulness and responsiveness of the measures in research and practice.

Purpose The purpose of the study was to explore self-regulation skills with real-time activity and glucose monitoring among Black women with type 2 diabetes (T2DM). Methods A small acceptability trial was conducted using technology (continuous glucose monitors and Fitbit) to facilitate core behaviors associated with self-regulation (self-monitoring/assessment, learning, mental contrasting [comparing current values with goal values], and goal setting/review). Participants were given continuous glucose monitors and Fitbit activity trackers for self-monitoring of blood glucose and activity. Two sessions of group diabetes education were also offered. Following the intervention, semistructured interviews and subsequent content analyses were conducted to explore how the women’s experiences reflected certain self-regulation behaviors. Results Eight underserved Black women with non-insulin-requiring T2DM were included (age = 68 ± 5.2 years; A1C = 6.6% ± 1.1%; 15.3 ± 7.2 years since diagnosis). Content analysis revealed themes that were consistent with core self-regulation behaviors: experiential learning through self-monitoring, mental contrasting, and impact on behavior (actual behavior change and motivation to change behavior). Conclusions With use of real-time glucose and activity monitoring, underserved Black women with T2DM described how they used the data from the devices to make choices about eating and activity behaviors.

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