Nursing Interventions to Improve the Sleep Quality of Hospitalized Patients: A Systematic Review and Meta-analysis

Abstract

Background The objective of this study was to evaluate the impact of nursing interventions on sleep quality in hospitalized patients. Methods A comprehensive literature search was conducted, encompassing databases such as PubMed/MEDLINE, Scopus, Web of Science, EMBASE, ProQuest, Science Direct, and Cochrane Library, with publications up until September 2022 being considered. A random-effects model was utilized to calculate standardized mean differences (SMD) and 95% confidence intervals (CIs) for continuous outcomes. Results A total of 77 studies involving 7771 participants were included in the systematic review. Among these, 18 studies met the inclusion criteria for the meta-analysis, involving a total of 1153 participants. The meta-analysis results indicated a positive effect of nursing interventions on sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI) score (SMD = −4.21, 95% CI = −5.75 to −2.67, P < 0.001), and the St. Mary’s Hospital Sleep Questionnaire (SMHSQ) (SMD = −1.87, 95% CI = −2.77 to −0.98, P < 0.001). However, there was substantial heterogeneity observed among the studies (I2 = 97.8%, P < 0.001 and I2 = 93.5%, P < 0.001, respectively). While a significant number of individual studies demonstrated that nursing interventions improved both sleep quantity and quality in hospitalized patients. Conclusions The meta-analysis identified three specific interventions; relaxation, music therapy, and the use of earplugs/eye masks, that had a positive impact on sleep quantity and quality. It is important to acknowledge that due to variations in methodological quality and heterogeneity among the included studies, drawing definitive conclusions regarding the effectiveness of different interventions is challenging, and interpreting the results with caution is necessary.