Patients’ perceptions of sleep in a Critical Care Unit

Kulakaç

Nursing in Critical Care

2020

Background Intensive care is a noisy environment for patients and one that affects pain, anxiety levels, and sleep quality. Aims and objectives To determine the relationship between noise levels and pain, anxiety, and sleep levels in patients in intensive care units. Design A descriptive and observational study design was used. Methods This study was conducted between June and December 2018 in a public hospital and included 111 patients admitted to surgical critical care for at least 24 hours. Three Benetech Gm1351 manual sound level metres were used to measure noise. A Patient Information Form, a pain Visual Analog Scale (VAS), the Spielberger State‐Trait Anxiety Inventory, and the Richards Campbell Sleep Questionnaire (RCSQ) were used for data collection. Results The mean age of the patients was 57.29 years. The mean noise level detected in the intensive care unit was 66.52 dB (dB). Patients' mean pain VAS score was 3.79 ± 1.72, the mean State Anxiety Inventory score was 39.74 ± 2.98, and the mean total RCSQ score was 25.10 ± 13.17. Our findings show that patients in the intensive care unit are exposed to high noise levels and that, while this has no effect on pain, it significantly impacts anxiety and quality of sleep. Conclusions Noise levels in intensive care units significantly exceed recommended thresholds, and this adversely affects patients' anxiety levels and sleep quality. It is important for suitably restful conditions to be provided for patients, to be aware of the potential for anxiety, and for these factors to be borne in mind when planning nursing interventions. Relevance to clinical practice Further studies on the effects of noise levels on pain, anxiety, and sleep levels in patients admitted to intensive care units are needed.

Section: Discussionmentioning

confidence: 99%

The effects of noise levels on pain, anxiety, and sleep in patients

Kulakaç

Nursing in Critical Care

2020

“…One proposed solution is the introduction of "quiet times" for patients admitted to the ICU, when patients are given a period of reduced noise and light stimuli with the objective of improving sleep. Several studies have reported improvement in sleep quality at night and in the overall ICU environment in both patients and hospital personnel after the implementation of quiet times [9,[47][48][49]. These findings suggest that this intervention may help to prevent pain in patients rather than treating pain as it appears.…”

Section: Discussionmentioning

confidence: 91%

“…The second most common biological stressing factor was pain. Studies have shown that 20-75% of patients report that pain alters their sleep [9,29,32,33]. Stress caused by noise has been shown to increase the pain threshold in both animal and human experimentation models [34,35].…”

Section: Discussionmentioning

confidence: 99%

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Associations between stressors and difficulty sleeping in critically ill patients admitted to the intensive care unit: a cohort study

Miranda-Ackerman

Lira-Trujillo

Gollaz-Cervantez

et al. 2020

BMC Health Serv Res

Background: Patients admitted to the intensive care unit (ICU) experience sleep disruption caused by a variety of conditions, such as staff activities, alarms on monitors, and overall noise. In this study, we explored the relationship between noise and other factors associated with poor sleep quality in patients. Methods: This was a prospective cohort study. We used the Richards-Campbell Sleep Questionnaire to explore sleep quality in a sample of patients admitted to the ICU of a private hospital. We measured the noise levels within each ICU three times a day. After each night during their ICU stay, patients were asked to complete a survey about sleep disturbances. These disturbances were classified as biological (such as anxiety or pain) and environmental factors (such as lighting and ICU noise). Results: We interviewed 71 patients; 62% were men (mean age 54.46 years) and the mean length of stay was 8 days. Biological factors affected 36% and environmental factors affected 20% of the patients. The most common biological factor was anxiety symptoms, which affected 28% of the patients, and the most common environmental factor was noise, which affected 32.4%. The overall mean recorded noise level was 62.45 dB. Based on the patients' responses, the environmental factors had a larger effect on patients' sleep quality than biological factors. Patients who stayed more than 5 days reported less sleep disturbance. Patients younger than 55 years were more affected by environmental and biological factors than were those older than 55 years.

Open Access Maced J Med Sci

“…Jevon and Ewnes [9] state that there are several factors affecting the hemodynamic status in the intensive room, one of which is drugs/therapy such as analgesics and sedation. Several previous research mentions that the quality of sleep of patients in intensive and high care is influenced by noise, discomfort, pain, nursing procedures, medical equipment, anxiety, room brightness [12], [13], [14], [15], and also sleeping position [16].…”

Section: Introductionmentioning

confidence: 99%

Hemodynamics Changes in the Phase Before, During, and After Sleep Based on Patients’ Sleep Quality in High Care Unit

Suparti

Darono²,

Fitriana

et al. 2021

BACKGROUND: Sleep is a human physiological need that must be fulfilled. Sleep disturbance is generally experienced by hospitalized patients and measured by sleep quality. Sleep disturbance can adversely affect hemodynamic parameters, physiological, and psychological outcome that contribute to the healing of patients. However, few literatures discussing the hemodynamic changes based on the patients’ sleep quality. AIM: The study aimed to describe the hemodynamic changes before, during, and after sleeping phases METHODS: This is an observational analytic quantitative study conducted between February and March 2019 and involved 45 patients. The samples were the conscious patients, aged between 18 and 60 years old (adult) and had been hospitalized for more than 2 days. The Richards-Campbell Sleep Questionnaire was utilized to measure the patients sleep quality, while hemodynamic values were observed by patients’ bedside monitor before, during and after sleep. Data analysis used the Friedman test to determine hemodynamic changes. RESULTS: The results showed that most respondents were female (75.6%), used oxygen (46.7%), sleep in supine position (55.6%), and average age of 35.47 (standard deviation [SD] = 9.581) years old. Patients’ sleep quality score was 44.27 (SD = 22.809), with the average days of treatment were 2.47 days (SD = 694). The average score of Hemodynamic Mean Arterial Pressure (MAP), Heart Rate (HR), and Oxygen saturation (SpO2) before sleeping was 97.64, 94.04, and 94.09, during sleeping was 89.87, 85.00, and 91.22 while after sleeping was 98.27, 97.56, and 97.89, respectively. There was a significant change in HR with p = 0.019, and there was no significant change in the MAP (p = 0.152) and SpO2 (p = 0.149) CONCLUSION: There were variations in hemodynamic score changes before, during, and after sleep, changes in MAP, HR, and SpO2 score within normal ranges. The high hemodynamic changes in the early phase, decrease during sleep, and rise again after sleep. HR is a hemodynamic parameter that significantly changes in those three phases. Monitoring of hemodynamic values in patients could be carried out in the before, during, and after sleep phases to determine the patients’ physiological and psychological condition so as to contribute the healing process.