Sleep disruption experienced by surgical patients in an acute hospital

Queen's Medical Centre, Nottingham.
British journal of nursing (Mark Allen Publishing) 06/2008; 17(12):766-71. DOI: 10.12968/bjon.2008.17.12.30306
Source: PubMed

ABSTRACT Sleep has a common structure and pattern and is thought to be a restorative process. Sleep deprivation and disruption can cause a myriad of physical and psychological changes, which can all have an impact on health care. As such, sleep is recognized as being beneficial to health and an important aspect of nursing care.
This study used an expansion component mixed-method design to describe the sleep experience of patients on surgical wards. This involved establishing the factors which disturb sleep and describing patients' experiences of sleep disruption.
17 of the 24 patients approached participated in the study, providing a 71% response rate. Environmental factors were found to be strongly correlated with sleep disruption with a Pearson's coefficient of +0.795. Personal factors were also found to be correlated with sleep disruption although, with a Pearson's coefficient of +0.590, not as strongly as environmental factors.
This study found that environmental noise, pain and tension were most likely to disrupt the sleep of surgical patients. It has also established four recommendations to improve the sleep of hospital patients.
This study has some limitations that need to be considered: limited database access, a small sample size and a data collection tool which had not previously been tested for validity or reliability.
This study produced some compelling findings. It is recommended, however, that these findings be tested by larger studies using simple random sampling and in-depth interviews.

105 Reads
    • "A circadian rhythm is an internal bodily process that cycles approximately every 24 hours where the body's 'clock' responds to, or is entrained by, internal stimuli such as hormones, but primarily to the external cues of the naturally occurring daylight–darkness cycle (Higgins et al. 2007, Alzoubi et al. 2010). Disturbances in sleep–wake rhythms are known to have negative cognitive, psychological and physical consequences (Roehrs & Roth 2005, Lane & East 2008) and in the future, may even reveal asynchronies in cell cycles and between organ systems (Rea et al. 2008). Mood changes, depression and pain may be related to these sleep–wake disturbances (Roehrs & Roth 2005, Lane & East 2008). "
    [Show abstract] [Hide abstract]
    ABSTRACT: To describe light exposure, sleep-wake patterns, mood, pain and their relationships in adult medical inpatients. The hospital environment may contribute to patient discomfort by providing a lighting structure that interferes with circadian rhythmicity, sleep, mood and pain. A descriptive correlational design was used in this preliminary study. Between May 2011-April 2012, data were collected from a convenience sample of 23 women and 17 men admitted to a large academically affiliated hospital in the United States. Over 72 hours, light exposure and sleep-wake patterns were continuously measured with wrist actigraph/light meters for each participant. Mood was measured daily using the Profile Of Mood States Brief™ Form. Subjective pain scores were abstracted from medical records. Light exposure levels were low: mean daytime light intensity was 104·80 lux. Sleep time was fragmented and low: mean 236·35 minutes of sleep/night. Intra-daily stability scores indicated little sleep-wake synchronization with light. Fatigue and total mood disturbance scores were high and inversely associated with light. Pain levels were also high and positively associated with fatigue, but not directly with light exposure. Low light exposure significantly predicted fatigue and total mood disturbance. Medical inpatients were exposed to light levels insufficient for circadian entrainment. Nevertheless, higher light exposure was associated with less fatigue and lower total mood disturbance in participants with pain, suggesting the need for further investigation to determine if manipulating light exposure for medical inpatients would be beneficial in affecting sleep-wake disturbances, mood and pain.
    Journal of Advanced Nursing 10/2013; 70(5). DOI:10.1111/jan.12282 · 1.74 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Women report more postoperative pain and problems performing domestic activities than men in the first month of recovery after cardiac surgery. The purpose of this article is to describe how women rate and describe pain interference with daily life after early discharge from cardiac surgery. A qualitative study was conducted in 2004-2005 with ten women recruited from a large Norwegian university hospital before discharge from their first elective cardiac surgery. Various aspects of the women's postoperative experiences were collected with qualitative interviews in the women's homes 8-14 days after discharge: a self-developed pain diary measuring pain intensity, types and amount of pain medication taken every day after returning home from hospital; and the Brief Pain Inventory-Short Form immediately before the interview. Qualitative content analysis was used to identify recurring themes from the interviews. Data from the questionnaires provided more nuances to the experiences of pain, pain management, and interference of postoperative pain. Postoperative pain interfered most with sleep, general activity, and the ability to perform housework during the first 2 weeks after discharge. Despite being advised at the hospital to take pain medication regularly, few women consumed the maximum amount of analgesics. Early hospital discharge after open cardiac surgery implies increased patient participation in pain management. Women undergoing this surgery need more information in hospital on why postoperative pain management beyond simple pain relief is important.
    Pain management nursing: official journal of the American Society of Pain Management Nurses 06/2010; 11(2):99-107. DOI:10.1016/j.pmn.2009.04.001 · 1.53 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sleep disturbances are common problems among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. A systematic review was performed. In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal, nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Furthermore, the evidence strength of the interventions was assessed. Little evidence for the nursing interventions, sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy is found. However, large effect size of interventions were found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation, on the other hand, produced only small effects. The lack of high evidence strength for the nursing interventions together with the uncertainty about their effects calls for more research before implementing these interventions into clinical practice.
    Worldviews on Evidence-Based Nursing 10/2010; 8(3):128-42. DOI:10.1111/j.1741-6787.2010.00203.x · 2.38 Impact Factor
Show more