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


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.

Download full-text


Available from: Linda East, May 19, 2015
    • "Promoting sleep in hospital care is an important measure/intervention for the profession of nursing (Robinson et al., 2005). In earlier studies, the focus has often been on the physical factors influencing patients' sleep (Closs, 1992; Lane and East, 2008; Southwell and Wistow, 1995) while only a few studies have shown that there are other factors that affect the patients sleep (Lee et al., 2007; Tranmer et al., 2003). Pellat (2007) describes the importance of the nurse's basic knowledge about sleep and its physiology and suggests that it is essential to assess and take action regarding sleep disruption and/or insomnia. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Many patients experience sleep disturbances and a reduced quality of sleep while hospitalised. Studies have shown that a person with a disease and/or a bodily injury has an increased need for sleep. Patients' experiences of sleep should govern how sleep disturbances should be managed. It is thus necessary to focus upon and describe patients’ needs and experiences. The aim of this study was to explore and describe patients’ experiences of sleeping in hospital. This study is based on qualitative semi-structured interviews with 10 consecutively included patients. The interviews were conducted between October 2010 and March 2011 and were audio recorded and transcribed verbatim. Collected data were analysed by qualitative content analysis. The participants reported physical and psychological experiences that had affected their sleep. Their experiences were categorised using four themes: bedside manner, physical factors, being involved and integrity. Patients considered that experiencing some degree of control, feeling involved and preserving one’s integrity affect sleep during hospitalisation. Several factors have an impact on patients’ sleep. It is not only physical factors but also psychological factors such as bedside manner and having the opportunity to influence and be involved. The patients’ accounts provide a new perspective and open the door to changes in nursing care regarding patients’ sleep.
    No preview · Article · May 2014 · Journal of Research in Nursing
    • "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.
    No preview · Article · Oct 2013 · Journal of Advanced Nursing
  • 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.
    Full-text · Article · Jun 2010 · Pain management nursing: official journal of the American Society of Pain Management Nurses
Show more