Nursing management of anxiety and sleep disorders in patients hospitalized in a cardiac intensive care unit

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Abstract Funding Acknowledgements Type of funding sources: None. Introduction Cardiac intensive care unit is an environment that induces a high rate of stress, anxiety and sleep disorders in hospitalized patients. All these elements can create an obstacle in the continuity of care and increase cardiovascular risk. Purpose The purpose of our study was to evaluate the anxiety and sleep disorders in patients admitted to the ICUU and to evaluate nurses’ behavior to these disorders. Materials and methods We conducted a descriptive, transversal, observational, prospective study in the cardiology department of Habib Thameur Hospital, which included 37 patients admitted to the ICU and 11 nurses practicing in the department. A questionnaire including two validated scales (HADS-A for anxiety and RCSQ for sleep) was submitted to patients and a self-questionnaire was administered to nurses. Results Patients mean age was 61.24 ± 13.41 years with a sex ratio of 2.36. Eight patients (22%) admitted to the ICU had anxiety disorder. In univariate analysis, female gender and mean hospital stay were significantly associated with anxiety among patients admitted to the ICU. In multivariate analysis, female gender was the only independent factor associated with anxiety at ICU hospitalization (relative risk = 3, 95% confidence interval 2.25-3.37, p = 0.005). Seventeen patients (40%) were afraid of death. The majority of patients (92%, n = 34) felt safe with the health care team. Most patients (92%, n = 34) responded to their visitors (through the window), 97% of whom were family members. Seven patients (19%) had poor sleep. The item with the lowest average was the quality of sleep (53.86 ± 15.65). In univariate analysis, urban living and the average number of sleep hours were significantly associated with poor sleep. Surveillance of vital signs, noise and monitor alarms were the main factors of sleep disturbance. Eleven nurses were included in our study. Seven nurses considered the management of anxiety as not important, and six answered that the management of sleep disorders was not important. The most used medication by nurses to relieve both symptoms was Hydroxyzine tablets. The most common non-medical way to relieve anxiety was privacy. The most common non-medication way to improve sleep was brightness reduction. Conclusion Our study shows that despite the prevalence of anxiety and sleep disorders in patients admitted to the ICU, their care by nurses was not adequate. Specific training on assessment and coping with these disorders could improve nursing care.