Abstract
BackgroundPoor sleep quality is a common health problem for coronary artery bypass graft patients, however few studies have evaluated sleep quality during the period immediately following hospital discharge.PurposeThe aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge.MethodsWe used a descriptive correlational design for this study. One week after discharge, 87 patients who had undergone coronary artery bypass surgery completed two structured questionnaires: the Pittsburgh Sleep Quality Index and the Hospital Anxiety and Depression Scale. Three weeks later (1 month after discharge) the patients completed the surveys again. Pearson correlations, t-tests, ANOVA and linear multiple regression analysis were used to analyze the data.ResultsA majority of the participants had poor sleep quality at 1 week (82.8%) and 1 month (66.7%) post-hospitalization, based on the global score of the Pittsburgh Sleep Quality Index. Despite poor sleep quality at both time-points the sleep quality at 1 month was significantly better than at 1-week post hospitalization. Poorer sleep quality correlated with older age, poorer heart function, anxiety and depression. The majority of participants had normal levels of anxiety at 1 week (69.0%) and 1 month (88.5%) as measured by the Hospital Anxiety and Depression Scale. However, some level of depression was seen at 1 week (78.1%) and 1 month (59.7%). Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality.ConclusionSleep quality, anxiety and depression all significantly improved 1 month after hospital discharge. However, more than half of the participants continued to have poor sleep quality and some level of depression. Health care personnel should be encouraged to assess sleep and emotional status in patients after coronary artery bypass surgery and offer them appropriate management strategies to improve sleep and reduce anxiety and depression.
Highlights
Heart disease is the second leading cause of death in Taiwan [1] and half of all deaths are due to coronary artery disease
Depression was a significant predictor of sleep quality at 1 week; at 1 month after hospital discharge both anxiety and depression were significant predictors of sleep quality
To determine how many participants were experiencing poor sleep quality at the two time points and to determine if there was a significant change in this population, we evaluated the percent of participants with poor (>5) and good ( 5) sleep quality
Summary
Heart disease is the second leading cause of death in Taiwan [1] and half of all deaths are due to coronary artery disease. One of the major therapies to manage severe coronary artery disease is coronary artery bypass grafting (CABG), which accounts for 70% of cardiac surgery in adults in Taiwan [2]. Obtaining needed sleep is difficult for CABG patients due to postoperative insomnia, somnolence, poor sleep quality, and lack of sleep continuity. Failure to manage sleep problems can affect postoperative recovery and influence morbidity, mortality and the quality of life [4,5,6,7,8,9]. Poor sleep quality is a common health problem for coronary artery bypass graft patients, few studies have evaluated sleep quality during the period immediately following hospital discharge. The aim of this study was to investigate changes in sleep quality and emotional correlates in coronary artery bypass graft patients in Taiwan at 1 week and 1 month after hospital discharge
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