The relationship between anxiety and sleep disturbances in relatives of patients with acute physiological status changes in intensive care unit

Abstract

The relationship between anxiety and sleep disturbances in relatives of patients with acute physiological status changes in intensive care unit Bekir Opus, Funda Gok, Alper Kilicaslan, Alper Yosunkaya Necmettin Erbakan University, Meram Faculty of Medicine, Turkey Background/Purpose: In relatives of patients staying in intensive care units (ICU), changes such as anxiety, depression, physical dysfunction, sleep disturbances, and social isolation may be constituted (1). We aimed to determine the relationship between the changes seen in the physiological condition of ICU patients and the common symptoms of the anxiety and sleep disorders witnessed in first-degree relatives of these patients and to draw other health professionals' attention to this issue. Methods: Providing information to one 18-year-old and over firstdegree relative of the patient hospitalized for at least 24 hours in ICU about the study, those accepting to givewritten consents were included into the study. Before the questionnaire, demographic data, Glasgow Coma Scale, and APACHE II scores (Acute Physiological and Chronic Health Evaluation) of all patients were recorded. The relatives were informed before participating into the study by the lecturer on patients' status. The first survey was conducted the earliest 24 hours after the hospitalization, and the second survey was done 21 days after the admission. In the first application, State-Trait Anxiety Inventory (STAI) and Pittsburgh Sleep Quality Index (PUKI) and, in the second, only state anxiety scale and PUKI were performed. If the patient was discharged during this moment, the tests were done either during the discharge or within the first 24 hours in the clinic. If the patient was lost, the second part of the survey was completed by inviting the relative to the hospital or in patient's home. Results: After obtaining ethical approval, 47 patients' relatives (26 men and 21 women) were included into the study. No difference was detected between TAI scores of patients' relatives on the 1st day, while an increase was seen on the 21st day as to STI scores, compared to those on admission. However, compared PUKI scores on 1st and 21st days, quality of sleep was determined to be distorted with time (P b .05). Compared to PUKI-APACHE II scores, a positive correlation was detected on the first day. A significant correlation was determined between APACHE II scoring and STI performed in patients' relatives (P b .05). This correlation was more strongly seen on the 21st day (r N 0.50). Conclusions: An increasing relationship was determined between patients' acute physiological condition and anxiety level as the time passed. However, while there was an association between acute physiological status and sleep quality at initial, the association was observed to disappear with time.