Richards-Campbell Sleep Questionnaire Research Articles

Quantitative Impact of Traditional Open Surgery and Minimally Invasive Surgery on Patients' First-Night Sleep Status in the Intensive Care Unit: Prospective Cohort Study.

The sleep status of patients in the surgical intensive care unit (ICU) significantly impacts their recoveries. However, the effects of surgical procedures on sleep are rarely studied. This study aimed to investigate quantitatively the impact of traditional open surgery (TOS) versus minimally invasive surgery (MIS) on patients' first-night sleep status in a surgical ICU. Patients transferred to the ICU after surgery were prospectively screened. The sleep status on the night of surgery was assessed by the patient- and nurse-completed Richards-Campbell Sleep Questionnaire (RCSQ) and Huawei wearable sleep monitoring wristband. Surgical types and sleep parameters were analyzed. A total of 61 patients were enrolled. Compared to patients in the TOS group, patients in the MIS group had a higher nurse-RCSQ score (mean 60.9, SD 16.9 vs mean 51.2, SD 17.3; P=.03), self-RCSQ score (mean 58.6, SD 16.2 vs mean 49.5, SD 14.8; P=.03), and Huawei sleep score (mean 77.9, SD 4.5 vs mean 68.6, SD 11.1; P<.001). Quantitative sleep analysis of Huawei wearable data showed a longer total sleep period (mean 503.0, SD 91.4 vs mean 437.9, SD 144.0 min; P=.04), longer rapid eye movement sleep period (mean 81.0, 52.1 vs mean 55.8, SD 44.5 min; P=.047), and higher deep sleep continuity score (mean 56.4, SD 7.0 vs mean 47.5, SD 12.1; P=.001) in the MIS group. MIS, compared to TOS, contributed to higher sleep quality for patients in the ICU after surgery.

Based -evidence, an intervention study to improve sleep quality in awake adult ICU patients: a prospective, single-blind, clustered controlled trial

BackgroundEvidence-based guidelines advocate promoting sleep in intensive care unit (ICU) patients, yet many patients experience poor sleep quality. We sought to develop a collaborative evidence-based intervention with healthcare providers and assess whether evidence-based sleep interventions could improve sleep quality in awake adult ICU patients.MethodsWe conducted a prospective, nonrandomized cluster control trial in two intensive care units (ICUs) at a tertiary general teaching hospital in China. Patients aged 18 years or older who stayed in the ICU for one night or more and were conscious were eligible for enrollment. We only blinded the patients, not the outcome assessors. On the basis of evidence-based practice and clinical reality, we developed intervention measures for the intervention group, which mainly included four aspects: reducing environmental noise in the ICU, adjusting nursing actions, modifying nighttime lighting, and other measures. The assessment tools used were wearable actigraphy sleep monitoring devices and the Richards-Campbell Sleep Questionnaire (RCSQ). The primary outcomes were patient sleep quality, including total sleep time, deep sleep time, light sleep time, rapid eye movement (REM) time, number of awakenings, overall sleep score, and patients' self-assessment of their sleep quality that night. The data collected were analyzed via SPSS and Mplus statistical software for between-group analysis, pre-post comparison, profile analysis, and calculation of the intervention effect size.ResultsFrom September 1, 2023, to January 31, 2024, 713 patients underwent eligibility assessment, and ultimately 246 patients were included in the analysis, with 125 in the intervention group and 121 in the control group. Comparative analysis revealed no statistically significant differences in sleep quality between the two groups when the duration in the ICU = 1 night (P > 0.05), with a small intervention effect size. However, the intervention group had higher sleep quality scores (sleep monitoring wristband: 57.74 ± 22.55 > 57.72 ± 19.39; RCSQ questionnaire: 60.58 ± 22.14 > 57.61 ± 24.4) and total sleep time (440.42 ± 262.11 > 420.31 ± 236.89), a lower awakening frequency (3.98 ± 2.69 < 6.09 ± 4.66) and a lower awakening frequency (3.976 ± 2.693 < 6.09 ± 4.664) than did the control group. The sleep quality of patients who stayed in the ICU for > 1 night significantly improved in all the parameters except rapid eye movement time (min) according to the pre-post-test analyses (P < 0.05), with a medium to large intervention effect size and favorable intervention effects.ConclusionEvidence-based interventions significantly improve sleep quality in ICU patients hospitalized for more than one day. However, our results do not support the improvement of sleep quality in patients admitted to the ICU for one day.Clinical trial registration: ChiCTR2300075763, Registered 14 September 2023—Retrospectively registered, https://www.chictr.org.cn/bin/userProject

Effect of clustered nursing on liver function indexes, nutrition, and emotional status of patients with severe liver failure.

Liver failure is a metabolic disorder caused by a variety of mixed factors. For such diseases, adopting cluster care can effectively improve the relevant symptoms of patients. To explore the nursing effect of nutritional nursing combined with clustered nursing for patients with severe liver failure. A total of 129 patients with severe liver failure were selected as retrospective study subjects. Nine cases were due to an end event, such as death. The other patients were divided into control group and observation group according to different nursing methods. Among them, the control group adopted nutrition nursing, and the observation group implemented cluster nursing on this basis. The differences of liver function, anxiety and depression score, gastrointestinal recovery, nutritional status, and sleep quality were compared between the 2 groups before and after nursing. After nursing, the total bilirubin, albumin, and aspartate aminotransferase of the observation group were significantly higher than those of the control group (P < .05). The nursing staff used Self-Rating Anxiety Scale and Self-Rating Depression Scale of the observation group, which were slightly lower than those of the control group. The difference was statistically significant after testing (P < .05). After nursing, the observation group's upper arm circumference, brachial tri-scalp fold thickness, and hemoglobin were better than those of the control group. Statistics showed that the difference was statistically significant (P < .05). The depth of sleep, time to fall asleep, number of awakenings, time to fall asleep after awakening, overall sleep quality, and intensive care unit environmental noise intensity in the Richards-Campbell Sleep Questionnaire sleep scale after nursing in the 2 groups were significantly higher than those before nursing, and the scores of the observation group were significantly lower than those in the observation group. In the control group, this difference was statistically significant (P < .05). Nutritional nursing combined with clustered nursing can effectively promote the recovery of gastrointestinal function in patients with severe liver failure.

The Greek version of the Richards‐Campbell Sleep Questionnaire: Reliability and validity assessment

Background: The lack of sleep is a significant concern for ICU patients, necessitating effective sleep-promoting interventions by nurses. A user friendly and reliable tool is essential for Greek nurses to evaluate the impact of these interventions on patients' sleep. This study aimed to translate the Richards Campbell Sleep Questionnaire (RCSQ) into Greek and ascertain the reliability and validity of this version in measuring sleep quality among ICU patients in a Greek hospital. Method and Material: The study assessed the night-time sleep of 50 patients in the general ICU of a tertiary hospital in Athens, Greece, from January 2022 to March 2023. The translation of the RCSQ into Greek adhered to all guidelines for translating and adapting psychometric scales. The reliability of the RCSQ scale was tested using Cronbach's alpha (𝛼). Results: The study included 32 male and 18 female patients. Cronbach's alpha (𝛼) was calculated to be 0.906, indicating excellent reliability for the RCSQ. The overall mean RCSQ score was 52.8 (SD=15.41), ranging from 12 to 78. About 60% of participants reported "good sleep", while 8% experienced "very poor sleep". Conclusion: The assessment of patient sleep should utilize a valid and reliable instrument. The Greek version of the RCSQ shows great promise for use in Greek hospital settings. It is concise, user-friendly, and comprehensible, and it has demonstrated reliability and validity in capturing various sleep domains, thereby providing a comprehensive assessment of sleep akin to the original version.

Nursing-Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review.

Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions. To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients. A systematic review of interventional studies was established to meet the PRISMA guidelines. PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023. The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery. Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

Impact of mini-dose dexmedetomidine supplemented analgesia on sleep structure in patients at high risk of obstructive sleep apnea: a pilot trial.

Obstructive sleep apnea (OSA) is common in surgical patients and associated with worse perioperative outcomes. To investigate the effect of mini-dose dexmedetomidine supplemented analgesia on postoperative sleep quality pattern in patients at high risk of OSA. A pilot randomized, double-blind, placebo-controlled trial. A tertiary university hospital in Beijing, China. One hundred and fifty-two adult patients who had a STOP-Bang score ≥3 and a serum bicarbonate level ≥28 mmol/L and were scheduled for major noncardiac surgery between 29 January 2021 and 20 September 2022. After surgery, patients were provided with high-flow nasal cannula and randomized in a 1:1 ratio to receive self-controlled opioid analgesia supplemented with either mini-dose dexmedetomidine (median 0.02 μg/kg/h) or placebo. We monitored polysomnogram from 9:00 pm to 6:00 am during the first night. Our primary outcome was the percentage of stage 2 non-rapid eye movement (N2) sleep. Secondary and exploratory outcomes included other postoperative sleep structure parameters, sleep-respiratory parameters, and subjective sleep quality (Richards-Campbell Sleep Questionnaire; 0-100 score range, higher score better). All 152 patients were included in intention-to-treat analysis; 123 patients were included in sleep structure analysis. Mini-dose dexmedetomidine supplemented analgesia increased the percentage of stage N2 sleep (median difference, 10%; 95% CI, 1 to 21%; p = 0.029); it also decreased the percentage of stage N1 sleep (median difference, -10%; 95% CI, -20% to -1%; p = 0.042). Other sleep structure and sleep-respiratory parameters did not differ significantly between the two groups. Subjective sleep quality was slightly improved with dexmedetomidine on the night of surgery, but not statistically significant (median difference, 6; 95% CI, 0 to 13; p = 0.060). Adverse events were similar between groups. Among patients at high risk of OSA who underwent noncardiac surgery, mini-dose dexmedetomidine supplemented analgesia may improve sleep quality without increasing adverse events. Clinicaltrials.gov, identifier NCT04608331.

The effect of eye mask on sleep quality and pain in patients undergoing coronary artery bypass graft surgery: A double-blind randomized controlled trial.

Pain is one of the common postoperative issues that impair recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. It leads to prolonged recovery and sleep disturbances in patients. This study was conducted to examine the effect of eye mask use on sleep quality and pain in patients undergoing CABG surgery. A double-blind randomized trial design was employed. The study included 60 patients undergoing CABG surgery. They were divided into intervention and control groups through block randomization. Data were collected using a 'Demographic Characteristics Form', the 'Richards-Campbell Sleep Questionnaire (RCSQ)' and a 'Visual Analogue Scale' (VAS) through face-to-face interviews. While patients in the control group received standard care throughout the night, patients in the intervention group received standard care and used eye mask. All patients were followed up for three nights. The CONSORT was used to report the study. The main outcome of the study, the RCSQ score, was higher in the intervention group at baseline. The intervention group had higher RCSQ scores than the control group at time 1 and time 2. There were no differences between the groups in the secondary outcome, pain levels. The control group had higher pain scores at time 1 and time 2 than the intervention group. The use of an eye mask after CABG surgery is an effective, safe and simple nursing intervention to improve sleep quality and control pain. Because the use of an eye mask is an independent and unique nursing intervention, nurses should be supported and allowed to practise it.

The effect of itching on sleep quality and comfort in patients with hemodialysis and renal transplantation: A multi-center cross-sectional study

BackgroundThe aim of this study was to determine the effect of itching on sleep quality and comfort in hemodialysis (HD) and renal transplant (Tx) patients with itching. MethodsThis descriptive, correlational seeking and cross-sectional study was conducted in four hospitals affiliated with a private health group in Istanbul between April and June 2021. The sample of the study consisted of 42 patients receiving HD treatment and 49 patients with renal transplantation. Data were collected using the Patient Information Form, 5-D Itch Scale, Richards-Campbell Sleep Questionnaire and General Comfort Questionnaire. ResultsThere was a significant difference between the HD and renal transplantation groups in the Direction (p = 0.01) and Disability dimension (p = 0.002) of the 5- D Itch scale in favor of the renal transplant group. The mean sleep quality and comfort scores of the groups were similar and moderate. Itching negatively affects sleep quality in patients receiving HD treatment, and 22 % of the change in sleep quality is explained by disability of itching (R2 = 0.22; p = 0.002). Itching negatively affects comfort in both groups. Itching explains 27 % of the change in comfort level in the HD group (R2 = 0.27; p = 0.002) and 25 % of the change in comfort level in the renal transplantation group (R2 = 0.25; p = 0.001). ConclusionsAccording the study results during the hemodialysis treatment process, itching is more intense in terms of distribution and disability and affects the quality of sleep of patients. Itching has a significant impact on patients' perception of comfort. Patients experience itching both during HD treatment and after renal transplantation, which significantly impairs their comfort. Therefore, itching should be carefully monitored during renal replacement therapy and its effects on patients should be evaluated.

Effectiveness of Earplugs and Eye Masks on Sleep Quality and Fatigue Among Nonventilated Patients in an Intensive Care Unit.

Sleep is a basic physiological need and is imperative for healing and rejuvenation. However, the environment of the intensive care unit (ICU), including loud sounds and bright lights, can undermine patients' sleep quality. This study was designed to determine the effectiveness of overnight use of earplugs and eye masks to improve sleep quality and potentially influence hemodynamic parameters and mitigate fatigue among nonventilated patients in an ICU. This experimental study was conducted among 84 nonventilated patients in an ICU. The patients were evenly divided between an intervention group (n=42) and a control group (n=42). The intervention group patients received earplugs and eye masks for three consecutive nights from 10:30 pm to 6:30 am, while the control group patients received routine care. Clinical data, responses to the Richards-Campbell sleep questionnaire, and rankings on a numerical fatigue scale were collected before (pretest) and after the intervention each night and the next morning (posttests 1, 2, and 3). The results revealed a significant reduction in fatigue. At pretest, fatigue scores in the study group were 4.19±1.64. The score was significantly reduced to 3.40±1.39 at posttest 1 and then to 2.21±1.00 at posttest 3 (p<0.0001). The sleep quality for the study group showed a significant improvement from the pretest score of 43.73±8.27 to 60.35±6.85 at posttest 3 (p<0.001), whereas the control group had slightly worse sleep quality, with 40.64±8.67 at pretest and 45.63±6.95 at posttest 3. Continuous patient monitoring is an essential nursing care activity in ICUs while ensuring good-quality sleep promotes healing and reduces fatigue. Sleep quality can be supported by devices such as earplugs and eye masks to limit undue disturbances in the ICU settings.

Analgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical Trial

To compare the analgesic and sleep quality effects of dexmedetomidine infusion versus placebo in patients undergoing cardiac surgery with ultra-fast track extubation. The randomized, double-blind clinical trial study. At a single academic center hospital. We included patients aged 25 to 65 scheduled for elective cardiac surgery under general anesthesia with cardiopulmonary bypass from October 2021 to December 2022. After immediate extubation in the operating room, the patients who were allocated at first after providing their consent to either the dexmedetomidine group (Dex) or the placebo group (Placebo) received continuous infusion of dexmedetomidine (0.2 μg/kg/h) or saline for 12 hours postoperatively. The groups' demographic and perioperative variables were not statistically significant. Total morphine consumption in milligrams at 12 and 24 hours after administered study drug, total sleep time in hours by BIS value ≤85, and sleep quality with the Richard-Campbell Sleep Questionnaire were compared. The analysis included 22 Dex and 23 Placebo patients. The consumption of morphine was not statistically different between the Dex and Placebo groups at 12 and 24 hours (p = 0.707 and p = 0.502, respectively). The Dex group had significantly longer sleep time (8.7 h [7.8, 9.5]) than the Placebo group (5.8 h [2.9, 8.5]; p = 0.007). The Dex group also exhibited better sleep quality (7.9 [6.7, 8.7] vs 6.6 [5.2, 8.0]; p = 0.038). Sedation with low-dose dexmedetomidine infusion for ultra-fast track extubation following cardiac surgery enhances sleep duration and quality.

Effects of Chinese traditional five-element music intervention on postoperative delirium and sleep quality in elderly patients after non-cardiac surgery: a randomized controlled trial

BackgroundPostoperative delirium (POD) is a common neurologic disorder among elderly patients after non-cardiac surgery, which leads to various negative outcomes. Sleep disorder is considered an important cause of POD. The objective of this study was to investigate whether the Chinese traditional five-element music intervention could reduce POD by improving sleep quality in elderly patients undergoing non-cardiac surgery.MethodsA total of 132 patients aged 65 to 90 years who underwent non-cardiac surgery were randomized to two groups: the intervention (n = 60) and the control group (n = 63). Patients in the intervention group were subjected to the Chinese traditional five-element music intervention during the perioperative, while patients in the control group had no music intervention. POD was evaluated using the Confusion Assessment Method (CAM) in the first 5 days after surgery. The Richards‒Campbell Sleep Questionnaire (RCSQ) was used to assess subjective sleep quality. The levels of nocturnal melatonin and cortisol in saliva were measured on the preoperative and the first 2 postoperative days.ResultsThe incidence of POD within 5 days was 27.0% in the control group and 11.7% in the intervention group. Preoperative PSQI and MMSE scores were associated with POD. The RCSQ scores on the first postoperative day were significantly decreased in the two groups compared to the preoperative day. Compared to the control group, the RCSQ scores showed a significant improvement in the intervention group on the first postoperative day. Compared to the control group, the level of saliva melatonin in the intervention group showed a significant increase on the first postoperative day. However, there was no statistical difference in cortisol levels between the two groups.ConclusionsChinese traditional five-element music intervention decreased the incidence of POD in elderly patients who underwent noncardiac surgery via improving sleep quality, which may be associated with increased levels of melatonin.

To Determine how the Severity of Pain Relates to the Quality of Sleep Following Tube Thoracostomy

Background: Tube thoracostomy (TT) is a prevalent procedure in the management of various thoracic conditions, including pneumothorax, pleural effusion, and chest trauma. Despite its widespread use, TT is associated with significant complications such as pain and impaired sleep quality, which can affect patient recovery and overall health outcomes. Objective: This study aims to explore the relationship between pain severity and sleep quality following tube thoracostomy and to assess the impact of pain management on postoperative recovery. Methods: A descriptive, prospective, cross-sectional study was conducted at Dr. Ruth K. M. Pfau Civil Hospital Karachi and Dow University of Health Sciences from September 28, 2022, to March 27, 2023. The study included adults aged 18 to 70 who underwent TT for any indication. Patients were excluded if they withheld consent, had a history of substance use, psychological disorders, or were victims of poly-trauma. Pain severity was assessed using a visual analogue scale (VAS) and sleep quality was evaluated using the Richards-Campbell Sleep Questionnaire (RCSQ). Data were analyzed using SPSS version 25, employing descriptive statistics and Spearman correlation tests. Results: The study involved 77 participants with a mean age of 28.33 ± 10.50 years. The mean pain scores on postoperative days 1, 2, and 3 were 8.08 ± 0.66, 6.92 ± 0.99, and 4.92 ± 1.37, respectively. Corresponding sleep quality scores were 17.50 ± 7.53, 36.67 ± 9.84, and 57.50 ± 10.55. A significant negative correlation was found between pain scores and sleep quality scores on day 3 (r = -0.744, p &lt; 0.001). Conclusion: The findings suggest a significant association between lower pain scores and improved sleep quality among patients undergoing tube thoracostomy. Effective pain management may enhance sleep quality and facilitate recovery, highlighting the need for comprehensive postoperative care strategies in these patients.

Effects of gabapentin on slow-wave sleep period in critically ill adult patients: A randomized controlled trial.

Sleep deprivation is a prevalent problem in critically ill patients, which leads to delayed recovery and delirium. Slow-wave sleep (SWS) is essential to energy restoration, tissue repair, and immune system strengthening. This study aimed to investigate the effects of gabapentin on SWS in critically ill patients. We performed a prospective open-label randomized controlled study to compare SWS and the clinical outcomes of gabapentin versus a control intervention in critically ill adult patients admitted to the intensive care unit (ICU) within 24 h. The patients' characteristics and sleep-related outcomes were recorded. The sleep-related outcomes, namely, bispectral analysis (BIS), the Richards-Campbell Sleep Questionnaire (RCSQ), and insulin-like growth factor-1 (IGF-1) levels, were evaluated. Furthermore, clinical outcomes and safety were assessed. Sixty patients from 348 cases were eligible for randomization. On day 3 of the study, patients in the gabapentin group had significantly increased SWS (66.79 vs. 0.00 min; p < 0.001), total sleep time (TST) (331.39 vs. 46.16 min; p = 0.001), RCSQ score (55.05 ± 20.18 vs. 32.80 ± 15.31; p < 0.001), and IGF-1 concentrations (84.33 ± 12.40 vs. 44.00 ± 10.20 ng/mL, p < 0.001) compared with the control group. Improvements in clinical outcomes, such as delirium, ICU-free days, and mechanical ventilator-free days, were observed; however, these differences did not reach statistically significant. Gabapentin at bedtime increased SWS, TST, and IGF-1 concentrations in critically ill patients. This regimen might be beneficial to critically ill patients for improving their sleep quality.

Evaluating the efficacy of standardized pressure ulcer management protocols in the prevention of pressure injuries among patients undergoing neurosurgical procedures.

Pressure injuries are a significant concern for patients undergoing neurosurgical procedures due to prolonged immobility and the complexity of care. This study evaluates the efficacy of standardized pressure ulcer management protocols in preventing pressure injuries and enhancing patient care in a neurosurgical context. A comprehensive retrospective analysis was conducted at a single institution from December 2020 to December 2023, comparing 50 patients who received standardized pressure ulcer management (intervention group) with 50 patients who received conventional care (control group). The study assessed the incidence of pressure ulcers, patient comfort levels using the Kolcaba Comfort Scale and sleep quality using the Richards-Campbell Sleep Questionnaire (RCSQ). Statistical analysis was performed using SPSS software, version 27.0, applying t-tests and chi-square tests as appropriate. The intervention group exhibited a significantly lower incidence of pressure ulcers at all measured time points post-surgery compared to the control group. Patient comfort levels in the intervention group were consistently higher across psychological, environmental, physiological and socio-cultural domains. Sleep quality metrics, including sleep depth, latency to sleep onset and overall sleep quality, were significantly improved in the intervention group. The implementation of standardized pressure ulcer management protocols in neurosurgical care significantly reduces the incidence of pressure injuries, enhances patient comfort and improves sleep quality. These findings highlight the importance of adopting structured care protocols to improve postoperative outcomes and patient well-being in neurosurgical settings.

The Effect of Music on Pregnancy Complaints with Sleep and Quality of Life in Risky Pregnant Women

Objective: This study aimed to examine the effect of music therapy on pregnancy complaints and quality of sleep and life in risky pregnant women.&#x0D; Methods: This is a prospective randomized controlled study. The sample of the study consisted of a total of 112 pregnant women who referred to a hospital in a city in Turkey for pregnancy follow-up (56 in the experimental group, 56 in the control group). Risky pregnant women in the experimental group were listened to music for four weeks before going to sleep, and those in the control group received no intervention. The data were collected between July and October 2022, using an introductory information form (IIF), a risk assessment form (RAF), the Assessment Scale for Pregnancy Complaints and Their Impact on Life Quality (ASPCILQ), and the Richard-Campbell Sleep Questionnaire (RCSQ).&#x0D; Results: Risky pregnant women in the experimental group had higher ASPCILQ and RCSQ post-test mean scores than those in the control group, and the difference between them was statistically significant (p

The Richards Campbell Sleep Questionnaire for Assessment of Sleep in Critically Ill Patients: Translation, Reliability, and Validation of the Malay Language Version

Poor sleep quality is commonly observed among critically ill patients; however, the assessment of sleep perception in critically ill patients remains challenging. The Richards Campbell Sleep Questionnaire (RCSQ) is a simple, validated tool for sleep quality assessment that has been successfully translated into various languages. This study aimed to translate and assess the validity and reliability of the Malay language version of the RCSQ. The process of translation involved forward and reverse translation methods. The face validity of the translated RCSQ was tested during the pre-test on five non-participating subjects. The reliability of the translated questionnaire was tested with Cronbach’s alpha coefficient. A total of 150 critically ill patients were included in the analysis using the translated RCSQ. The average total score of the Malay language version of the RCSQ was 78.59 + 19.43. The Kaiser-Meyer-Olkin measure of sampling adequacy and Cronbach’s alpha coefficient showed a score of 0.839 and 0.930 respectively, indicating that the sampling of the study was meritorious and good internal consistency of the Malay RCSQ. In conclusion, the Malay language version of the RCSQ demonstrated excellent reliability and may aid in the assessment of sleep quality in critically ill patients in a local setting.

Association between perioperative self-reported sleep disturbances and delirium risk in elderly patients following total joint arthroplasty: a cohort study.

Perioperative sleep disturbance may increase delirium risk. However, the role of perioperative sleep disturbance in delirium following total joint arthroplasty remains unclear. This prospective cohort study aimed to observe the delirium risk in patients with sleep disturbances. After excluding pre-existing sleep disturbances, older patients scheduled for total joint arthroplasty from July 17, 2022, to January 12, 2023, were recruited. Preoperative sleep disturbance or postoperative sleep disturbance was defined as a Chinese version of the Richards-Campbell Sleep Questionnaire (RCSQ) score of <50 during hospitalisation. A cut-off score of 25 was used to classify the severity of sleep disturbance. The primary outcome was the incidence of postoperative delirium. In all, 11.6% of cohort patients (34/294) developed delirium. After multivariate analysis, a preoperative Day 1 RCSQ score of ≤25 (odds ratio [OR] 3.62, 95% confidence interval [CI] 1.19-10.92; p = 0.02), occurrence of sleep disturbances (OR 2.76, 95% CI 1.19-6.38; p = 0.02) and RCSQ score of ≤25(OR 2.91, 95% CI 1.33-6.37; p = 0.007) postoperatively were strong independent predictors of delirium. After sensitivity analysis for daily delirium, a postoperative Day 1 RCSQ score of ≤25 (OR 9.27, 95% CI 2.72-36.15; p < 0.001) was associated with a greater risk of delirium on postoperative Day 1, with a reasonable discriminative area under the curve of 0.730. We concluded that postoperative but not preoperative sleep disturbances may be an independent factor for delirium risk. Sleep disturbance on the first night after surgery was a good predictor of subsequent delirium, no matter the nature of self-reported sleep disturbance.

The effect of reflexology on pain, anxiety, fatigue, and sleep in patients undergoing coronary artery bypass graft surgery: A randomized controlled trial

IntroductionReflexology is a non-pharmacological method that helps normalization of bodily functions by applying pressure to the reflex points on the hands, feet and ears, which correspond to all the organs and glands in the body. This study aimed to evaluate the effect of reflexology on pain, anxiety, fatigue, and sleep in patients undergoing cardiovascular surgery. MethodsThis open-label, randomized parallel-group controlled trial was conducted between September 2020 to May 2021 in a university hospital in Turkey. Seventy eligible patients who underwent cardiovascular surgery were randomized into reflexology group (n = 35) or control group (n = 35). While foot reflexology was applied to the reflexology group for 40 min in the first three days after surgery, no intervention was applied to control group. The primary outcome was pain severity, assessed using the Visual Analog Scale, in the first three postoperative days. The other outcomes were anxiety level assessed using the State-Trait Anxiety Inventory, fatigue level assessed using the Visual Analog Scale in the first three postoperative days, and sleep quality assessed using the Richards-Campbell Sleep Questionnaire in the first four postoperative days. ResultsAfter applying reflexology on the first, second, and third postoperative days, pain scores (d=-2.736, 95% Cl=-3.388 to -2.084) (d=-7.954, 95% Cl=-9.352 to -6.555) (d=-7.528, 95% Cl=-8.860 to -6.196), anxiety scores (d=-3.462, 95% Cl=-4.202 to -1.721) (d=-6.077, 95% Cl=-7.187 to -4.967) (d=-6.537, 95% Cl=-7.717 to -5.357), and fatigue scores (d=-2.490, 95% Cl=-3.115 to -1.866) (d=-6.245, 95% Cl=-7.380 to -5.109) (d=-8.223, 95% Cl=-9.675 to -6.791, respectively) were statistically significantly lower in reflexology group compared to control group. On the second, third, and fourth postoperative days, sleep scores in reflexology group were statistically significantly higher than control group (d = 3.230, 95% Cl=2.519 to 3.941) (d = 4.280, 95% Cl=3.431 to 5.130) (d = 6.106, 95% Cl=4.992 to 7.221, respectively). During the study period, no adverse events were noted in either groups. ConclusionThis study showed that applying foot reflexology to patients undergoing cardiovascular surgery reduced pain, anxiety, and fatigue and improved sleep quality. Further studies on reflexology practice are recommended to be conducted with larger sample sizes and different groups. Trial registration ClinicalTrials.gov NCT04473287.

Comparison of the Effect of Swedish Massage and Earplugs/Eye Masks on Sleep Quality of Patients Admitted to ICUs

Background: Sleep is one of the basic physiological needs of human life. Hospitalization causes disturbances in the sleep pattern and decreases the quality of sleep. The present study aimed to compare the effect of Swedish massage and earplugs/eye masks on the quality of sleep of patients admitted to the intensive care units (ICUs) of the teaching hospitals affiliated with Zahedan University of Medical Sciences in Zahedan, Iran, in 2022. Methods: This quasi-experimental study was conducted on 40 patients admitted to the ICUs of Khatam Al-Anbia and Ali Ibne Abi-Talib hospitals in Zahedan. The participants were selected through convenience sampling from the patients who met the inclusion criteria. By using the permuted block technique with colored cards (red and yellow), the patients were placed into two Swedish massage and earplug/eye mask groups. After enrollment in the study, the patients in both groups did not receive any intervention during the first night, and their sleep quality was checked using the Richards-Campbell Sleep Questionnaire (RCSQ) as a pre-test during the first night. The participants in both groups received the intended interventions on the second night after entering the study, and their sleep quality on the second night was measured as a post-test. The participants in the first intervention group received a Swedish massage one night for 20 minutes before bedtime in the back area (lumbar cavity to the shoulder). Moreover, the participants in the second intervention group were asked to wear earplugs and eye masks for one night from 10 p.m. to 6 a.m. The collected data were analyzed using independent samples t-test, paired samples t-test, and chi-square test with SPSS software (version 26). Results: The results showed that the mean sleep quality scores for the participants in the Swedish massage group and earplug/eye mask group were 130.25 ± 41.91 and 135 ± 44.36 before the intervention, respectively. In addition, the mean sleep quality scores for the participants in the Swedish massage group and earplug/eye mask group were 202 ± 46.03 and 184.79 ± 39.5 after the intervention, respectively, showing a significant increase in the sleep quality scores for the participants in both groups after the intervention (P = 0.001). In addition, the independent samples t-test confirmed that the mean sleep quality score for the participants in the Swedish massage group was significantly higher than that of the participants in the earplug/eye mask group after the intervention (P = 0.037). Conclusions: Non-pharmacological interventions, such as Swedish massage and wearing earplugs and eye masks, can have a significant effect on increasing the sleep quality of patients admitted to the ICU. The data in this study indicated that compared to the earplug/eye mask group intervention, Swedish massage had a greater effect on improving the sleep quality of the patients. Therefore, the Swedish massage technique, which does not cause sensory restrictions similar to those of earplugs/eye masks, can be applied as an inexpensive intervention without any complications to improve patients’ sleep quality.

Sleep in the intensive and intermediate care units: Exploring related factors of delirium, benzodiazepine use and mortality

Aim of the studyThe primary purpose was to examine sleep difficulties and delirium in the Intensive and Intermediate Care Unit. Secondarily, factors impacting night-time sleep duration and quality, mortality, and the impact of benzodiazepine use on sleep outcomes were investigated. Materials and methodsThis retrospective study encompassed data from 323 intensive and intermediate care unit admissions collected in the Netherlands, spanning from November 2018 to May 2020. Sleep quality was measured using the Richards-Campbell Sleep Questionnaire. Night-time sleep duration was nurse-reported. We investigated associations of these sleep outcomes with age, sex, length-of-stay, natural daylight, disease severity, mechanical ventilation, benzodiazepine use, and delirium using Generalized Estimating Equations models. Associations with one-year post-discharge mortality were analyzed using Cox regression. ResultsNight-time sleep duration was short (median 4.5 hours) and sleep quality poor (mean score 4.9/10). Benzodiazepine use was common (24 % of included nights) and was negatively associated with night-time sleep duration and quality (B = -0.558 and -0.533, p <.001). Delirium and overnight transfers were negatively associated with sleep quality (B = -0.716 and −1.831, p <.05). The day-to-night sleep ratio was higher in the three days before delirium onset than in non-delirious individuals (p <.05). Age, disease severity and female sex were associated with increased one-year mortality. Sleep quality was negatively, but not-significantly, associated with mortality (p =.070). ConclusionsNight-time sleep in the critical care environment has a short duration and poor quality. Benzodiazepine use was not associated with improved sleep. Sleep patterns change ahead of delirium onset. Implications for clinical practiceConsistent sleep monitoring should be part of routine nursing practice, using a validated instrument like the Richards-Campbell Sleep Questionnaire. Given the lack of proven efficacy of benzodiazepines in promoting sleep in critical care settings, it is vital to develop more effective sleep treatments that include non-benzodiazepine medication and sleep hygiene strategies.