Richards-Campbell Sleep Questionnaire Research Articles

Dynamic prevalence of sleep disturbance among critically ill patients in intensive care units and after hospitalisation: A systematic review and meta-analysis

BackgroundSleep disturbance is a common complaint among critically ill patients in intensive care units and after hospitalisation. However, the prevalence of sleep disturbance among critically ill patients varies widely. ObjectiveTo estimate the prevalence of sleep disturbance among critically ill patients in the intensive care unit and after hospitalisation. MethodsElectronic databases were searched from their inception until 15 August 2022. Only observational studies with cross-sectional, prospective, and retrospective designs investigating sleep disturbance prevalence among critically ill adults (aged ≥ 18 years) during intensive care unit stay and after hospitalisation were included. ResultsWe found 13 studies investigating sleep disturbance prevalence in intensive care units and 14 investigating sleep disturbance prevalence after hospitalisation, with 1,228 and 3,065 participants, respectively. The prevalence of sleep disturbance during an ICU stay was 66 %, and at two, three, six and ≥ 12 months after hospitalisation was 64 %, 49 %, 40 %, and 28 %, respectively. Studies using the Richards–Campbell Sleep Questionnaire detected a higher prevalence of sleep disturbance among patients in intensive care units than non-intensive care unit specific questionnaires; studies reported comparable sleep disturbance prevalence during intensive care stays for patients with and without mechanical ventilation. ConclusionSleep disturbance is prevalent in critically ill patients admitted to an intensive care unit and persists for up to one year after hospitalisation, with prevalence ranging from 28 % to 66 %. The study results highlight the importance of implementing effective interventions as early as possible to improve intensive care unit sleep quality.

What are the sleep characteristics among early kidney transplant recipients? An objective and subjective measurement from China.

To evaluate the sleep quality by self-reported questionnaires and polysomnography (PSG) among early kidney transplant recipients (KTRs) and to further explore their correlation. This was a prospective and cross-sectional analysis of the sleep characteristics among early kidney transplant recipients through an objective and subjective measurement. Patients with end stage renal disease on the transplant waiting list and after kidney transplantation were from a major organ transplantation center in Southern China (n = 83). Objective outcomes: PSG, noise and light. Subjective outcomes: demographic and clinical questionnaires, self-reported pain and Richards Campbell sleep questionnaire (RCSQ). After agreement with the informed consent, participants first completed demographic and clinical questionnaires, then worn the PSG within 5-10 days after kidney transplantation. Both noise, light and self-reported pain were monitored during sleep. After completion of PSG, the RCSQs were filled out next morning. A total of 298 patients were recruited and 83 participants were finally analyzed. The total RCSQ mean score was 51.0±18.9mm. The prevalence of poor sleep quality among early KTRs was 45.1%. Most of PSG characteristics were significantly correlated with their corresponding RCSQ items. And the total RCSQ scores were significantly correlated with the number of awakenings, the N2 percentage and the total sleep time (r = 0.79, 0.47 and 0.40, P<0.05) respectively. Noise was a statistically significant factor affecting the subjective sleep quality. The sleep quality in early KTRs measured by both PSG and RCSQ exhibits consistency with each other. Sleep disruption always remains a substantial problem and is affected by self-reported noise among early KTRs. The RCSQ is easily applicable and interpretable so that it can be used for future daily clinical practice.

Deep sleep and beeps II: Sleep quality improvement project in general surgery patients

BackgroundPoor sleep leads to poor health outcomes. Phase I of our sleep quality improvement project showed severe sleep disturbance in the ward setting. We implemented a novel PostOp Pack to improve sleep quality. MethodsPatients underwent elective, general surgery procedures. Fitbit trackers measured total sleep time. Patients completed the inpatient Richards-Campbell Sleep Questionnaire, which combines 5 domains into a cumulative score (0–100). Patients completed the outpatient Pittsburgh Sleep Quality Index preoperatively and postoperatively. Patients received the PostOp Pack, which included physical items and a sleep-protective order set to reduce nighttime awakenings. Patients from phase I served as the historical control. The primary outcome was the percentage of patients with Richards-Campbell Sleep Questionnaire total sleep score ≥50. The secondary outcomes included the mean Richards-Campbell Sleep Questionnaire domain scores and Fitbit total sleep time. ResultsA total of 49 patients were compared with 64 historical controls. The percentage of patients with a total sleep score ≥50 was significantly higher in patients receiving a PostOp Pack versus historical control (69% vs. 44%, difference 26%, 95% confidence interval 6.1-45%, P = .01). The mean Richards-Campbell Sleep Questionnaire Total Sleep Score was significantly higher in patients with a PostOp Pack (62 vs 49, mean difference 13, 95% confidence interval 6–21, P ≤ .01). The PostOp Pack Richards-Campbell Sleep Questionnaire domain scores were significantly higher in various areas: Sleep Latency (68 vs 49, P ≤ .01), Awakenings (56 vs 40, P = .01), Sleep Quality (61 vs 49, P = .02), and Noise Disturbance (70 vs 59, P = .04). Of all patients, 92% would use PostOp Pack again in a future hospitalization. No patients had a failure to rescue event with PostOp Pack. The mean total sleep time was significantly improved with PostOp Pack on night 1 (6.4 vs 4.7 hours, P = .03). ConclusionThe PostOp Pack improves inpatient sleep quality and is safe.

Sleep assessment in critically ill adults: A systematic review and meta-analysis.

To systematically review sleep evaluation, characterize sleep disruption, and explore effects of sleepdisruption on outcomes in adult ICU patients. We systematically searched databases from May 1969 to June 2021 (PROSPERO protocol number: CRD42020175581). Prospective and retrospective studies were included studying sleep in critically ill adults, excluding patients with sleep or psychiatric disorders. Meta-regression methods were applied when feasible. 132 studies (8797 patients) were included. Fifteen sleep assessment methods were identified, with only two validated. Patients had significant sleep disruption, with low sleep time, and low proportion of restorative rapid eye movement (REM). Sedation was associated with higher sleep efficiency and sleep time. Surgical versus medical patients had lower sleep quality. Patients on ventilation had a higher amount of light sleep. Meta-regression only suggested an association between total sleep time and occurrence of delirium (p < 0.001, 15 studies, 519 patients). Scarce data precluded further analyses. Sleep characterized with polysomnography (PSG) correlated well with actigraphy and Richards Campbell Sleep Questionnaire (RCSQ). Sleep in critically ill patients is severely disturbed, and actigraphy and RCSQ seem reliable alternatives to PSG. Future studies should evaluate impact of sleep disruption on outcomes.

Validation Study of the Richards-Campbell Sleep Questionnaire in Patients with Acute Stroke.

Sleep disorders are frequent in acute stroke. The Richards-Campbell Sleep Questionnaire (RCSQ) is a validated scale for the sleep assessment in intensive care unit. The aim of the present study is to validate RCSQ for use in patients with acute stroke. We performed a validation study by comparing the RCSQ with polysomnography (PSG), the standardized measure of sleep. Inclusion criteria were age ≥ 18 years and a radiologically confirmed diagnosis of stroke. Exclusion criteria were global aphasia, extreme severity of clinical conditions and inability to attend PSG. All patients underwent PSG in a stroke unit, the day after a subjective sleep assessment by means of the RCSQ. The RCSQ was compared with PSG parameters to assess the degree of concordance of the two measures. The cohort consisted of 36 patients. Mean RCSQ score was 61.5 ± 24.8. The total score of the RCSQ showed a good degree of concordance with the sleep efficiency index of PSG. Accuracy of the RCSQ was 70%, sensitivity 71% and specificity 68%. The RCSQ is a good tool for screening the sleep quality in the setting of a stroke unit. Therefore, it could be useful to select the patients who might beneficiate from an instrumental sleep evaluation.

Effect of low-dose dexmedetomidine on sleep quality in postoperative patients with mechanical ventilation in the intensive care unit: A pilot randomized trial

BackgroundSleep disturbances are prevalent in patients requiring invasive mechanical ventilation in the intensive care unit (ICU) and are associated with worse outcomes. Sedative-dose dexmedetomidine may improve sleep quality in this patient population but is associated with adverse events. Herein, we tested the effect of low-dose dexmedetomidine infusion on nighttime sleep quality in postoperative ICU patients with invasive ventilation.MethodsIn this pilot randomized trial, 80 adult patients who were admitted to the ICU after non-cardiac surgery and required invasive mechanical ventilation were randomized to receive either low-dose dexmedetomidine (0.1 to 0.2 μg/kg/h, n = 40) or placebo (n = 40) for up to 72 h. The primary endpoint was overall subjective sleep quality measured using the Richards–Campbell Sleep Questionnaire (score ranges from 0 to 100, with a higher score indicating better quality) in the night of surgery. Secondary outcomes included sleep structure parameters monitored with polysomnography from 9:00 PM on the day of surgery to the next 6:00 AM.ResultsAll 80 patients were included in the intention-to-treat analysis. The overall subjective sleep quality was median 52 (interquartile 20, 66) with placebo vs. 61 (27, 79) with dexmedetomidine, and the difference was not statistically significant (median difference 8; 95% CI: −2, 22; P = 0.120). Among 68 patients included in sleep structure analysis, those in the dexmedetomidine group tended to have longer total sleep time [median difference 54 min (95% CI: −4, 120); P = 0.061], higher sleep efficiency [median difference 10.0% (95% CI: −0.8%, 22.3%); P = 0.060], lower percentage of stage N1 sleep [median difference −3.9% (95% CI: −11.8%, 0.5%); P = 0.090], higher percentage of stage N3 sleep [median difference 0.0% (95% CI: 0.0%, 0.4%); P = 0.057], and lower arousal index [median difference −0.9 (95% CI −2.2, 0.1); P = 0.091] but not statistically significant. There were no differences between the two groups regarding the incidence of adverse events.ConclusionAmong patients admitted to the ICU after surgery with intubation and mechanical ventilation, low-dose dexmedetomidine infusion did not significantly improve the sleep quality pattern, although there were trends of improvement. Our findings support the conduct of a large randomized trial to investigate the effect of low-dose dexmedetomidine in this patient population.Clinical trial registrationClinicalTrial.gov, identifier: NCT03335527.

The effect of lavender oil inhalation on pain, anxiety, and sleep quality after coronary artery bypass graft: a randomized controlled trial protocol

&lt;p&gt;&lt;strong&gt;Background:&lt;/strong&gt; Pain, anxiety, and sleep disorders are common side effects of coronary artery bypass graft (CABG) surgery. Although pharmacological agents are currently used in the treatment of these problems, in addition to their undesirable side effects, they increase healthcare costs, and their inadequate control leads to morbidities, prolonged hospital stay and increased burden of care. Therefore, supportive interventions are needed. The aim of this study is to determine the effect of lavender oil inhalation on the pain intensity, anxiety and sleep quality of patients that underwent CABG surgery.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was planned as a prospective randomized controlled trial. Participants meeting the inclusion criteria will be randomly assigned to the intervention and control groups. During the hospitalization period after CABG surgery, 2% lavender oil (&lt;em&gt;Lavandula angustifolia&lt;/em&gt;) inhalation will be applied to the intervention group three times a day, while the control group will only receive routine care. The pain intensity of the groups will be evaluated with the numeric rating scale, anxiety levels with the state-trait anxiety inventory, and sleep quality with the Richards-Campbell sleep questionnaire.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; There is a need for new approaches to improve the physiological and psychological health of patients after CABG surgery and help them return to their daily life activities and social lives in a shorter time. This trial will allow for the assessment of the effects of this intervention and provide valuable evidence to guide clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration:&lt;/strong&gt; This trial was registered in May, 2022 (NCT05377983).&lt;/p&gt;

Evaluation of Surgical Fear Level and Postoperative Consequences in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Objective: This study aims to evaluate the relationship between surgical fear level and postoperative pain, nausea–vomiting, and sleep quality in patients undergoing laparoscopic sleeve gastrectomy. Methods: The data for the descriptive and cross-sectional study were collected using the Descriptive Information Form, Surgical Fear Questionnaire, Visual Analog Scale, Rhodes Index of Nausea Vomiting and Retching, and Richard-Campbell Sleep Questionnaire. The study was conducted with 105 patients. The extent of the relationship between the predictors was evaluated through stepwise multiple linear regression analysis. Results: Preoperative surgical fear was determined as an effective factor in the severity of pain and sleep quality at the postoperative fourth hour. Concerning the increase of the severity of pain at the 12th and 24th hours, body mass index and accompanying comorbidities, postoperative nausea–vomiting, presence of chronic disease among the complaints, and age were effective factors. Pre-hospitalization sleep quality and comorbidity status of the patients were determined as predictors of postoperative sleep quality. Conclusions: Surgical fear of the patients was determined to increase the fourth-hour pain severity and decrease postoperative sleep quality. Some characteristics of the patients were associated with an increase in postoperative pain and nausea–vomiting symptoms and a decrease in sleep quality.

Effect of Perioperative Dexmedetomidine Infusion on Postoperative Delirium in Elderly Patients Undergoing Oral and Maxillofacial Surgery: A Randomized Controlled Clinical Trial.

PurposeThe aim of the study was to determine whether perioperative dexmedetomidine administration can improve postoperative delirium in elderly patients undergoing oral and maxillofacial surgery.Patients and MethodsThis was a prospective double-blind randomized controlled clinical trial conducted in Cangzhou Central Hospital from December 2021 to March 2022. Patients aged 65 and older underwent oral and maxillofacial surgery under general anesthesia. Eligible patients were randomly assigned to dexmedetomidine or control group. Dexmedetomidine was injected intravenously from 10 min before induction of anesthesia to 30 min before the end of surgery in dexmedetomidine group, while patients in the control group were given normal saline at the same rate during the same time period. The primary measurement indicators were the incidence and duration of delirium in the first five days after surgery. The secondary measurement indicators were Visual Analogue Score (VAS) for the first 24 hours following surgery, subjective sleep quality score within 24 hours postoperatively and intraoperative adverse reactions.ResultsOne hundred and twenty patients were randomly assigned. Baseline characteristics were similar between two groups. The incidence and duration of postoperative delirium did not differ statistically between two groups (all P > 0.05). Compared with control group, VAS scores in dexmedetomidine group were significantly lower at 6, 12, and 24 hours after surgery (all P < 0.05); moreover, Richards-Campbell Sleep Questionnaire (RCSQ) results were significantly improved 1 day after surgery in dexmedetomidine group (P < 0.05). Dexmedetomidine-related adverse reactions were similar in both groups (P > 0.05).ConclusionIntravenous infusion of dexmedetomidine 10 min before induction of anesthesia to half an hour before the end of surgery did not improve postoperative delirium in elderly patients undergoing oral and maxillofacial surgery; however, dexmedetomidine may be associated with decreased postoperative pain and improved postoperative sleep quality.

Sensitivity and specificity of proposed Richards-Campbell Sleep Questionnaire cut-off scores for good quality sleep during an ICU stay.

The 5-visual analogue scale Richards-Campbell Sleep Questionnaire subjective sleep measure is widely used in intensive care. A cut-off score indicative of good quality sleep has not been established and is required to guide the categorisation of individual patient and unit wide sleep quality. The aim was to determine the global Richards-Campbell Sleep Questionnaire cut-off score for good to very good sleep during an intensive care unit stay in non-ventilated patients. The study was a secondary (cohort) retrospective analysis of patient self-report data (n=32) from an interventional study testing a sleep promotion bundle. The Standards for Reporting Diagnostic Accuracy studies statement were used to report the study. The study was conducted in two mixed adult 12 and 20-bed ICUs of a tertiary referral hospital in a metropolitan area. In the morning, eligible patients were administered the Richards-Campbell Sleep Questionnaire together with a 5-category item Likert scale in which patients rated their nocturnal sleep quality as 'very poor', 'poor', 'fair', 'good' and 'very good'. Receiver Operator Curve analysis was performed. Thirty-seven per cent (n=32) of the total sample of 84 adult intensive care patients were females. The median age was 61.5 (51, 72) years. Self-reported median global Richards-Campbell Sleep Questionnaire score was 54.4 (30.1, 77.1) mm. A global score of ≥63.4mm was the optimal cut-off for self-reported 'good sleep' (sensitivity: 87%, specificity: 81% and area under the curve: 0.896). Although the study requires replication in ventilated patients and other ICU settings, the cut-off score (63mm) could be used to guide the categorisation of individual patient and unit wide sleep quality.

Subjective sleep quality among hospitalised adult patients: An observational, cross-sectional study

Background Inpatient sleep quality is influenced by multiple factors including medical conditions, use of medication and the ward environment. Without adequate rest, detrimental effects on patients’ physical and psychological performances may persist, inhibiting recovery and increasing length of stay. Objective This study examined the sleep quality of adult inpatients and its’ associations with sociodemographic, clinical and environmental factors. Methods An observational study was conducted in the medical wards of an acute care hospital in Singapore from July to December 2018. Patients completed the Pittsburgh Sleep Quality Index (PSQI) to establish baseline sleeping habits and the Richards-Campbell Sleep Questionnaire (RCSQ) to assess perception of sleep quality during hospitalisation. Noise levels were measured using the SL-4023SD sound level meter. Environmental factors affecting sleep were also recorded. Results 52 patients were recruited reported a mean RCSQ score of 5.83 (SD = 2.31) and mean Global PSQI score was 6.06 (SD = 3.33), indicative of poor baseline sleep. The highest mean noise level presented with an average reading of 80 dB, surpassing the WHO recommended noise levels by two times. Subjective sleep quality was not affected by demographic, clinical factors and bed locations. Patients exposed to night lamps reported a reduction in sleep quality ( p = .04). Conclusions Recognising the importance of overall sleep quality and the identification of external factors influencing patients’ sleep quality during hospitalisation is a vital step towards developing successful interventions to promote good sleep hygiene in the general wards of the Asian context.

Patient-nurse agreement on inpatient sleep and sleep disturbing factors

BackgroundSleep is vital for recovery during hospital stay. Many sleep-promoting interventions have been investigated in the past. Nurses seem to overestimate their patients sleep and their perspective is needed for these interventions to be successfully implemented. ObjectivesTo assess the patient's and nurse's agreement on the patient's sleep and factors disturbing sleep. MethodsThe instruments used included 1) five Richard-Campbell Sleep Questionnaire (RCSQ) items plus a rating of nighttime noise and 2) the Consensus Sleep Diary (CSD). The mean of the five RCSQ items comprised a total score, which reflects sleep quality. Once a week, unannounced, nurses and patients were asked to fill in questionnaires concerning last night's sleep. Neither nurses nor patients knew the others' ratings. Patient-nurse agreement was evaluated by using median differences and Bland-Altman plots. Reliability was evaluated by using intraclass correlation coefficients. ResultsFifty-five paired patient-nurse assessments have been completed. For all RCSQ subitems, nurses' scores were higher (indicating “better” sleep) than patients’ scores, with a significantly higher rating for sleep depth (median [IQR], 70 [40] vs 50 [40], P = .012). The Bland-Altman plots for the RSCQ Total Score (r = 0.0593, P = .008) revealed a significant amount of variation (bias). The intra-class correlation coefficient (ICC) indicated poor reliability for all 7 measures (range −0.278 – 0.435). Nurses were relatively overestimating their own role in causing sleep disturbances and underestimating patient-related factors. ConclusionsNurses tend to overestimate patients’ sleep quality as well as their own role in causing sleep disturbances.

Noise Levels and Sleep in a Surgical ICU

Sleep is disturbed in critically ill patients and is a frequently overlooked complication. The aim of our study is to evaluate the impact of sound levels in our surgical ICU on our patients’ sleep on the first night of admission. The study was performed in a tertiary care university hospital, in a 12-bed surgical ICU. Over a 6-week period, a total of 148 adult, non-intubated and non-sedated patients completed the study. During this six-week period, sound levels were continuously measured using a type II sound level meter. Sleep quality was evaluated using the Richards–Campbell Sleep Questionnaire (RCSQ), which was completed both by patients and nurses on the first morning after admission. A non-significant correlation was found between night sound levels and sleep quality in the overall sample (r = −1.83, 95% CI; −4.54 to 0.88, p = 0.19). After multivariable analysis, a correlation was found between higher sound levels at night and lower RCSQ evaluations (r = −3.92, 95% CI; −7.57 to −0.27, p = 0.04). We found a significant correlation between lower sound levels at night and a better quality of sleep in our patients; for each 1 dBA increase in LAFeq sound levels at night, patients scored 3.92 points lower on the sleep questionnaire.

The accuracy of simple, feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study

BackgroundSleep disturbance is common in intensive care patients. Understanding the accuracy of simple, feasible sleep measurement techniques is essential to informing their possible role in usual clinical care. ObjectiveThe aim of the study was to investigate whether sleep monitoring techniques such as actigraphy (ACTG), behavioural assessments, and patient surveys are comparable with polysomnography (PSG) in accurately reporting sleep quantity and quality among conscious, intensive care patients. MethodsAn observational study was conducted in 20 patients admitted to the intensive care unit (ICU) for a minimum duration of 24 h, who underwent concurrent sleep monitoring via PSG, ACTG, nursing-based observations, and self-reported assessment using the Richards–Campbell Sleep Questionnaire. ResultsThe reported total sleep time (TST) for the 20 participants measured by PSG was 328.2 min (±106 min) compared with ACTG (362.4 min [±62.1 min]; mean difference = 34.22 min [±129 min]). Bland–Altman analysis indicated that PSG and ACTG demonstrated clinical agreement and did not perform differently across a number of sleep variables including TST, awakening, sleep-onset latency, and sleep efficiency. Nursing observations overestimated sleep duration compared to PSG TST (mean difference = 9.95 ± 136.3 min, p > 0.05), and patient-reported TST was underestimated compared to PSG TST (mean difference = −51.81 ± 144.1 7, p > 0.05). ConclusionsAmongst conscious patients treated in the ICU, sleep characteristics measured by ACTG were similar to those measured by PSG. ACTG may provide a clinically feasible and acceptable proxy approach to sleep monitoring in conscious ICU patients.

Efforts to improve sleep quality in a medical intensive care unit: effect of a protocol of non-pharmacological interventions.

This study aimed to evaluate the effect of a protocol of nonpharmacological interventions to improve sleep quality in the intensive care unit (ICU). Due to its close relationship with sleep quality, the effects of the same interventions on noise levels and delirium rates were also evaluated in this study. This pretest-posttest design with a control group was carried out in a medical ICU over 8months. Data were collected using Acute Physiology and Chronic Health Evaluation II, the Glasgow Coma Scale, the Richmond Agitation-Sedation Scale, the Richards-Campbell Sleep Questionnaire (RCSQ), the Confusion Assessment Method for the Intensive Care Unit, and noise measurement devices. In the first phase of the study, patients receiving standard care in the ICU were followed. After the first stage, a training session was held for nurses to raise awareness and information. Then, the sleep-promoting protocol created by the researchers was applied. The ambient noise level was measured continuously. A total of 78 patients with a mean age of 70.0 ± 13.2years were followed in the ICU for an average of7.3 ± 3.8days. With protocol implementation, the ambient noise level in the ICU was reduced from 70.9 ± 3.8dB(A) to 62.7 ± 3.5dB(A) (p < 0.01); the RCSQ scores of the patients increased from 48.3 ± 1.4 to 62.1 ± 1.8 (p < 0.01). Although statistically nonsignificant, efforts to improve sleep quality also reduced the development of delirium by 15%. It is possible to improve sleep quality and reduce noise levels in anICU with a protocol consisting of multicomponent nonpharmacological interventions.

Improving critical care patients' sleep quality in a surgical high-dependency unit: An evidence-based practice project.

Sleep is an essential basic need. However, patients in critical care often experience poor and fragmented sleep. As such, there is a need to examine strategies to promote sleep in critical care patients. This project aimed to promote sleep in surgical high-dependency patients through the implementation of evidence-based best practice. An evidence-based practice (EBP) project was implemented in May 2015 in a 24-bed surgical high-dependency (progressive care) unit in a public tertiary hospital in Singapore in three phases using the JBI framework. Outcomes measured were sleep quality, using the Richards-Campbell Sleep Questionnaire, and nurses' adherence to sleep promotion activities, using an audit tool adapted from the JBI-Practical Application of Clinical Education System. Data were collected at baseline, 1, 3, 6, and 12months. Getting Research into Practice analysis was done at each time point. A total of 120 patients were surveyed, and 150 observation audits were conducted over 1year. Sleep quality was similar between pre-audit (mean 53, SD 19.89) and month 1 (mean 54, SD 24.40), improved at month 3 (mean 64, SD 19.34), and sustained at month 6 (mean 64, SD 24.13) and 12 (mean 64, SD 19.4). The effect size between pre-audit and month 3 was a medium effect size of 0.49, which continued to improve at month 12, with a medium effect size of 0.56. Nurses' adherence to the EBP generally improved, and the thresholds of 80% were exceeded by month 12. Sleep is an essential basic need and can be improved through simple evidence-based interventions. Best practice for promoting sleep includes grouping nursing activities and reducing light and noise at night.

Effect of earplug/eye mask on sleep and delirium in intensive care patients.

Environmental factors such as loud sounds and bright lights in intensive care units can cause sleep disorders and delirium. The present study aims to investigate the effects of the overnight use of earplugs and eye masks by intensive care patients on their sleep quality and the degree of delirium. This randomized controlled experimental study was conducted on the patients admitted to a coronary intensive care unit. The patients in the experimental group used earplugs and eye masks during the night, while those in the control group received only routine care. Data were collected using an information form, the Richards-Campbell sleep questionnaire (RCSQ), and the intensive care delirium screening checklist (ICDSC). The study included a total of 84 patients, 42 in the experimental group and 42 in the control group. The baseline average score of the patients in the experiment group on the RCSQ was 40.11 ± 16.55, with a Time 1 average score of 64.09 ± 14.07 and a Time 2 average score of 72.07 ± 11.75; their baseline average score on the ICDSC was 0.47 ± 0.50, with a Time 1 average score of 0.33 ± 065 and a Time 2 average score of 0.19 ± 039. The baseline average score of the patients in the control group on the RCSQ was 44.07 ± 7.30, with a Time 1 average score of 46.97 ± 9.22 and a Time 2 average score of 47.04 ± 11.53; the baseline average score of the control group on the ICDSC was 0.42 ± 0.50, with a Time 1 average score of 0.50 ± 0.70 and a Time 2 average score of 0.57 ± 0.66. A statistically significant difference was found between the Time 1 and Time 2 average scores of the experimental and control groups on the RCSQ and between the Time 2 average scores of the experimental and control groups on the ICDSC (U=198.00, P< .001; U=70.000, P< .001; U=614.000, P=·004 respectively). The earplugs and eye masks used by the intensive care patients overnight were associated with an increase in sleep quality and a decrease in the degree of delirium. The use of earplugs and eye masks is recommended for intensive care units in supporting sleep quality and preventing delirium.

The effect of domiciliary high flow nasal cannula treatment on dyspnea and walking distance in patients with interstitial lung disease - A pilot study.

Interstitial Lung Diseases (ILD) affect the lung parenchyma and are often complicated by respiratory failure (RF) and impaired physical activity. High Flow Nasal Cannula (HFNC) has proved effective in other disease entities with RF. The aim of this study is to investigate the effect of domiciliary HFNC in ILD on dyspnea and walking distance. A 6 weeks cross-over study with domiciliary HFNC-treatment/6 weeks' observation in ILD-patients requiring ambulatory oxygen therapy or with newly prescribed (within 12 months) long term oxygen therapy. Patients were advised to use HFNC 8 h/day, recommended night-time use. Body phletysmography; 6-min walk test (6MWT) including BORG-score, oxygen saturation (SO2) at start, minimum SO2 and time to recovery after 6MWT; arterial blood gasses; modified Medical Research Council (mMRC)-score; quality of life, by the St George Respiratory Questionnaire (SGRQ) and QoS, by the Richards-Campbell Sleep Questionnaire (RCSQ) were investigated at baseline; six weeks and 12 weeks. 10 patients were included; one later withdrew consent. Patients used HFNC between 8-<1 h/day. There were no differences in lung function; blood gasses; SGRQ or RCSQ over the observational period). Walking distance improved significantly (393-441m p = 0.049) as did time to recovery (3.4-2-2 min, p = 0.001). When correcting for HFNC use (hours/day) significant improvement was also seen in mMRC-score (p = 0.035) and minimum saturation during 6MWT (p = 0.01). Despite a very heterogenous group and no effect on quality of life and -sleep, the study indicates an improvement in dyspnea and physical ability of HFNC in ILD patients.

Kolorektal Cerrahi Öncesi Hastalarda Uyku Kalitesini Artırmada Uyku Hijyeni Konusunda Görsel Materyal Kullanımı: Randomize Kontrollü Bir Çalışma

Objective: Surgical intervention takes the first place in the treatment of colorectal cancer, and anxiety, fear and concern in the preoperative period may cause difficulty in meeting the sleep requirements of these patients. This study is to investigate the effect on patients, who will undergo colorectal surgery, of providing information on sleep quality through the use of sleep hygiene visual material. Material and Methods: This randomized controlled and quasi-experimental study was conducted on 62 patients with 31 patients in study group and 31 controls who were scheduled to undergo colorectal surgery in the general surgery department of a university hospital in Türkiye between January 25,2018 and June 28, 2018. Data were collected using patient identification form, Richards-Campbell Sleep Questionnaire, and sleep hygiene visual material. Patients in both groups who were hospitalized 2 days prior to surgery were visited by the researcher in their rooms and verbally informed about sleep hygiene. Sleep hygiene visual material was used for instructing the patients in the study group. Sleep quality was evaluated on the day before surgery and on the day of operation. Results: In this study, both groups were informed about sleep hygiene and this process was was significantly higher in improving the sleep quality of patients in both groups on the morning of the operation (p=0.000; p=0.000, respectively). The evaluation of the study group on the morning of the operation, found that the mean sleep quality total scale score of the study group was significantly higher when compared with that of the control group (p=0.043). Conclusion: In the study, it was found that using visual material of sleep hygiene in informing patients about sleep hygiene in the preoperative period contributed positively to improving sleep quality of the patients. We recommend the use of visual materials to help the patient remember information.

The effects of a team-based planned care program on the quality of sleep in cardiac surgery patients hospitalized in the intensive care unit: A two-group controlled clinical trial.

BACKGROUND:Sleep disturbances as a major health problem are common in patients hospitalized in critical care units. This study examined the effects of a team-based care plan on the quality of sleep in patients hospitalized in a cardiac surgery intensive care unit (CSICU) of a multidisciplinary hospital.MATERIALS AND METHODS:In this clinical trial, 100 patients with cardiac surgery were selKMected through convenience sampling and then nonrandomly allocated to the intervention and or the control group. A plan of care with the recommendation of all intensive care unit care teams was designed and then applied. In this study, the Richards-Campbell Sleep Questionnaire was used to evaluate sleep quality. Patients in the intervention group received the care plan for two consecutive nights. The study's national approval code is IRCT2017091915512N2. Collected data were analyzed using SPSS software (v. 21), and by paired, independent t, Chi-square, and Fisher's exact tests.RESULTS:Quality of sleep in patients admitted to the CSICU is significantly improved by noise reduction both in the first and second nights. Moreover, the team-based care plan requires good coordination between all team members taking care of cardiac surgery patients admitted to the CSICU (P < 0.001).CONCLUSIONS:The team-based care plan significantly improves the quality of sleep. It may be due to the close coordination between all team members to avoid sleep disturbances.