Richards-Campbell Sleep Questionnaire Research Articles

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.

A multi-intervention protocol to improve sleep quality in a coronary care unit.

Poor sleep is a frequent occurrence in the critical illness. Evaluate sleep quality and test the effect of a multi-intervention sleep care protocol in improving sleep quality in a coronary care unit (CCU). Quasi-experimental study, carried out in two phases. During the first phase, the control group (n = 58 patients) received usual care. Baseline sleep data were collected through the Richards-Campbell Sleep Questionnaire (RCSQ) and the Sleep in the Intensive Care Unit Questionnaire (SICUQ). During the second phase (n = 55 patients), a sleep care protocol was implemented. Interventions included actions to promote analgesia, reduce noise, brightness, and other general measures. Sleep data were collected again to assess the impact of these interventions. The intervention group had better scores in overall sleep depth [median (interquartile range)] [81 (65-96.7) vs. 69.7 (50-90); P = 0.046]; sleep fragmentation [90 (65-100) vs. 69 (42.2-92.7); P = 0.011]; return to sleep [90 (69.7-100) vs. 71.2 (40.7-96.5); P = 0.007]; sleep quality [85 (65-100) vs. 71.1 (49-98.1); P = 0.026]; and mean RCSQ score [83 (66-94) vs. 66.5 (45.7-87.2); P = 0.002] than the baseline group. The main barriers to sleep were pain [1 (1.0-5.5)], light [1 (1.0-5.0)], and noise [1 (1.0-5.0)]. The most rated sources of sleep-disturbing noise were heart monitor alarm [3 (1.0-5.25)], intravenous pump alarm [1.5 (1.0-5.00)]. and mechanical ventilator alarm [1 (1.0-5.0)]. All were significantly lower in the intervention group than in the baseline group. A multi-intervention protocol was feasible and effective in improving different sleep quality parameters and reducing some barriers to sleep in CCU patients.

Effectiveness of alternative nursing strategy on sleep pattern in coronary intensive care during hospitalization

BackgroundCritically ill patients suffer from sleep pattern disturbances in intensive care units, negatively affecting their recovery. With this, nurses are faced with a great challenge to deal with these disturbances in critically ill patients. AimThis study aimed to explore the effectiveness of alternative methods to nursing strategies for promoting night sleep pattern among coronary intensive care patients. MethodsThe study was conducted at the coronary intensive care unit (CCU) of the Aswan University Hospital (Aswan– Egypt). Pertinent data were collected utilizing two tools. The first tool was the quality of sleep sheet, which included two parts: personal bio demographic data and a Richards–Campbell sleep questionnaire for monitoring the sleep qualities of ICU patients. The second tool was the stress factors in the ICU questionnaire used to measure stress perception. A quantitative survey was carried out to meet the aim of this study, and the purposive sample included 85 conscious CCU patients. ResultsImplementation of the alternative methods to nursing strategies revealed highly significant impacts regarding the domains in stress factor perception (p < 0.000) and items of sleep quality in the ICU. Significant differences were found in the means of sleep depth, latency, returning to sleep, sleep quality, and noise in the ICU (p < 0.005). ConclusionAlternative nursing strategies improved the sleep quality of ICU patients using the following alternative methods performed by nurses, which included aromatherapy, body massage, listening to calm music, and decrease of stress factors in the ICU. Therefore, it is recommended to use these alternative nursing strategies in intensive care units to improve the patients' night sleep pattern.

Quality of life of locally advanced pancreatic cancer patients after FOLFIRINOX treatment

BackgroundQuality of life in cancer patients might be affected by chemotherapy-induced toxicity. Especially in patients with pancreatic ductal adenocarcinoma (PDAC), with a short life expectancy, fear of poor quality of life is often a reason for both patients and medical oncologists to refrain from further treatment. In this study, we investigated quality of life (QoL), pain, sleep, and activity levels in locally advanced pancreatic cancer (LAPC) patients after FOLFIRINOX treatment.MethodsA total of 41 LAPC patients with stable disease or partial response were included after completion of at least four cycles of FOLFIRINOX. QoL was measured with the EORTC QLQ-C30 and NRS pain scores. Patients completed the Richards-Campbell Sleep Questionnaire (RCSQ) for five consecutive nights and wore a GENEActiv tri-axial accelerometer (Actiwatch) for 7 days, registering sleep duration, efficiency, and activity.ResultsMean EORTC QLQ-C30 score for global health status was 78.3 (± 17.3), higher than reference values for cancer patients (P < 0.001) and general population (P = 0.045). LAPC patients reported few disease-related symptoms. Two patients (5%) reported pain scores > 3. Mean sleep duration was 8 h/night (± 1.2 h) and sleep efficiency 70% (± 9%) with high patient-reported quality of sleep (mean RCSQ score 72.0 ± 11.4). Mean duration of moderate-vigorous activity was 37 min/week (± 103 min/week).ConclusionsQoL is very good in most LAPC patients with disease control after FOLFIRINOX, measured with validated questionnaires and Actiwatch registration. The fear of clinical deterioration after FOLFIRINOX is not substantiated by this study and should not be a reason to refrain from treatment.Trial registrationDutch trial register NL7578.

The effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality

BackgroundThe pain, anxiety, and sleep disorders that burn patients experience due to burn dressing negatively affect their treatment process. The aim of this study was to determine the effect of reflexology massage and passive music therapy intervention before burn dressing on pain, anxiety level and sleep quality. MethodsThis study was a randomized controlled trial. The study sample consisted of 36 patients who were hospitalized in the Burn Center of a University Hospital. After obtaining written consent, patients were enrolled to study according to inclusion criteria and then, divided into Reflexology Massage (n = 12), Reflexology Massage with Passive Music Therapy (n = 12) and Control (n = 12) groups using simple random allocation. In the experimental groups, in addition to standard care, interventions were performed for consecutive three days. Interventions were done before dressing for 40 min in the patient’s room. The control group received only standard care during this time. Severity of pain in three groups was measured using “Visual Analog Scale” twice a day (before dressing change and 2 h after dressing change). Severity of state anxiety and sleep quality in three groups was measured using “State Anxiety Scale” and “Richards-Campbell Sleep Questionnaire” once a day (before dressing change). Severity of trait anxiety in three groups was measured using “Trait Anxiety Scale” for two times (before and after study). The drugs used by the patients for 3 days were recorded in the “Opioid and Analgesic Drug Form.” Data were analyzed using Pearson Chi-square, Independent Samples T-test, One-Way ANOVA, Bonferroni, Paired Sample T-Test, Repeated Measures ANOVA tests were used. ResultsThe results showed no significant difference in severity of pain, anxiety, and sleep quality (p > 0,05) between the three groups on the first day. However, the mean pain scores showed a significant difference between the experimental and control groups in the third (p < 0,05) and fourth (p < 0001) days after intervention. Anxiety scores also showed a significant difference between the experimental and control groups on the fourth (p < 0001) day. Sleep quality of the experimental groups was higher than the control group on the fourth day (p < 00001). No significant difference using of opioid and analgesic drugs between the three groups (p > 0,05). ConclusionsOur results showed reflexology massage and passive music therapy before burn dressing reduced pain and anxiety level, and increased sleep quality.

Evaluation of Sleep Architecture using 24-hour Polysomnography in Patients Recovering from Critical Illness in an Intensive Care Unit and High Dependency Unit: a Longitudinal, Prospective, and Observational Study.

Background and objectiveThe sleep architecture of critically ill patients being treated in Intensive Care Units (ICU) and High Dependency Units (HDU) is frequently unsettled and inadequate both qualitatively and quantitatively. The study aimed to investigate and elucidate factors influencing sleep architecture and quality in ICU and HDU in a limited resource setting with financial constraints, lacking human resources and technology for routine monitoring of noise, light and sleep promotion strategies in ICU.MethodsThe study was longitudinal, prospective, hospital-based, analytic, and observational. Insomnia Severity Index (ISI) and the Epworth Sleepiness Scale (ESS) pre hospitalisation scores were recorded. Patients underwent 24-hour polysomnography (PSG) with the simultaneous monitoring of noise and light in their environments. Patients stabilised in ICU were transferred to HDU, where the 24-hour PSG with the simultaneous monitoring of noise and light in their environments was repeated. Following PSG, the Richards-Campbell Sleep Questionnaire (RCSQ) was employed to rate patients’ sleep in both the ICU and HDU.ResultsOf 46 screened patients, 26 patients were treated in the ICU and then transferred to the HDU. The mean (SD) of the study population’s mean (SD) age was 35.96 (11.6) years with a predominantly male population (53.2% (n=14)). The mean (SD) of the ISI and ESS scores were 6.88 (2.58) and 4.92 (1.99), respectively. The comparative analysis of PSG data recording from the ICU and HDU showed a statistically significant reduction in N1, N2 and an increase in N3 stages of sleep (p<0.05). Mean (SD) of RCSQ in the ICU and the HDU were 54.65 (7.70) and 60.19 (10.85) (p-value = 0.04) respectively. The disease severity (APACHE II) has a weak correlation with the arousal index but failed to reach statistical significance (coeff= 0.347, p= 0.083).ConclusionSleep in ICU is disturbed and persisting during the recovery period in critically ill. However, during recovery, sleep architecture shows signs of restoration.

Effects of an earplug placement intervention on sleep quality in patients in a medical intensive care unit: A randomized controlled trial.

This study aimed to evaluate the effects of an intervention involving earplug placement during nocturnal sleep in non-ventilated intensive care unit patients. A randomized controlled trial was conducted in 107 adult patients between January 2017 and December 2018. Participants in the intervention group (n = 55) slept with earplugs between 10 pm and 7 am on the second night of their intensive care unit stay. In the control group, participants slept with no earplugs. Outcome parameters included sleep, urinary 6-sulfatoxymelatonin levels, relaxation responses measured using the Richards-Campbell Sleep Questionnaire, liquid chromatography-mass spectrometry results and vital signs. Urine was collected between 10 pm and 7 am. Overall, 28.03% of participants showed virtually no 6-sulfatoxymelatonin excretion in the collected urine. Outcome parameters were not significantly different between the groups, indicating that wearing earplugs alone did not affect sleep quality, urinary 6-sulfatoxymelatonin and vital signs. The effects of using earplugs alone on sleep quality, urinary 6-sulfatoxymelatonin and relaxation responses in patients admitted to the intensive care unit were inconclusive. Additional research is required before earplugs alone can be widely used to improve sleep quality.

Development and Implementation of a Multicomponent Protocol to Promote Sleep and Reduce Delirium in a Medical Intensive Care Unit

Evidence suggests that poor sleep increases risk of delirium. Because delirium is associated with poor outcomes, institutions have developed protocols to improve sleep in critically ill patients. To assess the impact of implementing a multicomponent sleep protocol. In this prospective, preimplementation and postimplementation evaluation, adult patients admitted to the medical intensive care unit (ICU) over 42 days were included. Outcomes evaluated included median delirium-free days, median Richards-Campbell Sleep Questionnaire (RCSQ) score, median optimal sleep nights, duration of mechanical ventilation (MV), ICU and hospital length of stay (LOS), and in-hospital mortality. The preimplementation group included 78 patients and postimplementation group, 84 patients. There was no difference in median delirium-free days (1 day [interquartile range, IQR, = 0-2.5] vs 1 day [IQR = 0-2]; P = 0.48), median RCSQ score (59.4 [IQR = 43.2-71.6] vs 61.2 [IQR = 49.9-75.5]; P = 0.20), median optimal sleep nights (1 night [IQR = 0-2] vs 1 night [IQR = 0-2]; P = 0.95), and in-hospital mortality (16.7% vs 17.9%, P = 1.00). Duration of MV (8 days [IQR = 4-10] vs 4 days [IQR = 2-7]; P = 0.03) and hospital LOS (13 days [IQR = 7-22.3] vs 8 days [IQR = 6-17]; P = 0.05) were shorter in the postimplementation group, but both were similar between groups after adjusting for age and severity of illness. This report demonstrates that implementation of a multicomponent sleep protocol in everyday ICU care is feasible, but limitations exist when evaluating impact on measurable outcomes. Additional evaluations are needed to identify the most meaningful interventions and best practices for quantifying impact on patient outcomes.

Psychometric properties of a Thai version of the Richards-Campbell sleep questionnaire.

In critically ill patients, a poor sleep quality can escalate mortality and the length of hospital stays. Albeit being the gold standard for sleep assessment, polysomnography (PSG) is expensive and complicated. The Richards-Campbell sleep questionnaire (RCSQ) is another tool with proof of good correlation with PSG. RCSQ was translated into many languages. However, the Thai version (T-RCSQ) has not been developed. Our study aimed to translate the original RCSQ into Thai, to test the content validity and reliability, and to introduce the questionnaire into clinical practice at the surgical intensive care unit (SICU). Prospective cross-sectional study METHODS: This study enrolled 92 patients from the SICU between August 2019 and January 2020. The content validity of T-RCSQ was determined by the index of item-objective congruence (IOC). The reliability was tested by test-retest reliability at 7am and 9am after intensive care unit (ICU) admission. The internal consistency was expressed by Cronbach's alpha. Patients' demography was reported as percentage, mean and standard deviation, and median and interquartile range. The content validity and test-retest reliability of the T-RCSQ were 0.8 and 0.97, respectively. The internal consistency was 0.964. Most patients were female with American Society of Anesthesiologist physical status III. The mean RCSQ scores at 7am and 9am were 5.82 ± 2.15 cm and 5.61 ± 2.18 cm, respectively. The T-RCSQ is reliable and could be used as an alternative to PSG for sleep assessment of ICU patients. Further research is required to validate the T-RCSQ against PSG and to assess its impact on improving sleep quality and patients' clinical outcomes. T-RCSQ is a useful tool for sleep assessment in ICU. According to cost-effectiveness, convenience, and good reliability, it could be applied to determine proper sleep to minimize patient morbidity and mortality.

Assessing sleep quality in gynecologic oncology patients after surgery

<h3>Objectives:</h3> High quality sleep is important for maintaining immune function, wound healing, and physical and emotional well-being. Our objective was to determine the quality of sleep in women admitted for post-operative recovery after surgical management for a suspected gynecologic malignancy. <h3>Methods:</h3> We surveyed women who were admitted to the hospital for at least one midnight after undergoing a surgical procedure for a suspected gynecologic malignancy between September 2020 and October 2020. The Pittsburgh Sleep Quality Index (19 item self-report questionnaire) was used to assess baseline sleep quality in the month prior to the planned procedure. The Richards-Campbell Sleep Questionnaire (5 item self-report survey) was used to assess nightly sleep quality during the subject's hospitalization. A chart review was also completed to assess for patient or surgical factors associated with poor sleep. <h3>Results:</h3> Twenty-three patients met the study criteria, of which 20 (87%) agreed to participate. The mean age was 58 (SD = 15), the mean BMI was 32.2 (SD = 8.3). Eighty percent of patients underwent surgery for confirmed malignancy, with uterine cancer (30%) and ovarian cancer (25) comprising the majority of diagnoses. The median admission length was 2 days interquartile range (IQR = 1-4.5), fifty percent of patients underwent an open procedure. Based on Pittsburgh Sleep Quality Index (PSQI) results, 15 patients (75%) reported poor sleep quality in the month prior to their surgery. The total RCSQ score was the worst on the first post-operative day (38.3, SD=28.3). Sleep quality improved on post-operative day 2 (67.3, SD=12.2), but then declined over the remainder of the hospitalization. <h3>Conclusions:</h3> Sleep quality is poor in women hospitalized after surgery with gynecologic oncologists. Sleep is an under recognized factor in optimizing postoperative recovery. The high prevalence of poor sleep during hospital-based post-operative recovery among gynecologic oncology patients warrants the development of evidence-based interventions for improving sleep and sleep quality.

A Prospective Study Evaluating Sleep Quality and Disorders in Post-ARDS Patients.

IntroductionCritically ill patients are predisposed to developing sleep disorders due to multiple factors like pre-existing sleep disorders, severe acute illness, sleep-altering medical interventions, and the disturbing intensive care unit (ICU) environment. In the current study, a multi-modality approach has been attempted to capture the different aspects of sleep disturbances, including insomnia (using ISI), daytime sleepiness (using ESS), sleep quality (using PSQI), sleep architecture, and SDB (using PSG).Materials and MethodsThe eligible ARDS survivor patients were updated about the study's design prior to hospital discharge. At admission, data regarding demographic details, clinical history, etiology of ARDS, and PaO2/FiO2 (P/F) ratio at presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores was collected. All enrolled patients were evaluated twice (early-within 7 days of admission and late-after 6 weeks of discharge) by the Richards–Campbell Sleep Questionnaire (RCSQ), Insomnia severity index (ISI), and level 1 PSG. Additionally, ESS questionnaire and the Pittsburgh Sleep Quality Index (PSQI) were also recorded in late evaluation. Abnormal sleep was defined if one or more of the following characteristics met: ISI > 15, ESS > 10, global PSQI > 5, AHI ≥ 5 events/h.ResultsThirty patients were recruited out of the total of 88 ARDS patients screened at admission. The median (IQR) PaO2/FiO2 ratio and APACHE II scores were 176 (151–191.5) and 14 (14–16), respectively. The median (IQR) duration of stay in the ICU was 10 (7.3–19.5) days. The median RCSQ score in the early and late evaluation was 42 and 69, respectively. The mean ISI score in the early evaluation was 16.67 ± 4.72, which decreased to 11.70 ± 5.03 in late evaluation (p < 0.05). ISI score > 15 (clinical insomnia) was found in 18 out of 30 subjects (60%) in early evaluation and 11 out of 30 (36%) in late evaluation. During the early evaluation, sleep efficiency was low (median 59.9% and predominantly N1 and N2) which improved in late evaluation (median 80.6%). Of the 30 patients, only 4 had AHI > 5 in early evaluation and none in late evaluation. Neither of P/F ratio, SOFA, and APACHE II scores did correlate with ICU events in the early and late evaluations. Regression analysis showed subjects with ICU stay more than 10 days, duration of IMV more than 7 days, Fentanyl more than 7 mg, duration of sedative use more than 7 days was independently associated with poor objective sleep quality (low sleep efficiency, low TST and high arousal index) during the early and late evaluations after ICU discharge compared to counterparts (p value < 0.05).ConclusionWe conclude that sleep quality in ARDS survivors was poor within 7 days of ICU discharge, characterized by severe disruption of sleep architecture and sleep-disordered breathing. After 6 weeks of ICU discharge sleep quality showed significant improvement in the N3 stage and AHI, however persistent insomnia was observed even at 6 weeks. Therefore, prior identification of risk factors and early diagnosis of sleep quality disorders in post-ARDS patients is essential.

Evaluation of the effectiveness of delirium prevention care protocol for the patients with hip fracture: A randomised controlled study

This study aimed to investigate the effectiveness of a delirium prevention care protocol on pain, functional status, sleep quality and delirium prevention in patients with hip fractures. The development of delirium following hip fracture is common among older patients. According to the National Institute for Health and Care Excellence, 30% of delirium cases are preventable. The prevention of delirium, a multifactorial syndrome, can be achieved through a multicomponent care protocol that targets specific risk factors for delirium. A randomised controlled study was conducted according to the CONSORT 2010guidelines. The Clinical Trial Registry number is NCT04188795. A total of 84 patients were assigned to two groups by block randomisation. The intervention group (n=41) received nursing care according to a protocol and the control group (n=43) received standard nursing care. Study data were collected using the demographic information form, the Confusion Assessment Method-Intensive Care Unit (CAM-ICU), the Barthel Index, the Mini Nutritional Assessment-short form and the Richards-Campbell Sleep Questionnaire (RCSQ). The pain of the patients was assessed by using a Visual Analog Scale (VAS). The mean age of the patients was 80.6years (standard deviation 8.0; range 65.0- 97.5years), and the percentage of the male patients were 36.3%. No statistically significant differences were found between the groups in terms of pain and functional status in the preoperative period, on the first postoperative day, or in the predischarge period (p>0.05 for each). The sleep quality of patients in the intervention group was significantly better than in the control group for all three time measurements (p<0.05 for each). While 15% of patients in the control group developed delirium, no patient in the intervention group developed delirium (x2 =6.486, p=0.026). This study demonstrated that a delirium prevention care protocol may reduce the incidence of delirium and improve sleep quality. The study highlighted that nurses can contribute to preventing patients' delirium using nonpharmacologic and independent nursing interventions.

Evaluation of dyspnea severity and sleep quality in patients with novel coronavirus.

AimDyspnea, a common symptom of novel coronavirus, can negatively affect sleep quality. The aim of this study was to evaluate the relationship between dyspnea severity and sleep quality in patients with COVID‐19.Study DesignA cross‐sectional design was used.MethodsUsing the researcher's mobile phone, data were collected via an online questionnaire from patients (n = 100) who agreed to participate in the study. The data‐collection form comprised three parts: a patient descriptive information form, the Dyspnea–12 Questionnaire, and the Richards–Campbell Sleep Questionnaire (RCSQ).ResultsThe mean age of patients was 46.39 ± 12.61 years and 66.0% were men. Patients who were treated in the intensive care unit had bachelor's degree or more and patients with comorbid diseases had low mean scores from the RCSQ and high mean scores from the Dyspnea–12 Questionnaire (P < .001, P < .001; P = .047, P < .001; P < .001, P < .001, respectively). Patients who were not receiving oxygen therapy had higher RCSQ mean scores and lower Dyspnea–12 Questionnaire scores (P < .001, P < .001; P < .001, P < .001, respectively). There was a strong negative relationship between the total scores obtained from the RCSQ and the Dyspnea–12 Questionnaire (r = −.701, P < .001).ConclusionsSleep quality is affected by dyspnea severity in patients with COVID‐19. Sleep quality and dyspnea severity are also influenced by quite different factors, and these should be addressed and eliminated by nurses as part of a holistic approach. The results of this study will help nurses, especially those providing treatment and care for patients with COVID‐19, to identify the factors affecting dyspnea and sleep quality and to plan, implement and evaluate nursing interventions that will reduce their workload.

The relationship between pain severity and sleep quality: Posttube thoracostomy.

The presence of a chest tube is a factor significantly associated with pain and pain posttube thoracostomy that negatively affects sleep quality (SQ). To determine the relationship between the pain severity and SQ of patients who underwent the tube thoracostomy (TT). This was a descriptive and cross-sectional survey conducted from May 1, 2018, to December 30, 2018, in the thoracic surgery department of Sivas Cumhuriyet University Hospital in Central Anatolia/Turkey. Data were collected using a questionnaire form, a Numerical Rating Scale to determine pain severity, and the Richard-Campbell Sleep Questionnaire to assess SQ. The study was carried out with 102 patients who underwent the TT. The mean age of the participants were 48.94 years. The mean scores for the scale items indicated that during the procedure and on the first day of post-TT, the pain severity of the patients was very high, their SQ was low. Pain level decreased gradually in the following days, and the SQ increased. There was a positive, strong correlation between the post-TT first day pain and first night SQ (r = 0.380, p = 0.000), second day pain and second night SQ (r = -0.537, p = 0.000), and third day pain and third night SQ (r = -0.507, p = 0.000). The results of this study highlight that the pain severity of post-TT significantly affect the quality of the patients' night sleep.

Cross-cultural adaptation of the Richards-Campbell Sleep Questionnaire for intensive care unit inpatients in Brazil: internal consistency, test-retest reliability, and measurement error

Study objectivesTo perform the cross-cultural adaptation of the Richards-Campbell sleep questionnaire (RCSQ) to Portuguese-Brazil and to eval its internal consistency, test-retest reliability, and measurement error in intensive care unit (ICU) inpatients. MethodsThe study enrolled 113 inpatients at medical/surgical ICU in Curitiba, Brazil. The RCSQ was first translated to Portuguese-Brazil according to the principles of good practice for the translation and cultural adaptation process for patient-reported outcomes and then applied in 30 inpatients. The final version (RCSQ-PT-Br) was applied to measure content validity (83 inpatients, 47 men [56.6%], 60.4 ± 14.2 years), and test-retest reliability and measurement error (a subset of 53 inpatients). Internal consistency of the RCSQ-PT-Br was estimated using Cronbach's a; test-retest reliability (2 independent rates) was assessed using the single measurement, absolute agreement, two-way random effects model (ICC2,1). ResultsGroup-average RCSQ-PT-Br total score was 46.9 ± 26.7 (range 3.4–98.8). The RCSQ-PT-Br total score showed good content internal consistency (Cronbach's α = 0.850 95%CI = [0.789–0.897]) and excellent test-retest reliability (ICC2,1 = 0.840 95% CI = [0.739–0.904]). Measurement error was low (standard error of mean = 11 mm, mean difference = 30 mm). ConclusionsThe RCSQ-PT-Br is a valid and reliable instrument to evaluate the sleep of patients hospitalized in the ICU in Brazil.

Is it Noise? Factors Linked With Sleep Interruption in Hospitalized Patients.

The aim of this study was to explore the perceived quality of sleep and sleep disturbances in hospitalized patients. A prospective descriptive, exploratory, cross-sectional study was conducted at a 172-bed community hospital in Northeast Ohio. A convenient sample of 100 hospitalized patients was recruited from medical/surgical, progressive care, and intensive care units. Participants used the Richards-Campbell Sleep Questionnaire to report sleep. A quality of sleep assessment survey was used to collect information regarding 17 factors leading to decreased quality of sleep. Mean sleep score was 47.92 for each question regarding sleep depth, latency, awakenings, time spent awake, and overall sleep quality. Pearson's correlation showed a significantly positive correlation between measure of noise and sleep score. Five environmental factors were identified as most disruptive to sleep: pain, laboratory draws, staff, blood pressure checks, and intravenous alarms. The positive correlation between sleeping well and higher noise levels is noteworthy. Raising awareness about the importance of sleep in the hospital setting and introducing interventions to promote a quiet environment and minimize sleep-disturbing factors may increase patient satisfaction scores and improve healing.