University of Michigan School of Nursing, Ann Arbor, MI, USA.
Barnes-Jewish College Goldfarb School of Nursing, St. Louis, MO, USA.
J Clin Nurs. 2018 Apr;27(7-8):e1377-e1384. doi: 10.1111/jocn.14262. Epub 2018 Jan 23.
To explore the context and the influence of night-time care routine interactions (NCRIs) on night-time sleep effectiveness (NSE) and daytime sleepiness (DSS) of patients in the cardiac surgery critical-care and progressive-care units of a hospital.
There exists a paucity of empirical data regarding the influence of NCRIs on sleep and associated outcomes in hospitalised adult cardiac surgery patients.
An exploratory repeated-measures research design was employed on the data provided by 38 elective cardiac surgery patients (mean age 60.0 ± 15.9 years). NCRI forms were completed by the bedside nurses and patients completed a 9-item Visual Analogue Sleep Scale (100-mm horizontal lines measuring NSE and DSS variables). All data were collected during postoperative nights/days (PON/POD) 1 through 5 and analysed with IBM SPSS software.
Patient assessment, medication administration and laboratory/diagnostic procedures were the top three NCRIs reported between midnight and 6:00 a.m. During PON/POD 1 through 5, the respective mean NSE and DSS scores ranged from 52.9 ± 17.2 to 57.8 ± 13.5 and from 27.0 ± 22.6 to 45.6 ± 16.5. Repeated-measures ANOVA showed significant changes in DSS scores (p < .05). NSE and DSS were negatively correlated (r = -.44, p < .05), but changes in NSE scores were not significant (p > .05). Finally, of 8 NCRIs, only 1 (postoperative exercises) was significantly related to sleep variables (r > .40, p < .05).
Frequent NCRIs are a common occurrence in cardiac surgery units of a hospital. Further research is needed to make a definitive conclusion about the impact of NCRIs on sleep/sleep disruptions and daytime sleepiness in adult cardiac surgery. Worldwide, acute and critical-care nurses are well positioned to lead initiatives aimed at improving sleep and clinical outcomes in cardiac surgery.
探索夜间护理常规互动（NCRI）对医院心脏外科重症监护病房和渐进式护理病房患者夜间睡眠效果（NSE）和日间嗜睡（DSS）的影响。
关于夜间护理常规互动对住院成年心脏手术患者睡眠和相关结果的影响，实证数据很少。
采用 38 名择期心脏手术患者（平均年龄 60.0 ± 15.9 岁）提供的数据，采用探索性重复测量研究设计。床边护士填写夜间护理常规互动表格，患者使用 9 项视觉模拟睡眠量表（100 毫米长的水平线段，测量 NSE 和 DSS 变量）。所有数据均在术后第 1 天至第 5 天的夜间/白天（PON/POD）期间收集，并使用 IBM SPSS 软件进行分析。
患者评估、药物管理和实验室/诊断程序是午夜至早上 6:00 之间报告的前三大夜间护理常规互动。在 PON/POD 1 至 5 期间，各自的平均 NSE 和 DSS 评分范围为 52.9 ± 17.2 至 57.8 ± 13.5，以及 27.0 ± 22.6 至 45.6 ± 16.5。重复测量方差分析显示 DSS 评分有显著变化（p <.05）。NSE 和 DSS 呈负相关（r = -.44，p <.05），但 NSE 评分的变化不显著（p >.05）。最后，在 8 项夜间护理常规互动中，只有 1 项（术后运动）与睡眠变量显著相关（r >.40，p <.05）。
频繁的夜间护理常规互动在医院的心脏外科病房很常见。需要进一步的研究来确定夜间护理常规互动对成年心脏手术患者睡眠/睡眠障碍和日间嗜睡的影响。在全球范围内，急性和重症监护护士非常适合领导旨在改善心脏手术患者睡眠和临床结果的倡议。
