Iwamoto Junko, Obayashi Kenji, Kobayashi Miwa, Kotsuji Toshimichi, Matsui Rie, Ito Kyoko, Yoshida Osamu, Kurumatani Norio, Saeki Keigo
a Department of Nursing , Tenri Health Care University , Nara , Japan.
b Department of Epidemiology , Nara Medical University School of Medicine , Nara , Japan.
Chronobiol Int. 2018 May;35(5):719-723. doi: 10.1080/07420528.2018.1430036. Epub 2018 Jan 26.
Light is crucial for the synchronization of internal biological rhythms with environmental rhythms. Hospitalization causes a range of unfavorable medical conditions, including delirium, sleep disturbances, depressed mood, and increased fall, especially in elderly people. The hospital room environment contributes significantly to patients' circadian physiology and behavior; however, few studies have evaluated light intensity in hospital settings. In this study, bedside light intensity during the daytime (6:00-21:00) was measured at 1-min intervals using a light meter on 4869 bed-days at the Inabe General Hospital in Mie, Japan (latitude 35°N), for approximately 1 month in each season. Daytime light exposure in home settings was measured in nonhospitalized elderly individuals (n = 1113) for two consecutive days at 1-min intervals using a wrist light meter. Median daytime light intensities at window and nonwindow hospital beds were 327.9 lux [interquartile range (IQR), 261.5-378.4] and 118.4 lux (IQR, 100.6-142.9), respectively, and daytime light intensity measured in nonhospitalized elderly individuals was 337.3 lux (IQR, 165.5-722.7). Compared with data in nonhospitalized elderly individuals, nonwindow beds were exposed to significantly lower daytime light intensity (p < 0.001), whereas window beds were exposed to similar daytime light intensity to that of home settings (p = 1.00). These results were consistent regardless of seasons (spring, summer, fall, and winter) or room directions (north vs. south facing). The lowest median daytime light intensity was observed at nonwindow beds in north-facing rooms during the winter (84.8 lux; IQR, 76.0-95.8). Further studies evaluating the incidence of in-hospital outcomes between patients hospitalized in window and nonwindow beds are needed.
光线对于使内部生物节律与环境节律同步至关重要。住院会引发一系列不利的医疗状况,包括谵妄、睡眠障碍、情绪低落以及跌倒风险增加,尤其是在老年人中。医院病房环境对患者的昼夜生理和行为有显著影响;然而,很少有研究评估医院环境中的光照强度。在本研究中,日本三重县伊贺市伊贺综合医院(北纬35°),在每个季节约1个月的时间里,使用光度计在4869个床日的白天(6:00 - 21:00)每隔1分钟测量一次床头光照强度。使用腕式光度计,对1113名未住院的老年人连续两天每隔1分钟测量其在家中的白天光照暴露情况。窗边和非窗边病床的白天光照强度中位数分别为327.9勒克斯[四分位间距(IQR),261.5 - 378.4]和118.4勒克斯(IQR,100.6 - 142.9),未住院老年人测量的白天光照强度为337.3勒克斯(IQR,165.5 - 722.7)。与未住院老年人的数据相比,非窗边病床的白天光照强度显著更低(p < 0.001),而窗边病床的白天光照强度与家中环境相似(p = 1.00)。无论季节(春、夏、秋、冬)或房间朝向(朝北与朝南),这些结果都是一致的。冬季朝北房间的非窗边病床白天光照强度中位数最低(84.8勒克斯;IQR,76.0 - 95.8)。需要进一步研究评估在窗边和非窗边病床住院的患者之间院内结局的发生率。