Martin David, Hurlbert Anya, Cousins David Andrew
Gateshead Health NHS Foundation Trust, Queen Elizabeth Hospital, Sheriff Hill, Gateshead, Tyne and Wear NE9 6SX, United Kingdom.
Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE1 7RU, United Kingdom.
Arch Psychiatr Nurs. 2018 Jun;32(3):379-383. doi: 10.1016/j.apnu.2017.12.001. Epub 2017 Dec 5.
Psychiatric inpatient units often maintain a degree of lighting at night to facilitate the observation of patients, but this has the potential to disrupt sleep. Certain wavelengths of light may be less likely to disturb sleep and if such lighting permitted adequate observations, patient wellbeing may be improved.
This study explored the effects of changing night-lights from broad-band white to narrow-band red on the amount of sleep observed, 'as required' medication administered and number of falls, in an old age psychiatry inpatient setting. Qualitative data was also gathered with a staff questionnaire. We hypothesised that compared to the use of white lights, red lights would be associated with a greater amount of recorded sleep, lesser use of 'as required' medication and no increase in the number of falls (reflecting comparable safety).
Whilst there were no significant differences in quantitative measures recorded, there were more observations of sleep during the red light period than the white light period (14.1 versus 13.9 times per night) (U=627.5, z=-0.69, p=0.49) and fewer 'as required' medication administrations during the red light period compared to the white light period (3.3 versus 4.8 times per night) (U=640.0, z=0.56, p=0.57). Qualitatively, the staff of the organic assessment unit reported that patients were sleeping better and less agitated at night.
Larger and more in-depth studies are required to examine the full effectiveness of using safe, sleep-enhancing lighting on wards at night.
精神科住院病房夜间通常保持一定程度的照明以方便观察患者,但这有可能扰乱睡眠。某些波长的光可能不太容易干扰睡眠,如果这种照明能允许进行充分的观察,患者的健康状况可能会得到改善。
本研究探讨了在老年精神科住院环境中,将夜间照明从宽带白光改为窄带红光对观察到的睡眠时间、按需给药量和跌倒次数的影响。还通过工作人员问卷收集了定性数据。我们假设,与使用白光相比,红光与更多的记录睡眠时间、更少的按需给药量以及跌倒次数不增加(反映出相当的安全性)相关。
虽然记录的定量指标没有显著差异,但红光期间观察到的睡眠次数比白光期间更多(每晚14.1次对13.9次)(U = 627.5,z = -0.69,p = 0.49),且红光期间按需给药的次数比白光期间少(每晚3.3次对4.8次)(U = 640.0,z = 0.56,p = 0.57)。定性方面,有机评估单元的工作人员报告称,患者夜间睡眠更好且躁动更少。
需要进行更大规模和更深入的研究,以检验夜间在病房使用安全的、有助于睡眠的照明的全面有效性。