强化睡眠管理在住院精神科病房中的可行性及效用
Feasibility and utility of enhanced sleep management on in-patient psychiatry wards.
作者信息
Novak Chloe, Packer Emma, Paterson Alastair, Roshi Ambrina, Locke Rosie, Keown Patrick, Watson Stuart, Anderson Kirstie N
机构信息
Department of Psychology, Newcastle University, UK.
Department of Psychology, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, UK.
出版信息
BJPsych Bull. 2020 Dec;44(6):255-260. doi: 10.1192/bjb.2020.30.
AIMS AND METHOD
Sleep disturbance is common in psychiatry wards despite poor sleep worsening mental health. Contributory factors include the ward environment, frequent nightly checks on patients and sleep disorders including sleep apnoea. We evaluated the safety and feasibility of a package of measures to improve sleep across a mental health trust, including removing hourly checks when safe, sleep disorder screening and improving the ward environment.
RESULTS
During the pilot there were no serious adverse events; 50% of in-patients were able to have protected overnight sleep. Hypnotic issuing decreased, and feedback from patients and staff was positive. It was possible to offer cognitive-behavioural therapy for insomnia to selected patients.
CLINICAL IMPLICATIONS
Many psychiatry wards perform standardised, overnight checks, which are one cause of sleep disruption. A protected sleep period was safe and well-tolerated alongside education about sleep disturbance and mental health. Future research should evaluate personalised care rather than blanket observation policies.
目的与方法
尽管睡眠质量差会使心理健康恶化，但睡眠障碍在精神科病房中很常见。促成因素包括病房环境、夜间对患者的频繁检查以及包括睡眠呼吸暂停在内的睡眠障碍。我们评估了一套措施在一个心理健康信托机构中改善睡眠的安全性和可行性，这些措施包括在安全的情况下取消每小时的检查、睡眠障碍筛查以及改善病房环境。
结果
在试点期间没有严重不良事件；50%的住院患者能够获得受保护的夜间睡眠。催眠药物的发放减少，患者和工作人员的反馈是积极的。有可能为选定的患者提供失眠的认知行为疗法。
临床意义
许多精神科病房进行标准化的夜间检查，这是睡眠中断的一个原因。受保护的睡眠时间是安全的，并且在对睡眠障碍和心理健康进行教育的同时，耐受性良好。未来的研究应该评估个性化护理而不是一刀切的观察政策。
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