Fernández-Puerta Laura, Prados Germán, Quiñoz-Gallardo María Dolores, Vellido-González Dolores, González-Guerrero María Leticia, Rivas-Campos Antonio, Jiménez-Mejías Eladio
Author Affiliations: Department of Nursing, School of Health Sciences, University of Granada (Ms Fernández-Puerta and Dr Prados); Virgen de las Nieves University Hospital, Granada (Ms Quiñoz-Gallardo, Vellido-González, González-Guerrero, and Mr Rivas-Campos); and Department of Preventive Medicine and Public Health, University of Granada (Dr Jiménez-Mejías), Spain.
Clin Nurse Spec. 2023;37(6):272-280. doi: 10.1097/NUR.0000000000000778.
Caregivers must cope with a poor sleep environment when caring for someone admitted to the hospital. The aim was to study the environmental factors associated with a sleep disruption pattern in caregivers during hospitalization and to test their association with caregivers' insomnia symptoms.
This was a cross-sectional study.
One hundred twenty-three caregivers completed the study. The effect of environmental stimuli on sleep disruption was measured on a scale from 1 to 10 (1 = no disruption, 10 = significant disruption). Type of room (single vs shared), insomnia symptoms, anxiety and depression, and patients' dependence (Barthel Index) were assessed as well. Caregiver and patient characteristics as well as identified hospital disruptors were compared with Student t test, χ2 test, and Fisher exact test according to the caregivers' type of room. A linear regression model using main caregiver and patient sociodemographic variables, questionnaires, and the sum of all hospital disruptors determined the factors associated with caregivers' insomnia symptoms.
Of the caregivers and their care recipients, 51.2% shared a room with 1 to 2 other patients. Higher self-reported levels of sleep disruption due to environmental stimuli were found in shared rooms when compared with single rooms (eg, nursing care, noise, and light) (P < .05). Hospital sleep disruptors (adjusted regression coefficient, 0.15; 95% confidence interval, 0.06-0.24) and caregiver anxiety (adjusted regression coefficient, 0.57; 95% confidence interval, 0.33-0.81) were predictors for insomnia (P < .01). However, caregivers' type of room was not associated with insomnia severity symptoms (P > .05).
Interventions are urgent to implement, such as relieving caregivers from patient needs during the night, providing them with single rooms, and conducting multiple nursing tasks in 1 visit to minimize night hospital noise.
照顾住院患者时，护理人员必须应对恶劣的睡眠环境。本研究旨在探讨住院期间与护理人员睡眠中断模式相关的环境因素，并检验这些因素与护理人员失眠症状的关联。
这是一项横断面研究。
123名护理人员完成了本研究。环境刺激对睡眠中断的影响采用1至10分制进行测量（1分 = 无干扰，10分 = 严重干扰）。同时评估了病房类型（单人病房与多人病房）、失眠症状、焦虑和抑郁情况以及患者的依赖程度（Barthel指数）。根据护理人员的病房类型，采用Student t检验、χ2检验和Fisher精确检验对护理人员和患者的特征以及确定的医院干扰因素进行比较。使用主要护理人员和患者的社会人口统计学变量、问卷以及所有医院干扰因素的总和构建线性回归模型，以确定与护理人员失眠症状相关的因素。
在护理人员及其护理对象中，51.2%的人与1至2名其他患者共用一间病房。与单人病房相比，多人病房中因环境刺激导致的自我报告睡眠中断水平更高（如护理、噪音和光线）（P < .05）。医院睡眠干扰因素（调整后的回归系数为0.15；95%置信区间为0.06 - 0.24）和护理人员焦虑（调整后的回归系数为0.57；95%置信区间为0.33 - 0.81）是失眠的预测因素（P < .01）。然而，护理人员的病房类型与失眠严重程度症状无关（P > .05）。
迫切需要实施干预措施，例如夜间让护理人员从照顾患者需求中解脱出来，为他们提供单人病房，并一次完成多项护理任务以尽量减少夜间医院噪音。
