Lee Sueyeon, Chen Pei, Park Chang, Zhu Bingqian, Balserak Bilgay I
Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, Illinois, USA.
College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
J Clin Nurs. 2024 Dec 4. doi: 10.1111/jocn.17583.
To synthesise up-to-date research evidence for non-pharmacological interventions to improve various sleep outcomes (e.g., sleep quality, duration) in postsurgical cardiac patients.
Sleep disturbances are common amongst postsurgical cardiac patients, yet the effectiveness of non-pharmacological interventions in improving various sleep outcomes has not been comprehensively reviewed.
A systematic review and meta-analysis guided by the PRISMA protocol.
CINAHL, PubMed, PsycINFO, Embase, Web of Science, and Cochrane Library were searched for relevant research in May 2023. Included studies used a randomised controlled trial design that applied a non-pharmacological intervention for postsurgical cardiac patients and reported sleep as an outcome. For the meta-analysis, mean effect sizes were separately calculated for studies with regular and reverse-scored scales.
Of 37 studies included, the most common cardiac surgery was coronary artery bypass graft. Most interventions were performed within the first postoperative week and assessed sleep quality outcomes using the Pittsburgh Sleep Quality Index. The interventions are categorised into five types. Human resource-based strategies emerged as the most effective. The meta-analysis of 27 eligible studies showed a mean effect size of 0.76 for studies with regular scoring scales and - 1.04 for those with reverse-scored scales, indicating medium to large effect sizes.
Our findings provide strong evidence that non-pharmacological interventions, particularly human resource-based strategies, significantly improve sleep quality in postsurgical cardiac patients. The medium to large effect sizes underscore the clinical significance of these findings.
Healthcare professionals should consider incorporating non-pharmacological interventions, especially human resource-based strategies, in care plans for postsurgical cardiac patients to improve sleep outcomes and promote recovery. These interventions should be tailored to individual physical and cultural differences for maximum effectiveness. Future research should evaluate the long-term effects of these interventions on various sleep outcomes, using both objective and subjective measures to provide a comprehensive assessment of their efficacy.
This study adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol.
Patient and public contributions were not required for this review.
综合最新研究证据，探讨非药物干预措施对改善心脏手术后患者各种睡眠结局（如睡眠质量、睡眠时间）的效果。
睡眠障碍在心脏手术后患者中很常见，但非药物干预措施在改善各种睡眠结局方面的有效性尚未得到全面综述。
采用PRISMA方案进行系统评价和荟萃分析。
于2023年5月检索CINAHL、PubMed、PsycINFO、Embase、Web of Science和Cochrane图书馆，查找相关研究。纳入的研究采用随机对照试验设计，对心脏手术后患者实施非药物干预，并将睡眠作为结局指标进行报告。对于荟萃分析，分别计算采用常规评分量表和反向评分量表的研究的平均效应量。
在纳入的37项研究中，最常见的心脏手术是冠状动脉搭桥术。大多数干预措施在术后第一周内进行，并使用匹兹堡睡眠质量指数评估睡眠质量结局。干预措施分为五种类型。基于人力资源的策略被证明是最有效的。对27项符合条件的研究进行的荟萃分析显示，采用常规评分量表的研究平均效应量为0.76，采用反向评分量表的研究平均效应量为 -1.04，表明效应量为中等至较大。
我们的研究结果提供了有力证据，表明非药物干预措施，特别是基于人力资源的策略，能显著改善心脏手术后患者的睡眠质量。中等至较大的效应量凸显了这些研究结果的临床意义。
医疗保健专业人员应考虑将非药物干预措施，特别是基于人力资源的策略，纳入心脏手术后患者的护理计划中，以改善睡眠结局并促进康复。这些干预措施应根据个体的身体和文化差异进行调整，以达到最大效果。未来的研究应评估这些干预措施对各种睡眠结局的长期影响，同时使用客观和主观测量方法全面评估其疗效。
本研究遵循系统评价和荟萃分析的首选报告项目（PRISMA）方案。
本综述无需患者和公众参与。
