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重症监护病房患者睡眠障碍非药物管理的最佳证据总结

Summary of the Best Evidence for Non-Pharmacological Management of Sleep Disturbances in Intensive Care Unit Patients.

作者信息

Zhang Meijie, Yang Fei, Wang Chenwei, Xiu Meng, Zhang Weiying

机构信息

School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.

Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

J Clin Nurs. 2025 Jan 21. doi: 10.1111/jocn.17622.

Abstract

AIM

To retrieve, evaluate and summarise the best evidence for non-pharmacological management of sleep disturbances in ICU patients, and to provide basis for clinical nursing practice.

DESIGN

This study was an evidence summary followed by the evidence summary reporting standard of Fudan University Center for Evidence-based Nursing.

METHODS

All evidence on non-pharmacological management of sleep disturbances in ICU patients from both domestic and international databases and relevant websites was systematically searched, including guidelines, expert consensuses, best practice, clinical decision-making, evidence summaries and systematic review.

DATA SOURCES

UpToDate, BMJ Best Practice, Joanna Briggs Institute, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, National Institute for Health and Clinical Excellence, Yi Maitong Guidelines Network, Registered Nurses Association of Ontario, Canadian Medical Association: Clinical Practice Guideline, Guidelines International Network, WHO, the Cochrane Library, CINAHL, Embase, PubMed, Web of Science, CNKI, WanFang database, VIP database, SinoMed, The American Psychological Association, European Sleep Research Society, American Academy of Sleep Medicine and National Sleep Foundation were searched from the establishment of the databases to June 1, 2024.

RESULTS

A total of 18 pieces of literature were included, involving 4 guidelines, 2 expert consensuses, 1 best practice and 11 systematic reviews. 25 pieces of evidence covering 4 categories of risk factors, sleep monitoring, non-pharmaceutical intervention, education and training were summarised.

CONCLUSION

This study summarises the best evidence for non-pharmacological management of sleep disturbances in ICU patients. In clinical application, medical staff should make professional judgements and fully combine clinical situations and patient preferences to select evidence, laying a theoretical foundation for later empirical research to reduce the incidence of sleep disturbances in ICU patients and improve the sleep quality of critically ill patients.

IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE

Medical staff can refer to the best evidence to provide reasonable non-pharmacological management plans for sleep disturbances in ICU patients, improving their sleep quality and life satisfaction.

IMPACT

The management of sleep disturbances in critically ill patients has not received sufficient attention and standardisation. This study summarises 25 pieces of the best evidence for non-pharmacological management of sleep disturbances in critically ill patients. Accurate and standardised evaluation and monitoring are the foundation of sleep management for ICU patients. This summary of evidence can help ICU nurses enhance their clinical practice.

REPORTING METHOD

This evidence summary followed the evidence summary reporting specifications of Fudan University Center for Evidence-based Nursing, which were based on the methodological process for the summary of the evidence produced by the Joanna Briggs Institute. This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing; the registration number is 'ES20231708'.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

摘要

目的

检索、评估和总结ICU患者睡眠障碍非药物管理的最佳证据,为临床护理实践提供依据。

设计

本研究是一项循证总结,遵循复旦大学循证护理中心的循证总结报告标准。

方法

系统检索国内外数据库及相关网站中关于ICU患者睡眠障碍非药物管理的所有证据,包括指南、专家共识、最佳实践、临床决策、循证总结和系统评价。

数据来源

检索UpToDate、BMJ最佳实践、乔安娜·布里格斯研究所、苏格兰校际指南网络、国家指南库、英国国家卫生与临床优化研究所、医脉通指南网络、安大略省注册护士协会、加拿大医学协会临床实践指南、指南国际网络、世界卫生组织、考克兰图书馆、护理学与健康领域数据库、荷兰医学文摘数据库、医学期刊数据库、科学引文索引数据库、中国知网、万方数据库、维普数据库、中国生物医学文献数据库、美国心理学会、欧洲睡眠研究学会、美国睡眠医学学会和美国国家睡眠基金会,检索时间从各数据库建库至2024年6月1日。

结果

共纳入18篇文献,包括4篇指南、2篇专家共识、1篇最佳实践和11篇系统评价。总结出25条证据,涵盖危险因素、睡眠监测、非药物干预、教育培训4个类别。

结论

本研究总结了ICU患者睡眠障碍非药物管理的最佳证据。临床应用中,医护人员应进行专业判断,充分结合临床情况和患者偏好选择证据,为后续实证研究奠定理论基础,以降低ICU患者睡眠障碍的发生率,提高危重症患者的睡眠质量。

对专业和患者护理的意义

医护人员可参考最佳证据,为ICU患者睡眠障碍提供合理的非药物管理方案,提高其睡眠质量和生活满意度。

影响

危重症患者睡眠障碍的管理未得到充分重视和规范。本研究总结了25条危重症患者睡眠障碍非药物管理的最佳证据。准确规范的评估和监测是ICU患者睡眠管理的基础。这一证据总结有助于ICU护士提升临床实践水平。

报告方法

本循证总结遵循复旦大学循证护理中心的循证总结报告规范,该规范基于乔安娜·布里格斯研究所的证据总结方法流程。本研究基于复旦大学循证护理中心的循证总结报告规范;注册号为“ES20231708”。

患者或公众贡献

无患者或公众参与。

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