The Effect of Music and Eye Masks on Sleep Quality and Delirium in Abdominal Surgery Intensive Care Patients: Randomized Controlled Trial.

BACKGROUND

Postoperative delirium is a negative surgical outcome that can affect patients of any age, from children to elderly.

AIM

This study evaluated the impact of eye masks and music on sleep quality and delirium among patients in surgical intensive care units.

STUDY DESIGN

This study was designed as a randomized controlled trial. The study sample consisted of 45 patients (21 intervention and 24 control) who were hospitalized in the General Surgery Intensive Care Unit, underwent abdominal surgery and met the inclusion criteria. Patients were assigned to the experimental and control groups by simple randomization method. Patient Identification Form, Richard-Campbell Sleep Questionnaire (RCSQ), Nursing Delirium Screening Scale (Nu-DESC) and Richmond Agitation-Sedation Scale (RASS) were utilized. In the intervention group, patients were left with the eye masks applied after 22:00. Concurrently with the application of the eye masks, calming classical music was played for 1 h. Descriptive statistics, Chi-square test, Student's t-test, one-way analysis of variance (ANOVA), two-way repeated measures ANOVA and linear regression analysis were used. The CONSORT checklist was used in reporting the study.

RESULTS

On the third day of the study, the mean RCSQ score in the intervention group was statistically higher (72.95 ± 7.47, 49.66 ± 10.80; p < 0.001). The intervention group's mean Nu-DESC score was 0.14 ± 0.35, and the control group's score was 0.83 ± 0.56 (p < 0.001). Additionally, throughout the study, no delirium was observed in the intervention group, while delirium developed in 8.3% of the control group. A significant positive relationship was found between the application of music and eye masks post-surgery and the difference in RCSQ scores (zβ: 0.843; p < 0.001; [95% CI: 0.027; 0.041]). A significant negative relationship was found between the application of music and eye masks post-surgery and the difference in Nu-DESC delirium scale scores (zβ: -0.579; p < 0.001; [95% CI: -0.593; -0.234]).

CONCLUSION

The research concluded that listening to calming music for 1 h daily and wearing an eye mask before sleeping increased sleep quality and decreased the incidence of delirium.

RELEVANCE TO CLINICAL PRACTICE

Intensive care nurses can contribute to improving patients' sleep quality and preventing delirium by applying eye masks and playing music for the patients.