Sleep Patterns During Hospitalization Following Hematopoietic Stem Cell Transplantation.
Sleep Patterns During Hospitalization Following Hematopoietic Stem Cell Transplantation.
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DOI：
10.1188/15.onf.371-379
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发表时间：
2015-07
影响因子：
1.9
通讯作者：
Larson JL
中科院分区：
文献类型：
--
作者：
Hacker ED;Kapella MC;Park C;Ferrans CE;Larson JL
描述患者报告和客观的睡眠评估，并提供睡眠、生活质量和人口统计学或治疗因素之间关系的初步检查。使用描述性相关设计的二次数据分析。伊利诺伊大学医院和健康科学系统：40例接受造血干细胞移植（HCT）的患者住院接受调理方案、干细胞输注和立即恢复期。每位患者从HCT后第4天至第8天连续佩戴手腕活动记录仪，以客观评估睡眠模式（总睡眠时间、睡眠发作潜伏期、睡眠效率、睡眠发作后醒来和醒来次数）。在5天研究结束时，患者完成了睡眠障碍和生活质量的测量。客观睡眠（总睡眠时间、睡眠开始潜伏期、睡眠效率、睡眠开始后醒来和醒来次数）、主观睡眠（睡眠障碍）和生活质量。平均夜间总睡眠时间（客观获得）为232分钟（SD = 71分钟），14名患者（35%）在一个或多个研究日内连续睡眠时间少于3小时。年龄与患者报告的睡眠障碍呈负相关。患者报告的睡眠障碍与住院时间显著相关。患者报告和客观睡眠评估之间没有发现相关性。本研究客观地记录了接受HCT的住院患者睡眠不足和不规律。仅仅依赖病人报告的睡眠评估可能并不能代表问题的全部程度。尝试简化夜间护理，不叫醒病人进行常规护理，除非病人的病情表明（如美国护理学会所提倡的），并在夜间对症状（如腹泻）提供支持性护理，可能会减少醒来的次数，并可能改善整体睡眠质量。
To characterize patient-reported and objective sleep assessments and provide a preliminary examination of the relationships among sleep, quality of life, and demographic or treatment factors. A secondary data analysis using a descriptive-correlational design. University of Illinois Hospital and Health Sciences System. 40 patients undergoing a hematopoietic stem cell transplantation (HCT) hospitalized for the conditioning regimen, stem cell infusion, and immediate recovery period. Each patient wore a wrist actigraph continuously from the fourth day following HCT to the eighth day to objectively assess sleep patterns (total sleep time, sleep onset latency, sleep efficiency, wake after sleep onset, and number of awakenings). At the end of the five-day period, patients completed measures of sleep disturbance and quality of life. Objective sleep (total sleep time, sleep onset latency, sleep efficiency, wake after sleep onset, and number of awakenings), subjective sleep (sleep disturbance), and quality of life. The mean total nighttime sleep (objectively obtained) was 232 minutes (SD = 71 minutes), with 14 patients (35%) sleeping less than three consecutive hours during one or more study days. Age was negatively correlated with patient-reported sleep disturbance. Patient-reported sleep disturbance was significantly associated with length of hospital stay. No correlations were found between patient-reported and objective sleep assessments. This study objectively documents inadequate and irregular sleep in hospitalized patients undergoing HCT. Sole reliance on patient-reported sleep assessments may not represent the full extent of the problem. Attempts to streamline care during the night by not waking patients for routine care unless indicated by the patient’s condition (as advocated by the American Academy of Nursing) and providing supportive care for symptoms (such as diarrhea) during the night may reduce the number of awakenings and possibly improve overall sleep quality.