Impacto del ambiente hospitalario en el ciclo sueño vigilia y la calidad del sueño de los pacientes
- Padilla Martínez, Julia María
- Eva Abad Corpa Director
- María Montserrat Sánchez Ortuño Director
Defence university: Universidad de Murcia
Fecha de defensa: 05 December 2024
- María José López Montesinos Chair
- Ismael Jiménez Ruiz Secretary
- Mª Teresa Rodríguez González Moro Committee member
Type: Thesis
Abstract
Introduction: Sleep constitutes a resting phase that is intrinsically linked to wakefulness, integrating the circadian sleep-wake cycle that repeats itself in a 24-hour interval. The scientific literature indicates that night-time sleep is frequently disturbed in hospitalised patients, mainly due to the constant noise of the environment, the activities carried out during the night by healthcare professionals, such as administering medication, taking vital signs, taking samples, etc., pain and the discomfort derived from certain hospital characteristics, among others. Inadequate sleep causes disturbances during the waking period and has repercussions on other rhythms and functions of the organism. Objectives: To analyse the characteristics of the sleep-wake cycle of patients admitted to National Health Service hospitals objectively and subjectively, as well as the relationship between them. To explore the relationship between the socio-demographic and health characteristics of the patients, as well as the variables derived from the hospitalisation itself and the nursing activities carried out during the night with the quality of sleep perceived by the patients. Methodology: Observational, descriptive and multicentre study carried out in 12 public hospitals of the National Health Service with a minimum of 350 beds and with professionals participating in the project SueñOn®. Inclusion criteria were: subjects over 18 years of age, minimum duration of the hospitalisation process of 96h, conscious and oriented. Exclusion criteria: people with visual and/or hearing impairment, Glasgow scale score of less than 9, patients with any type of isolation and those included in the palliative care plan. The variables assessed were obtained through two different methods. On the one hand, a data collection booklet was used to obtain socio-demographic, health and lifestyle variables, referring to the hospitalisation and sleep quality of the patients, as well as the different activities carried out by the nursing staff during the night. On the other hand, wrist devices were used to obtain circadian variables, differentiated between the period of sleep and wakefulness, and the stability of these. Data analysis was performed with SPSS 24.0, grouping descriptive data into categories. Qualitative variables were described with frequencies and percentages, and quantitative variables with means and standard deviations. For inferential analysis, the chi-square test was used for associations between qualitative variables, Spearman's correlation coefficient for quantitative variables and Student's t-test or ANOVA for relationships between quantitative and qualitative variables. A value of p<0.05 was considered significant. Conclusions: • During the hospitalisation period, changes are observed in the schedules of circadian variables related to sleep and wakefulness in patients, compared to normative values for a healthy adult population. • During the hospitalisation period, the stability/homogeneity of circadian variables is greater. • The age of the patients was associated with a delay in the circadian variable TAP_Sleep, which refers to the fact that the later the age, the later the central sleep time is located. • Poor sleep quality during the hospitalisation period was related to having pain throughout the time of admission, sharing a room most of the time, the discomfort of some hospital features such as the bed and linen, and the organisation of nursing activities carried out at night.