Sasmita Das1,
Deepa O.V.2, Jhunilata
pradhan2, Sashmita kumari2
1Associate Dean, SUM Nursing College, SOA University,
Bhubaneswar.
2M.Sc Nursing, Jeopardize.
Corresponding Author
Email:
ABSTRACT:
Sleep is an essential part of the normal human
circadian rhythm. It is essential for maintenance of physical, sexual and
mental functions of the body. Studies well document the negative effects of
sleep deprivation (decreased vigilance, impaired decision-making, reduced
concentration, irritability, sleepiness, increased fatigue, and difficulty in
thinking clearly). Sleep deprivation is also well recognized as a stressor,
affecting human health in many adverse ways including memory impairment and
prolonged treatment spans of patients suffering from various illnesses. A quiet
environment is a prerequisite for most of the people to get into sleep. The
sleep pattern of persons getting admitted to the hospital can easily be
affected by illness or the unfamiliar routines. Both the quality and quantity
of sleep can be affected by the various reasons. The research approach adopted
was descriptive in nature. The study was conducted in IMS and SUM Hospital,
Bhubaneswar with a sample size of 100 patients. Non probability sampling method
was used for selecting the sample. Here descriptive and inferential statistics
were used for data analysis and interpretation. In major findings of the study
it was observed that, there are some factors which is responsible for sleep
disturbance during hospitalization and no significant association between the
sleep disturbances and selected socio demographic variable with age, marital
status, occupation, physical work and duration of hospitalization as the chi-
square value is 0.012, 0.105, 0.713, 1.033, 0.437 and 0.164 respectively which
is less than the tabulated value at 0.05 level of significant. The study
findings may useful for the health care personnel to assess the factors
affecting sleep disturbances during hospitalization, and they should take care
about that.
KEYWORDS: Assess, Sleep disturbances, selected factors and
Patients.
INTRODUCTION:
“Sleep is the golden chain that ties health
and our bodies together” -Thomas Dekker.
Sleep is a basic human need. It is a state of rest
accompanied by altered consciousness. Although the exact function of sleep is
unclear, people spend one third of their lives asleep. The advice that “Everything will look better
after a goodnight’s sleep” is based on the belief that
it promotes physical well being.
Without adequate rest, the brain's ability to function
quickly deteriorates. The brain works harder to counter act sleep deprivation
effects, but operates less effectively: concentration levels drop, and memory
becomes impaired. Sleep deprivation weakens the immune system leaving us more
susceptible to other diseases and disorders like diabetes, cancer and even the
common cold.
Similarly, problem solving and
decision-making abilities are compromised, and the brain falls into rigid
thought patterns that make it difficult to generate new problem-solving ideas.
Insufficient rest can also cause people to have hallucinations. Other typical
effects include depression, heart disease, hypertension, irritability, tremors
etc.
A sectional survey was conducted to assess quality of
sleep among 46 psychiatric In patients of London
psychiatric hospital. Pittsburg Sleep Quality Index was used to collect data.
Among that 78% of patients were poor sleepers. 8 patients reported anxiety, 3
reported medication errors, and 2 reported environmental noise as sleep
distracters. Excessive thinking, hard distress, food eaten, hunger, asthma, and
noises were reported as other sleep distracters by at least 1 patients each.1
A study conducted in Finland reveals that sleep
restriction increases the risk of developing cardiovascular diseases. It was
conducted among 13 young men by providing 4hrs of sleep per day for 5continous
nights and 8hrs sleep for other 2 continuous nights. Then the blood
investigation was done and the results showed that there is a significantly
increased activation of serum CRP (145%) and pro inflammatory cytokines after
sleep restriction which are important risk factors for
cardio vascular diseases.2
Disruption of sleep delays the recovery from traumatic
brain injury and it also causes anxiety, depression and worsens pain. It is
seen that it hinders the overall rehabilitation from TBI. Neural remodeling
that is necessary for recovery from brain injury is also affected by sleep disruption.3
Insufficient sleep is a common and long-standing
condition, most strongly associated with sleep/wake variables. One third of the
liability to it is attributed to genetic influences. Sleep sufficiency should
be assessed in health examinations of working adults.4
Environmental factors were found to be related to most of
the patients' sleep disturbances: 80% of them regarded those factors as the
cause for their disturbed sleep. Other patients, noise, and the nurses' work
were regarded as the most disturbing of the environmental factors. The internal
factors had disturbed patients' sleep in the hospital less than the
environmental factors. Pain was regarded as the most sleep disturbing internal
factor: over half of the researched patients felt disturbed by it. During their
stay in the hospital the patients experienced more positive (trust,
contentment, safety) than negative feelings (fear, anxiety, depression,
distrust), and those who experienced negative feelings had more difficulties in
sleeping.5
Majority of patients were experiencing changes in their
sleep behaviors in hospital .As for the factors affecting the patient’s sleep;
environmental factors such as poor ventilation of hospital rooms, treatments
and assessments during sleeping hours, frequent visits, and individual factors
such as pain were noted. Gender and the education level of patients were
considered to influence sleep patterns, but the patient’s age, clinics stayed
in, duration of hospital stay, room characteristics and former experience were
not considered to influence the patient’s sleep pattern.6
Disturbed sleep affects recovery from illness. By
identifying the factors that interfere with the sleep of patients sleep, nurses
can take care to prevent these factors and can promote early recovery. Above
mentioned factors motivated the researcher to conduct this study.
OBJECTIVES:
Ø To assess
a. Factors associated with sleep
disturbances.
b. Level of sleep disturbances among the
patient admitted in different ward of IMS AND SUM Hospital.
Ø To find out the association between the sleep disturbances with selected
demographic factors.
RESEARCH
METHODOLOGY:
Research Approach
and Research Design:-
An descriptive survey approach and
quantitative cross-sectional design was
adopted for the study.
Setting of the study:-
The study was conducted in IMS andSUM
Hospital, Bhubaneswar.
Sample and Sampling Technology:-
The sample size is 200 patients of various wards of SUM Hospital
Bhubaneswar by non probability purposive sampling.
Tools Used for Data Collection:-
A background information format and self structured questionnaire was
used to assess the sleep disturbance among patients admitted in IMS and SUM
Hospital.
Development of Tool:-
The investigators undertook a detailed review of literature about sleep
disturbance among patients admitted in hospital and developed data collection
tool. The tool consisted of two sections.
Section-A includes information’s regarding their age, marital status, monthly
income, occupation, physical work and duration of hospitalization.
Section-B Questionnaire is prepared to assess sleep disturbances among the
patients admitted in different wards of IMS and SUM HOSPITAL.
Data analysis:-
Descriptive and Inferential statistics were used for the
data analysis and interpretation. Frequency and percentage distribution of
socio demographic characteristics of sample was done.
RESULTS AND
DISCUSSION:
Ø The characteristic of patients in terms of their percentage distribution
were were16% of them were in age group 20 -30 years, 33% of them were in the
age group of 30-40 years, 29% of them were in age group 40-50 years22% of them
were in age group above 50 years.
Ø Related to marital status 76% of
them were married, 23% of them were unmarried, 0% divorcee and 1% of them was widow.
Ø Distribution of samples according to monthly income was found in 65% in
5000-15000 Rs/month, 35%15001-25000/month, 0% for 25001-35000/month and 0% for
above 35000/month.
Ø Distribution of samples according to occupation were found 57% in
private job,26% in Govt job, 16% in Semi Govt job and 1% were unemployed.
Ø According to type of physical work 27% was heavy work, 35%was sedentary
work, 38% of them were moderate.
Ø Distribution of samples according to duration of hospitalization 42% for
1-5 days,33% for 6-10 days,14% for 11-15 days,11%for above 15 days.
Analysis for the factors influencing in sleep
disturbances in terms of percentage were
Ø
57% of them had adequate sleep during
hospitalization,
Ø
53% of them were anxious about their
hospitalization,
Ø
36% of patients had disturbance in
sleep during hospital rounds
Ø
28% of patients were interrupted in
sleep during medication time in hospital
Ø
36% of them were interrupted in sleep
for investigations
Ø
44% of patients sleep was disturbed due
to neighbor patient
Ø
53% of patients were feeling insecure
by observing neighbor patients procedure
Ø
62% of patients sleep was disturbed due
to sound produced in hospital
Ø
68% of patients felt hospital bed
comfortable for sleep
Ø
44% of patient’s sleep was disturbed
due to light coming from the own shared room or from the ward
Ø
67% of patient’s sleep was disturbed
due to noise coming from the own shared room or from the ward,
Ø
23% patient’s sleep was disturbed due
to interaction among staff
Ø
55% patients sleep was disturbed due to
hospital visiting schedule
Ø
62% patients sleep was disturbed due to
any kind of thoughts or worries related to disease
Ø
19% patients sleep was disturbed while
taking vital signs.
This study
finds that there was significant association between the sleep disturbances and
selected socio demographic variable with age, marital status, physical work and
duration of hospitalization as the chi-square value is 4.012, 5105, 5.713,
4.033, and 7.437 respectively which is more than the tabulated value at 0.05
level of significance.
On this basis of above findings of the study, it is
recommended that can be replicated on large sample in a different setting to
have a wider applicability by generalization.
CONCLUSION:
The findings of the study showed that various factors are
responsible for sleep disturbances of the patients during hospitalization,
which may stand as an obstacle for the early recovery. This indicates that
sleep is a golden chain which should be of major concern in the present day
health care scenario.
REFERENCE:
1.
Donaldson L, Chintapanti P K. Mental illness and comorbid
insomnia : a cross sectional study of a population of psychiatric in
patients. British journal of medical practitioners 2009 june ; 2( 2). P 36-41.
2.
Leuwen V, Lehto M etal. Sleep restriction increases the risk of developing
cardio vascular diseases by augmenting pro inflammatory responses through IL-17
and CRP. PLoS one 2009 Feb; l4 (2): 134
3.
Zeitzer J M, Friedman L. Insomnia in the context of traumatic brain
injury. Journal of rehabilitation and research development 2009 46(6):827-36.
4.
Hublin C, Kaprio J,
Partinen M, Koskenvuo M.
Insufficient sleep--a population-based study in adults. Sleep 2001;24: 392-400.
5.
Kuivalainen L, Ryhanen A, Isola A, Merilainen P. Sleep disturbances affecting hospital
patients. Hoitotiede 1998; 10: 134-43.
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Serife Karagozoglu,
Sibel cabuk et al . Some factors influencing the sleep of hospitalized adult
patients. Taraks Dergisi
2007; 8(4):234-40
Received on 15.11.2014 Modified on 18.11.2014
Accepted on 02.12.2014 © A&V Publication all right reserved
Asian
J. Nur. Edu. and Research 5(2): April-June
2015; Page302-304
DOI: 10.5958/2349-2996.2015.00061.0