A scoping review of sleep education and training for nurses

Shift work sleep disorder in nurses: a concept analysis

AIM

This study seeks to elucidate the concept of shift work sleep disorder (SWSD) among nurses, thereby offering a comprehensive understanding that can inform future research and practical interventions.

METHODS

Walker and Avant's concept analysis method was employed to guide the study. A systematic literature review was conducted utilizing various databases, including PubMed, Embase, EBSCO, Web of Science, CNKI, WanFang, and Sino Med. The inclusion criteria were specifically designed to focus on studies that define SWSD, along with its attributes, antecedents, consequences, and assessment tools relevant to nursing professionals.

RESULTS

The analysis identified four key attributes of SWSD: internal/external circadian rhythm imbalance, impaired sleep, multidimensional health problems, and dynamic changes in symptoms. Antecedents include individual factors like personal health, lifestyle, family support, shift patterns, work environment, and other organizational factors. Consequences of SWSD encompass physiological health issues, mental health challenges, impaired social adaptability, and decreased nursing performance.

CONCLUSION

SWSD has a significant impact on the health and performance of nurses. Understanding its attributes, antecedents, and consequences is crucial for developing targeted interventions. Enhancing sleep hygiene, fostering supportive work environments, and implementing appropriate shift scheduling can help mitigate the adverse effects associated with SWSD.

Determinants of sleep quality and their impact on health outcomes: a cross-sectional study on night-shift nurses

Purpose

This study aimed to identify determinants of sleep quality and explore their adverse health outcomes among night-shift nurses in China.

Method

Through convenience sampling, this cross-sectional study enrolled a total of 711 night-shift nurses aged 20-55 years who completed questionnaires from which details regarding their sociodemographic characteristics, health-related indicators and sleep quality based on the Pittsburgh Sleep Quality Index (PSQI) were extracted. A generalized linear regression analysis was then created to identify factors influencing sleep quality. Pearson correlation analysis was used to analyze the relationship between sleep quality and chronic fatigue.

Results

The prevalence rate of poor sleep quality among night-shift nurses reached as high as 90.1%. Our results showed that education level, years of working experience, quality of make-up sleep before and after night shifts, daily routine and diet were the primary factors affecting sleep quality (p < 0.01). Nurse fatigue had a significant positive correlation with subjective sleep quality, sleep latency, sleep duration, sleep disturbance, medications to sleep, daytime dysfunctions and global sleep quality (p < 0.01). However, nurse sleep efficiency had a significant negative correlation with fatigue (p < 0.01).

Conclusions

Higher education level, longer working years, worse quality of make-up sleep before and after night shifts, daily routine and daily diet were risk factors for poor sleep quality among nurses. Poor sleep among night-shift nurses is strongly correlated with chronic fatigue.

Barriers and enablers to screening, management and referral of sleep disorders in patients attending cardiac rehabilitation: A qualitative descriptive study

AIMS

To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings.

DESIGN

A qualitative descriptive study. Data were collected via semi-structured interviews.

METHODS

In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized.

RESULTS

Six themes and 20 sub-themes were identified. Non-validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed.

CONCLUSION

Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness.

IMPACTS

The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post-cardiac event counselling.

REPORTING METHOD

Adherence to COREQ guidelines was maintained.

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution as this study explored health professionals' experiences only.

Sleep Quality Should Be Assessed in Inpatient Rehabilitation Settings: A Preliminary Study

OBJECTIVES

In this preliminary, longitudinal study, our objective was to assess changes in sleep quality during an inpatient stay in a rehabilitation setting in the United States and to relate changes to patients' demographic and clinical characteristics (i.e., age, gender, BMI, ethnicity, reason for hospitalization, pre-hospital living setting, prior diagnosis of sleep disorders, and mental health status).

METHODS

A total of 35 patients participated in this preliminary study (age = 61 ± 16 years old, 50% <65; BMI = 30 ± 7 kg/m²; 51% female; 51% Caucasian). The average length of hospitalization was 18 ± 8 days. Reasons for hospitalization included orthopedic-related issues (28%), spinal cord injury (28%), stroke (20%), and other (23%). In this sample, 23% had prior sleep disorders (mostly sleep apnea), and 60% came from an acute care unit. Patients' sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) at admission and before discharge. Demographic and medical data were collected. Patients' mental health status was also assessed at the same intervals. Nighttime sound levels and the average number of sleep disturbances were also collected throughout the study (6 months).

RESULTS

Our data revealed that most patients had poor sleep (PSQI > 5) at admission (86%) and discharge (80%). Using a repeated ANOVA, a significant interaction was obtained between sleep quality and the presence of a diagnosed sleep disorder [F (1, 33) = 12.861, p = 0.001, η²_p = 0.280]. The sleep quality of patients with sleep disorders improved over their stay, while the sleep of patients without such disorders did not. The mean nighttime sound collection level averages and peaks were 62.3 ± 5.1 dB and 86.1 ± 4.9 dB, respectively, and the average number of sleep disturbances was 2.6 ± 1.1.

CONCLUSION

The improved sleep observed in patients with vs. without sleep disorders might be related to the care received for treating such disorders over the stay. Our findings call for the better detection and management of poor sleep in acute inpatient rehabilitation settings. Furthermore, if our findings are replicated in the future, studies on the implementation of quiet times for medical staff, patients, and family should be performed to improve sleep quality in the inpatient rehabilitation setting.