The effect of nursing care provided to coronary intensive care patients according to their circadian rhythms on sleep quality, pain, anxiety, and delirium: a randomised controlled trial

BMC Nursing, Год журнала: 2025, Номер 24(1)

Опубликована: Фев. 7, 2025

This study carried out to examine the effects of nursing care given coronary intensive patients according their circadian rhythms on sleep quality, pain, anxiety, and delirium. was designed as a randomised controlled, clinical investigation. The population consisted treated in unit training research hospital between September 2022 February 2023. Total 44 participants were included. included followed up for 3 days unit. Data collected using "Patient Information Form, Sleep Quality Scale Coronary Intensive Care Patients (SQ-CC), Visual Analogue (VAS), Morningness-Eveningness Questionnaire (MEQ), Hospital Anxiety Depression (HADS), Delirium Screening Checklist (ICDSC)." In addition, melatonin cortisol measurements made, data taken with smartwatch. intermediate chronotype, delirium, ventilator support, or sedative drugs excluded. chronotypes determined, intervention group by rhythms. No made control group, routine continued accordance functioning. Frequency distribution, dependent independent sample t-test, Wilcoxon test, repeated measures analysis variance, Mann Whitney U, chi-square used evaluate data. has been registered ClinicalTrials.gov (Identifiers: NCT04934436). During statistical analysis, groups coded Group A B, ensuring blinding statistician. group's quality increased compared (post-test SQ-CC total scores: 22.41 ± 6.67 vs. 50.45 10.63, p < 0.001). Although no significant difference found result study, there decrease pain score (VAS pre-test: 1.55 2.15, post-test: 0.68 2.21, = 0.036). anxiety decreased significantly HADS-Anxiety 3.18 3.29 8.50 5.66, post-test delirium higher ICDSC 0.32 0.48 1.18 0.50, Melatonin both without statistically differences them (melatonin levels: > 0.05). Considering sound levels environment, first-night decibel mean than (first-night mean: 56.58 2.43 dB 54.51 2.41 dB, Finally, smartwatch show times (p 0.05), but had more deep sleep, while less sleep. Nursing rhythm increases reduces risk acute syndrome

Язык: Английский

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The Impact of Earplugs and Eye Masks on Sleep Quality in Surgical ICU Patients at Risk for Frequent Awakenings

Critical Care Medicine, Год журнала: 2021, Номер 49(9), С. e822 - e832

Опубликована: Апрель 8, 2021

OBJECTIVES: Sleep disturbances may contribute to the development of delirium, prolonged ICU stay, and increased mortality. There is conflicting data on effectiveness earplugs eye masks for sleep promotion in ICU. This study evaluates impact quality postoperative surgical patients at risk frequent awakenings. DESIGN: Prospective randomized controlled trial. SETTING: Surgical within University Texas Southwestern Medical Center. PATIENTS: Adult, female admitted requiring hourly assessments following breast free flap surgery between February 2018 October 2019. INTERVENTIONS: Patients were into an intervention group or a control group. The received addition standard care, whereas care. MEASUREMENTS AND MAIN RESULTS: primary outcome was overall assessed via Richards-Campbell Questionnaire. Secondary outcomes patient satisfaction rates delirium with modified version Family Satisfaction survey Confusion Assessment Method After planned interim analysis, stopped early because prespecified criteria significance attained. Compared group’s average Questionnaire total score 47.3 (95% CI, 40.8–53.8), significantly higher 64.5 58.3–70.7; p = 0.0007). no significant between-group differences scores scores. CONCLUSIONS: These results suggest that are effective improving undergoing assessments. strengthen evidence nonpharmacologic sleep-promoting adjuncts

Язык: Английский

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Dexmedetomidine: a magic bullet on its way into palliative care—a narrative review and practice recommendations

Annals of Palliative Medicine, Год журнала: 2022, Номер 11(4), С. 1491 - 1504

Опубликована: Апрель 1, 2022

Background and Objective: Dexmedetomidine is a potent adrenergic alpha-2 receptor agonist. It was first approved for sedation mechanically ventilated patients. Being sedative medication that not associated with respiratory depression holding analgesic properties fosters the interest this drug in palliative care field. The primary objectives of review were to identify key indications real-world use dexmedetomidine other disciplines. Methods: A narrative after extensive PubMed search performed from 1950 present on October 21st 2021. language publications restricted English, German, French Italian. Key Content Findings: (I) Current use. There growing body evidence may reduce incidence severity delirium, opioid-consumption postoperative nausea intensive settings. also used facilitate withdrawal different substances (alcohol, opioids, heroin). Concerning safety aspects drug, some studies reported an increased rate serious cardiovascular events patients pre-existing heart conditions due bradycardia arterial hypo- hypertension. Since has main hepatic metabolism, dose reduction mandatory impairment. (II) care. have been sporadic case reports about successful Indications symptom control included hyperactive cancer pain, opioid-induced-hyperalgesia, dystonia, cough, vomiting, shivering dyspnea. mainly applied via intravenous (i.v.), subcutaneous, but nasal and, buccal routes. Admixture ("syringe-driver") showed compatible morphine, hydromorphone, hyoscine haloperidol. In 2021, prospective cohort study became available. Here, authors promising result terminal delirium reducing intensity agitation. Especially unique "conscious sedation" or "awake allows arouse easily under report comfort distress discussed by authors. Conclusions: review, we findings settings potential benefits criticalities are practical recommendations its provided.

Язык: Английский

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The effectiveness of non-pharmacological sleep interventions for improving inpatient sleep in hospital: A systematic review and meta-analysis

Sleep Medicine, Год журнала: 2023, Номер 107, С. 243 - 267

Опубликована: Май 18, 2023

Sleep disturbance is common in hospital. The hospital environment can have a negative impact on sleep quality, through factors such as noise, light, temperature, and nursing care disruptions. Poor lead to delays recovery, wound healing, increase risk of post-operative infection.We conducted systematic review evaluating the effectiveness non-pharmacological interventions for improving inpatient sleep. primary outcome was secondary length stay, harm adverse events. MEDLINE, Embase, CINAHL, PsycINFO Cochrane Library were searched from inception 17th February 2022. Meta-analysis using fixed effects model, with narrative synthesis studies no useable data. Risk bias assessed tool.76 identified 5375 people randomised comparing 85 interventions. Interventions focused physical aids (n = 26), relaxation 25), manual therapy 12), music 9), psychological 5), light 3), protocols 2), milk honey 1), exercise 1). In meta-analysis, medium large improvements quality noted aids, relaxation, music, therapies. Results generally consistent at lower bias. Length stay events reported some studies, benefit trials but this not across all interventions.Physical strong evidence base quality. Research needed evaluate how optimise into routine care.

Язык: Английский

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TCMFP: a novel herbal formula prediction method based on network target’s score integrated with semi-supervised learning genetic algorithms

Briefings in Bioinformatics, Год журнала: 2023, Номер 24(3)

Опубликована: Март 20, 2023

Abstract Traditional Chinese medicine (TCM) has accumulated thousands years of knowledge in herbal therapy, but the use formulas is still characterized by reliance on personal experience. Due to complex mechanism actions, it challenging discover effective for diseases integrating traditional experiences and modern pharmacological mechanisms multi-target interactions. In this study, we propose a formula prediction approach (TCMFP) combined therapy experience TCM, artificial intelligence network science algorithms screen optimal efficiently, which integrates herb score (Hscore) based importance targets, pair (Pscore) empirical learning predictive (FmapScore) intelligent optimization genetic algorithm. The validity Hscore, Pscore FmapScore was verified functional similarity topological evaluation. Moreover, TCMFP used successfully generate formulae three diseases, i.e. Alzheimer’s disease, asthma atherosclerosis. Functional enrichment analysis indicates efficacy targets predicted formula. proposed may provides new strategy formula, TCM herbs drug development.

Язык: Английский

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Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial

Trials, Год журнала: 2020, Номер 21(1)

Опубликована: Апрель 15, 2020

Abstract Background Different non-pharmacological techniques, including hypnosis and virtual reality (VR) are currently used as complementary tools in the treatment of anxiety, acute chronic pain. A new technique called (VRH), which encompasses a combination both tools, is regularly although its benefits underlying mechanisms remain unknown to date. With goal improve our understanding VRH effects, it necessary conduct randomised controlled research trials order understand their clinical interest potential benefits. Methods Patients (n = 100) undergoing cardiac surgery at Liège University Hospital will be randomly assigned one four conditions (control, hypnosis, VR or VRH). Each patient receive two sessions techniques: day before after. Physiological assessments made on monitor patients rate levels fatigue, pain, absorption dissociation. Discussion This study help expand knowledge application reality, specific context intensive care procedures, influence these techniques patient’s pain phenomenological experience. Trial registration ClinicalTrials.gov : NCT03820700 . Date registered 29 January 2019. Study recruitment date: October 6, 2018. anticipated completion December 28, 2020.

Язык: Английский

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Effect of earplugs and eye masks on the sleep quality of intensive care unit patients: A systematic review and meta‐analysis

Journal of Advanced Nursing, Год журнала: 2021, Номер 77(11), С. 4321 - 4331

Опубликована: Июнь 7, 2021

Abstract Aims To evaluate the effect of earplugs and eye masks on sleep quality patients in intensive care unit (ICU). Design Systematic review meta‐analysis. Data Sources Randomized controlled trial studies conducted before May 5, 2020 were searched for Embase, MEDLINE, Cochrane Library, CINAHL Index to Taiwan Periodical Literature System databases. Review Methods Analyses this study according PRISMA statement. The heterogeneity data was investigated through sub‐group analysis while a meta‐analysis performed using Manager 5.3 software. Results A total 797 from 13 included study. Without considering alone or combined use masks, supported that there significant self‐reported quality. overall standardized mean difference size 1.44 (95% confidence interval [CI]: [0.80, 2.09]). Sub‐group indicated had no (effect size: 0.07, 95% [−0.50, 0.64]). 1.56, [1.08, 2.05]). both proved have largest 2.08, [0.95, 3.21]). Conclusion standalone is non‐invasive, economical effective way promote adult ICU patients. Impact Clinical nurses could as it recommends provide with either one improve patients’ Study Registration protocol registered priori published online PROSPERO database systematic reviews ( www.crd.York.ac.uk/Prospero registration number # CRD42021221185).

Язык: Английский

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Non-pharmacological sleep interventions for adult patients in intensive care Units: A systematic review

Intensive and Critical Care Nursing, Год журнала: 2021, Номер 67, С. 103124 - 103124

Опубликована: Авг. 26, 2021

Язык: Английский

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Vital-sign circadian rhythms in patients prior to discharge from an ICU: a retrospective observational analysis of routinely recorded physiological data

Critical Care, Год журнала: 2020, Номер 24(1)

Опубликована: Апрель 28, 2020

Background: Circadian deregulation in patients treated an intensive care unit (ICU) is commonplace and associated with complications such as immune system disruption delirium.The presence nature of circadian rhythms the vital signs recorded ICU are not well documented, nor their generalisability across different populations.This paper investigates 24 h prior to discharge from who subsequently recovered.We hypothesise that vital-sign will be observable this cohort patients, these resemble known behaviour healthy individuals, generalisable populations patients.Methods: investigated several commonly measured signs: systolic blood pressure, heart rate, respiratory temperature.The data employed MIMIC-III (2001-2012), eICU-CRD (2014-2015), PICRAM (2009-2015) databases, spanning 198,205 211 hospitals USA UK.Evaluation encompasses a comparison between observed rhythm profiles peak-nadir excursions those found literature, assessment correlation databases.Results: patterns all four were conform reported for non-ICU cohorts.Additionally, correlated databases at p = 0.05 level.The excursion was suppressed by factor 2-5 relative results literature cohorts young, individuals.Conclusions: Across three datasets, temperature showed variation ICU.However, amplitude variations markedly reduced adults.The strongly suggesting there state during (Continued on next page)

Язык: Английский

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The effect of music on sleep in hospitalized patients: A systematic review and meta-analysis

Sleep Health, Год журнала: 2023, Номер 9(4), С. 441 - 448

Опубликована: Июнь 27, 2023

Sleep is often severely disturbed in hospitalized patients due to multiple factors such as noise, pain, and an unfamiliar environment. Since sleep important for patient recovery, safe strategies improve are warranted. Music interventions have been found general, the aim of this systematic review assess effect music on among patients. We searched 5 databases identify randomized controlled trials evaluating Ten studies including a total 726 matched inclusion criteria. The sample sizes ranged from 28 222 participants per study. varied how was chosen well duration time day. However, most studies, intervention group listened soft 30 minutes evening. Our meta-analysis showed that improved quality compared standard treatment (standardized mean difference 1.55 [95% CI 0.29-2.81], z = 2.41; p 0.0159). Few reported other parameters, only one study used polysomnography objective measurement. No adverse events were any trials. Hence, may constitute low-cost adjunctive Prospero registration number: CRD42021278654.

Язык: Английский

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