Date Presented 4/8/2016
Simple sleep-enhancing education can significantly improve perceptions of sleep quality, wake disturbance, and fatigue in hospitalized adults. Occupational therapists have the opportunity to implement this education in their daily roles.
Primary Author and Speaker: Steven Heidt
Contributing Authors: J. Ryan Scott, Kristen Clore, Christelle David, Melissa Johnson, Brittany Gappy, Bridget Higgins, Zainab Rasheed, Julia Meireles, Peter Farrehi
HYPOTHESIS: We hypothesized that a sleep tool education intervention would significantly improve patient-reported sleep quality, physical function, and fatigue.
BACKGROUND: Hospital noise negatively affects patient sleep quality and is associated with increased fatigue. Here we present data for an easy-to-implement, low-cost clinical intervention to improve hospitalized patient sleep quality.
DESIGN: This was an experimental study design with single sample and pre–post testing.
PARTICIPANTS: Adults ages 18–75 yr who were on a non–intensive care unit and medically stable were approached. Bed-ridden patients or those with hearing aids or communicable diseases were not recruited.
Fifty-two patients were included, 23 women and 29 men (mean [M] age = 57.5 yr, standard deviation [SD] = 9.9). All patients provided informed consent. Patients completed surveys on Days 1 (baseline) and 3. At baseline, patients were educated by a research assistant on the benefits of sleep and provided with three sleep-enhancing tools: eye mask, ear plugs, and white noise machine.
METHOD: Patients completed self-reported PROMIS short-form surveys. Four domains were included: (1) sleep disturbance, a measure of sleep quality; (2) wake disturbance, the measure of impairment due to poor sleep; (3) fatigue; (4) physical function, ability to carry out physical activities (e.g., activities of daily living). Short forms consist of 8–10 items with 5-point Likert scale. Raw scores are standardized to 100-point scoring scale, with higher scores indicating improved outcome.
ANALYSIS: Paired t tests for a single sample were performed to assess for significant change from baseline to Day 3. Tests were two tailed, with p < .05 considered significant and analyzed with SPSS Version 22.
RESULTS: Patients had significant improvements in fatigue (t = 5.5, p < .001), sleep disturbance (t = 3.9, p < .001), and wake disturbance (t = 3.8, p < .001), with a mean 5.3 (SD = 6.9), 5.1 (SD = 9.4), and 3.1 (SD = 5.8) point improvement, respectively, on a 100-point scale. Perceived physical function improved (M = 1.1, SD = 4.73) but did not reach significance (p = .106).
DISCUSSION: The intervention significantly improved patient perceptions of sleep quality and significantly decreased perceptions of sleep-related impairment and fatigue. Such positive improvements with a small sample size indicate that future research on this topic should seek to assess improvements in occupational therapy (OT)–specific outcomes.
IMPACT STATEMENT: Simple sleep tool education from a research assistant significantly improved fatigue and sleep quality in hospitalized adults; one could argue that expanding hospital-based OT’s roles to include sleep education could significantly improve both patient-reported and OT-specific outcomes.
