RELATIONSHIPS BETWEEN SLEEP AND THE HOSPITAL CARE ENVIRONMENT IN CHILDREN WITH CANCER

2.50
Hdl Handle:
http://hdl.handle.net/10755/157283
Type:
Presentation
Title:
RELATIONSHIPS BETWEEN SLEEP AND THE HOSPITAL CARE ENVIRONMENT IN CHILDREN WITH CANCER
Abstract:
RELATIONSHIPS BETWEEN SLEEP AND THE HOSPITAL CARE ENVIRONMENT IN CHILDREN WITH CANCER
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Linder, Lauri, PhD, APRN, CPON
P.I. Institution Name:University of Utah College of Nursing and Primary Children's Medical Center
Title:Joint Appointment: Assistant Professor (Clinical) and Clinical Nurse Specialist
Contact Address:10 S. 2000 E., Salt Lake City, UT, 84112, USA
PURPOSES/AIMS:
The purpose of this study was to examine sleep-wake patterns and influences of environmental stimuli on sleep-wake patterns among children with cancer. Aims were to describe nighttime sleep-wake patterns among children with cancer receiving inpatient chemotherapy and to describe relationships between sleep-wake patterns, environmental, and clinical variables.
RATIONALE/CONCEPTUAL BASIS/BACKGROUND:
Thirty to 45% of children with cancer experience disturbed sleep, yet sources of sleep disturbances are not well understood. Disturbed sleep in the child with cancer may contribute to other cancer-related symptoms, impair normal growth, delay physical recovery, and increase infection risk. Hospital environmental stimuli are associated with impaired sleep quantity and quality; however, the influence of the hospital environment has not been investigated outside critical care settings. Nursing care activities and the presence of other symptoms also may contribute to disrupted sleep.
METHODS: The UCSF Symptom Management Model guided this exploratory, descriptive study. The setting was an inpatient pediatric oncology unit in a tertiary pediatric hospital. Participants were 15 children with cancer 5 to 12 years of age (mean = 8.8; SD = 2.3) receiving inpatient chemotherapy 3 days or longer. Sleep-wake patterns were measured using wrist actigraphs and sleep diaries. Light and temperature levels in the child's room were measured continuously using data loggers. Sound was measured using digital sound pressure level meters. Children's medical records were reviewed to identify medication doses and occurrences of pain, nausea, and vomiting.
RESULTS:
Children's nighttime sleep was marked by frequent awakenings (mean = 12.4; SD = 5.3) with mean nighttime sleep episodes of 53.4 minutes (SD = 25.4). Mean nighttime sound levels were persistently greater than 45 dB with spikes above 80 dB each night. Data were organized into 2-hour epochs within each 12-hour night shift. A basic mixed linear model indicated that children's total sleep minutes varied based on epoch (F = 56.27, p < .01) with sleep onset delayed past 10:00 pm. A basic mixed linear model also analyzed the influence of environmental variables on minutes of sleep. Significant fixed effects were identified for both sound (F = 50.87, p < .01) and light (F = 7.04, p < .01), indicating that both sound and light influenced the children's sleep. Minutes of sleep within an epoch were negatively correlated with sound, light, number of medication doses, and pain (p < .01). A backward regression model including sound, light, medication doses, pain, and nausea accounted for 57.4% of the variance in sleep minutes within each epoch (F = 62.85, p < .01).
IMPLICATIONS:
Multiple factors in the hospital care environment contribute to children's disturbed sleep, including noise and light, nursing care activities, and the presence of other symptoms. This study was the first to provide direct measurements of environmental variables, including variation within a night shift, outside of a critical care setting. Areas for future research include investigating sources of nighttime sound and their relative intensities. Additional research is warranted to develop and test interventions modifying the care environment to promote nighttime sleep in the hospital for children with cancer.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleRELATIONSHIPS BETWEEN SLEEP AND THE HOSPITAL CARE ENVIRONMENT IN CHILDREN WITH CANCERen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157283-
dc.description.abstract<table><tr><td colspan="2" class="item-title">RELATIONSHIPS BETWEEN SLEEP AND THE HOSPITAL CARE ENVIRONMENT IN CHILDREN WITH CANCER</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Linder, Lauri, PhD, APRN, CPON</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Utah College of Nursing and Primary Children's Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Joint Appointment: Assistant Professor (Clinical) and Clinical Nurse Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">10 S. 2000 E., Salt Lake City, UT, 84112, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lauri.linder@nurs.utah.edu</td></tr><tr><td colspan="2" class="item-abstract">PURPOSES/AIMS: <br/>The purpose of this study was to examine sleep-wake patterns and influences of environmental stimuli on sleep-wake patterns among children with cancer. Aims were to describe nighttime sleep-wake patterns among children with cancer receiving inpatient chemotherapy and to describe relationships between sleep-wake patterns, environmental, and clinical variables. <br/>RATIONALE/CONCEPTUAL BASIS/BACKGROUND: <br/>Thirty to 45% of children with cancer experience disturbed sleep, yet sources of sleep disturbances are not well understood. Disturbed sleep in the child with cancer may contribute to other cancer-related symptoms, impair normal growth, delay physical recovery, and increase infection risk. Hospital environmental stimuli are associated with impaired sleep quantity and quality; however, the influence of the hospital environment has not been investigated outside critical care settings. Nursing care activities and the presence of other symptoms also may contribute to disrupted sleep. <br/>METHODS: The UCSF Symptom Management Model guided this exploratory, descriptive study. The setting was an inpatient pediatric oncology unit in a tertiary pediatric hospital. Participants were 15 children with cancer 5 to 12 years of age (mean = 8.8; SD = 2.3) receiving inpatient chemotherapy 3 days or longer. Sleep-wake patterns were measured using wrist actigraphs and sleep diaries. Light and temperature levels in the child's room were measured continuously using data loggers. Sound was measured using digital sound pressure level meters. Children's medical records were reviewed to identify medication doses and occurrences of pain, nausea, and vomiting. <br/>RESULTS: <br/>Children's nighttime sleep was marked by frequent awakenings (mean = 12.4; SD = 5.3) with mean nighttime sleep episodes of 53.4 minutes (SD = 25.4). Mean nighttime sound levels were persistently greater than 45 dB with spikes above 80 dB each night. Data were organized into 2-hour epochs within each 12-hour night shift. A basic mixed linear model indicated that children's total sleep minutes varied based on epoch (F = 56.27, p &lt; .01) with sleep onset delayed past 10:00 pm. A basic mixed linear model also analyzed the influence of environmental variables on minutes of sleep. Significant fixed effects were identified for both sound (F = 50.87, p &lt; .01) and light (F = 7.04, p &lt; .01), indicating that both sound and light influenced the children's sleep. Minutes of sleep within an epoch were negatively correlated with sound, light, number of medication doses, and pain (p &lt; .01). A backward regression model including sound, light, medication doses, pain, and nausea accounted for 57.4% of the variance in sleep minutes within each epoch (F = 62.85, p &lt; .01). <br/>IMPLICATIONS: <br/>Multiple factors in the hospital care environment contribute to children's disturbed sleep, including noise and light, nursing care activities, and the presence of other symptoms. This study was the first to provide direct measurements of environmental variables, including variation within a night shift, outside of a critical care setting. Areas for future research include investigating sources of nighttime sound and their relative intensities. Additional research is warranted to develop and test interventions modifying the care environment to promote nighttime sleep in the hospital for children with cancer.<br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:43:55Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:43:55Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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