Treating Depression and Sleep Impairment to Improve Pain Levels and Quality of Life for Patients with Sickle Cell Disease: A Quality Improvement Project

2.50
Hdl Handle:
http://hdl.handle.net/10755/621394
Category:
Full-text
Format:
Text-based Document
Type:
Dissertation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Treating Depression and Sleep Impairment to Improve Pain Levels and Quality of Life for Patients with Sickle Cell Disease: A Quality Improvement Project
Author(s):
Simo, Sheran Maxwell
Additional Author Information:
Sheran Maxwell Simo, DNP, MS, APRN, ACHPN, FNP-BC
Advisors:
Siela, Debra
Degree:
DNP
Degree Year:
2017
Grantor:
Ball State University
Abstract:

Background: Vaso-occlusive crisis (VOC) pain is both an acute and chronic factor for patients with sickle cell disease (SCD).  Acute, recurrent, and unrelenting pain is often joined by other affective disorders that impact pain chronicity, and some patients with sickle cell disease have depression and/or sleep disturbances that may impact pain levels and quality of life.   

Aim: The purpose of this quality improvement project is to improve the process of assessment and treatment of depression and sleep disturbance in patients admitted to Bridgeport Hospital, Bridgeport, CT with VOC.  The goal of this project is to improve overall pain levels and quality of life for patients with SCD through efficient and effective evaluation and treatment for depression and sleep disturbance.

Method: An interdisciplinary team, led by the palliative care (PC) advance practice registered nurse (APRN), used the Stetler Model to guide the process of translating existing research regarding the impact of depression and sleep impairment on pain and quality of life in patients presenting with VOC, into evidence-based practice.  The team created the Guideline for the Evaluation and Treatment of Depression and Sleep Impairment in Sickle Cell Disease.  Patients were assessed, offered treatments and reassessed during the project period. 

Results:  Both depression and QOL scores showed significant improvement by the end of the project.  Significant correlations were found between pain, depression and sleep; depression, pain, sleep and QOL; sleep, pain, and depression; and QOL and depression.  Patient admissions as well as average length of stay decreased over the course of the project. 

Limitations: The small convenience sample size limits the generalizability of the results to other practice sites.  Patients who were not readmitted during the project timeframe were lost to follow-up, and were not reassessed to determine the effects of treatment recommended by the guideline. 

Conclusions: Interdisciplinary teams are effective in creating a guideline to assess and treat depression and sleep impairment and their effects on pain and QOL in patients with SCD.  

Implications for Practice: PC APRNs provide support and symptom management to patients with life-limiting and serious illnesses, including patients with SCD, as a means of improving QOL.  This project has significance for APRNs in both palliative care and specialty SCD/Hematology care as a means to translate existing research into evidence-based practice; as well as provide an efficient and effective means to evaluate and treat depression and sleep impairment and their impact on pain and quality of life.

Keywords:
Sickle Cell Disease; Depression; Sleep Impairment; Guidelines; Quality Improvement
CINAHL Headings:
Anemia, Sickle Cell; Anemia, Sickle Cell--Complications; Pain Management; Pain Management--Methods; Depression--Therapy; Depression; Sleep Disorders--Therapy; Sleep Disorders; Quality of Life
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2017-05-19T15:50:53Z
Date of Publication:
2017-05-19

Full metadata record

DC FieldValue Language
dc.contributor.advisorSiela, Debraen
dc.contributor.authorSimo, Sheran Maxwellen
dc.date.accessioned2017-05-19T15:50:53Z-
dc.date.available2017-05-19T15:50:53Z-
dc.date.issued2017-05-19-
dc.identifier.urihttp://hdl.handle.net/10755/621394-
dc.description.abstract<p><strong><em>Background:</em></strong> Vaso-occlusive crisis (VOC) pain is both an acute and chronic factor for patients with sickle cell disease (SCD).  Acute, recurrent, and unrelenting pain is often joined by other affective disorders that impact pain chronicity, and some patients with sickle cell disease have depression and/or sleep disturbances that may impact pain levels and quality of life.   </p> <p><strong><em>Aim: </em></strong>The purpose of this quality improvement project is to improve the process of assessment and treatment of depression and sleep disturbance in patients admitted to Bridgeport Hospital, Bridgeport, CT with VOC.  The goal of this project is to improve overall pain levels and quality of life for patients with SCD through efficient and effective evaluation and treatment for depression and sleep disturbance.</p> <p><strong><em>Method: </em></strong>An interdisciplinary team, led by the palliative care (PC) advance practice registered nurse (APRN), used the Stetler Model to guide the process of translating existing research regarding the impact of depression and sleep impairment on pain and quality of life in patients presenting with VOC, into evidence-based practice.  The team created the <em>Guideline for the Evaluation and Treatment of Depression and Sleep Impairment in Sickle Cell Disease.  </em>Patients were assessed, offered treatments and reassessed during the project period. </p> <p><strong><em>Results:  </em></strong>Both depression and QOL scores showed significant improvement by the end of the project.  Significant correlations were found between pain, depression and sleep; depression, pain, sleep and QOL; sleep, pain, and depression; and QOL and depression.  Patient admissions as well as average length of stay decreased over the course of the project. </p> <p><strong><em>Limitations: </em></strong>The small convenience sample size limits the generalizability of the results to other practice sites.  Patients who were not readmitted during the project timeframe were lost to follow-up, and were not reassessed to determine the effects of treatment recommended by the guideline. </p> <p><strong><em>Conclusions: </em></strong>Interdisciplinary teams are effective in creating a guideline to assess and treat depression and sleep impairment and their effects on pain and QOL in patients with SCD.  </p> <p><strong><em>Implications for Practice: </em></strong>PC APRNs provide support and symptom management to patients with life-limiting and serious illnesses, including patients with SCD, as a means of improving QOL.  This project has significance for APRNs in both palliative care and specialty SCD/Hematology care as a means to translate existing research into evidence-based practice; as well as provide an efficient and effective means to evaluate and treat depression and sleep impairment and their impact on pain and quality of life.</p>en
dc.formatText-based Documenten
dc.language.isoen_USen
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.subjectSickle Cell Diseaseen
dc.subjectDepressionen
dc.subjectSleep Impairmenten
dc.subjectGuidelinesen
dc.subjectQuality Improvementen
dc.titleTreating Depression and Sleep Impairment to Improve Pain Levels and Quality of Life for Patients with Sickle Cell Disease: A Quality Improvement Projecten_US
dc.typeDissertationen
thesis.degree.grantorBall State Universityen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.-
dc.primary-author.detailsSheran Maxwell Simo, DNP, MS, APRN, ACHPN, FNP-BCen
thesis.degree.year2017en
dc.type.categoryFull-texten
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.subject.cinahlAnemia, Sickle Cellen
dc.subject.cinahlAnemia, Sickle Cell--Complicationsen
dc.subject.cinahlPain Managementen
dc.subject.cinahlPain Management--Methodsen
dc.subject.cinahlDepression--Therapyen
dc.subject.cinahlDepressionen
dc.subject.cinahlSleep Disorders--Therapyen
dc.subject.cinahlSleep Disordersen
dc.subject.cinahlQuality of Lifeen
This item is licensed under a Creative Commons License
Creative Commons
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.