ÖZET
Amaç:
Hastanede yatan hastalarda yaygın olarak görülen uyku bozuklukları, yıkıcı faktörlerin varlığından etkilenir. Uyku bozuklukları ile deliryum veya ağrı arasında kanıtlanmış bir ilişki vardır. Bu ilişkinin çift yönlü olduğu, olumsuz etkilerinin olduğu ve kötü sonuçlara yol açtığı varsayılabilir.
Gereç ve Yöntem:
Bu çalışma prospektif gözlemsel bir çalışma olarak dizayn edildi. Yüksek riskli bir hasta popülasyonunda (60 yaşın üzerinde, hastanede 48 saatten uzun bir süre kalış) uyku kalitesini değerlendirmek için, sübjektif olarak Richards-Campbell Uyku Ölçeği (RCSQ) ve objektif olarak aktigrafi kullanıldı. Ayrıca bunun seçilen risk faktörleriyle, yani ağrı ve deliryum ile olan ilişkilerini analiz etmek amacıyla sırasıyla görsel analog skala (VAS) ve yoğun bakım ünitesi konfüzyon değerlendirme yöntemi kullanıldı.
Bulgular:
Çalışılan bazı parametrelerden görüldüğü gibi, hem nesnel hem de öznel olarak gece uykusu bozuldu. Hemşirelerin uyku kalitesini fazla önemseme eğiliminde oldukları gözlendi. Deliryumlu hastalarda, birkaç aktigrafi parametresinde (toplam uyku süresi -0,5707; hareket indeksi 0,4155; uyanma sayısı 0,2868; uyku başlangıcından sonra uyanma 0,3874) ve ayrıca RCSQ maddelerinde (uyku derinliği -0,3712; uyku kalitesi -0.2985) anlamlı değişiklikler görüldü (p<0,05). Ağrısı olan hastalarda (VAS ≥4), aktigrafide (hareket indeksi 0,3226) ve RCSQ parametrelerinde (uyku derinliği -0,2908; uykuya dönüş -0,2856; RCSQ toplam -0,2746) bazı değişiklikler bulundu.
Sonuç:
Çalışma, hastanede yatan hastalarda uyku bozuklukları ile seçilmiş faktörler (ağrı ve deliryum) arasındaki ilişkileri göstermiştir. Elde edilen verileri objektif olarak değerlendirmek için, sübjektif ve objektif ölçümlerin kombinasyonu bir ön koşuldur. Bununla birlikte, kanıt tabanını güçlendirmek için daha sağlam, çok merkezli bir çalışmaya ihtiyaç duyulacaktır.
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