Date of Award

11-22-2021

Degree Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

First Advisor

Dr. Laila Ladak

Second Advisor

Dr. Sara Mithani

Third Advisor

Dr. Aysha Almas

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: Sleep is a basic human need that is necessary for health and recovery. Good sleep is essential because it allows the body to heal, new cells to develop, and the brain to process information. During hospitalization, sleep can be affected by the care environment and patients' health conditions, as the reason for hospitalization. However, lack of sleep can adversely affect the body's ability to recover from disease conditions. Environmental factors in the care setting can affect the sleep of hospitalized patients. Despite the significance of sleep and its quality, there was hardly any study found in the literature that explored the sleep quality of hospitalized patients in medicine wards in Pakistan. Therefore, this study assessed the sleep quality and environmental factors affecting the sleep of internal medicine patients.
Purpose: The purpose of this research was to assess sleep quality and to identify environmental factors affecting the sleep of patients hospitalized in the internal medicine wards, at a tertiary care hospital in Karachi, Pakistan.
Methodology: A quantitative cross-sectional analytical study design was utilized to address the study question. The consecutive sampling technique was used to recruit a total of 157 patients hospitalized in the internal medicine wards to assess the sleep quality and identify the environmental factors affecting sleep. The data was collected from the study participants through a validated tool, PSQI, to assess sleep quality and a modified form of the Questionnaire for Assessing Environmental Factors (QEA), used for identifying environmental factors in patients. Moreover, the data was analyzed using SPSS version 26. In addition, the ANOVA, t-test for independent sample, and Pearson correlation test were used to assessed the relationship between demographics, clinical characteristics, and sleep quality.
Result: The study's findings revealed that 71.3 percent of the study participants had poor sleep quality based on global PSQI (>5), and the mean score was found to be 6.94± 3.07. Furthermore, the mean score of PSQI in seven sub-components were found as follow, the sleep duration components (1.87± 0.81), followed by subjective sleep quality (1.38 ± 0.52), habitual sleep efficiency (1.20± 1.17), sleep latency (1.10± 1.03), sleep disturbance (0.93± 0.55), daytime dysfunction (0.34± 0.57), and use of sleep medication (0.08 ± 0.40) The univariate analysis of independent variables showed that socio-demographic variables, that is age (p-value = 0.047) and gender (p-value = 0.032), and clinical characteristics, that is pulmonary disease (p-value = 0.001) and administered medication bronchodilators (p-value = 0.033), were significantly associated with sleep quality. Moreover, environmental factors, such as medical-device-related factors (r = 0.158; pvalue 0.048), care-related factors (r = 0.161; p-value = 0.044), and surrounding noise (r = 0.168; p-value = 0.036), were also significantly associated with sleep quality.
Conclusion: Sleep is important for maintaining human health, well-being, and the ability to recover. The majority of the patients hospitalized in the internal medicine wards had poor sleep quality. Nurses could play a critical role in providing a safe environment for hospitalized patients to improve their sleep quality. Moreover, sleep disturbances caused by environmental factors should be minimized by eliminating unnecessary noise sources, maintaining a consistent schedule and timing for medical devices, providing personcentered care, and scheduling the care plan.

First Page

1

Last Page

91

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