Aim: The purpose of this case study was to examine the sleep quality of patients receiving noninvasive positive pressure ventilation (NPPV) or nasal high-flow oxygen therapy (NHF) in an intensive care unit and to investigate what types of nursing support are offered to such patients. Methods: We examined one patient each for NPPV and NHF. Polysomnography (PSG), review of the patient charts, and semi-structured interviews were used to collect the data for analysis. Results: Patients treated with NPPV or NHF demonstrated a noticeable reduction in deep sleep, with most of their sleep being shallow. Their sleep patterns varied greatly from those of healthy individuals. These results suggest that, in addition to experiencing extremely fragmented sleep, sleep in these patients was more likely to be interrupted by nursing interventions, such as during auscultation of breath sounds. Furthermore, it was revealed that "anxiety or discomfort that accompanies the mask or air pressure" in patients treated with NPPV and "discomfort that accompanies the nasal cannula or NHF circuit" in patients treated with NHF may be primary causes of disrupted sleep. Our results suggest a need for nursing care aimed at improving sleep quality in patients treated with NPPV or NHF.
Aims
The purpose of this study was to determine the reliability and validity of the Japanese version of the Richards‐Campbell Sleep Questionnaire as a measure of sleep among intensive care unit patients in a Japanese hospital.
Design
Cross‐sectional survey.
Methods
The Richards‐Campbell Sleep Questionnaire was initially translated into Japanese using the back‐translation method. Validity was evaluated by determining the association between sleep efficiency, measured using simplified polysomnography, and the total score on the Japanese version of the Richards‐Campbell Sleep Questionnaire. Adult non‐intubated intensive care unit patients who completed the five‐item visual analogue scale underwent polysomnography for one night. Reliability was tested using Cronbach's alpha coefficient.
Results
Thirty‐three patients were included in the analysis. After excluding four patients with subsyndromal delirium, the Pearson correlation coefficient was 0.602 (
p
= 0.001). Cronbach's alpha coefficient was 0.911.
Conclusion
The Japanese version of the Richards‐Campbell Sleep Questionnaire could be used as an alternative to polysomnography when assessing sleep quality in lucid intensive care unit patients.
In the initial stage of NPPV, focusing on dyspnea, sleep loss, discomfort, delirium, and the realization of the necessity of NPPV were critical in deciding on continuing this intervention or the early conversion to intubation.
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