No abstract

Three variables were found useful in predicting moral distress: the type of unit and responses to two qualitative questions related to quitting their job. Identification of these variables allows organizations to focus their interventions.

Purpose To examine clinical and psychological indicators associated with sleeplessness and insomnia in adult patients with sickle cell. Data sources PubMed, Scopus, Cochrane Library. Data were collected from adult sickle cell participants (N = 72) in outpatient clinics at a Midwest National Cancer Institute designated comprehensive cancer center. A retrospective chart review observed for clinical and psychological indicators associated with sleeplessness and insomnia. Conclusions Findings included that adults with sickle cell experienced insomnia (47%) and sleep impairment (15%). Significant associations existed between pain and sleep impairment (p = .00), insomnia and pain (p = .00), morning hours of sleep (p = .00), and evening hours (p = .00). Pain may contribute to insomnia or interrupt sleep; daytime sleeping was not conducive to nighttime sleep. Anxiolytics, antidepressants, and long‐acting opioids were not associated with insomnia (p = .00, p = .43, and p = .10), respectively; reduction in anxiety may reduce insomnia. Long‐acting opioids may provide for improved pain control sleep. Implications for practice Healthcare providers play a pivotal role in the assessment of sleep impairment or disorders. Effective management is necessary for improved quality of life. Further investigation is warranted to understand the meaning of sleep impairment in adult patients with sickle cell with prospective controlled studies to examine the efficacy of interventions.