Vloga medicinske sestre pri zagotavljanju kakovostnega spanca pri kritično bolnih v enotah intenzivnega zdravljenja : diplomsko delo

Bogataj, Lucija (author), Djekić, Bernarda (mentor), Gogova, Tina (comentor), Mihelič Zajec, Andreja (reviewer)

Uvod: Kritično bolni so v času hospitalizacije v enoti intenzivnega zdravljenja bolj podvrženi pomanjkanju spanja. Motnje spanja so pogosto opredeljene kot pomemben stresor v času hospitalizacije. Pomanjkanje spanja je povezano z množico neželenih učinkov, ki vplivajo na potek zdravljenja in čas hospitalizacije kritično bolnih. Namen: Namen diplomskega dela je predstaviti problem nezadostnega in nekakovostnega spanja kritično bolnih v enoti intenzivnega zdravljenja ter izpostaviti pomembno vlogo medicinskih sester pri zagotavljanju kakovostnega spanca. Metode dela: Uporabili smo deskriptivno metodo dela s sistematičnim pregledom domače in tuje literature. Vire smo iskali v naslednjih podatkovnih bazah: PubMed/Medline, CINAHL, DiKUL in COBIB. SI. Skupaj s pregledom referenčnih seznamov smo identificirali 857 enot, od katerih smo v končno analizo vključili 13 člankov. Za oceno kakovosti analiziranih člankov smo uporabili štiristopenjsko lestvico, po zgledu avtorjev Eccles in Mason. Rezultati: Najpogosteje naveden vzrok za motnje spanja je po oceni kritično bolnih hrup. Sledi bolečina, ki še vedno predstavlja velik dejavnik motenj spanja tako po oceni kritično bolnih kot tudi zdravstvenih delavcev. Kritično bolni so izpostavljali tudi bujenju, ki je velikokrat posledica izvajanja rutinskih aktivnosti zdravstvenih delavcev ponoči. Pomembno je omeniti tudi psihološke dejavnike, ki imajo velikokrat večji vpliv na spanje kot dejavniki okolja. Z uporabo ušesnih čepkov, očesih mask in s poslušanjem glasbe pred spanjem se je pri kritično bolnih izboljšala globina spanja, zaznane so bile nižje vrednosti srčnega utripa, bilo je manj prebujanj ponoči, kritično bolni so ocenili spanje kot bolj kakovostno. Najpogosteje omenjene opazovalne lestvice za oceno spanja pri kritično bolnih, ki vključujejo njihovo subjektivno oceno spanja so: Richards Campbell lestvica spanja, Verran in Snyder-Halpern lestvica spanja in Vprašalnik o spanju v enoti intenzivnega zdravljenja. Razprava in zaključek: Zdravstveni delavci s svojim delom pomembno vplivajo na kakovost spanja kritično bolnih. Na spanje kritično bolnih vplivajo vsi, ki se gibajo v enoti intenzivnega zdravljenja. Pri načrtovanju in izvajanju aktivnosti ima veliko vlogo medicinska sestra, saj lahko najbolje spodbuja terapevtsko okolje in zdravstveno nego, ki omogoča daljši čas in boljšo kakovost spanja kritično bolnih. Za nadaljnji razvoj promocije spanja kritično bolnih je pomembno poznavanje različnih orodij za oceno spanja. Dobro bi bilo, da bi se v Sloveniji bolj uveljavila ocenjevalna orodja, ki bi pripomogla k bolj celostni zdravstveni negi kritično bolnih.

• Language: Slovenian
• Keywords: diplomska dela, zdravstvena nega, dejavniki tveganja, moten spanec, ocena spanja, aktivnosti zdravstvene nege, promocija spanja
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [L. Bogataj]
• Year: 2020
• Number of pages: 35 str.
• PID: 20.500.12556/RUL-121413
• UDC: 616-083
• COBISS.SI-ID: 31769859
• Publication date in RUL: 08.10.2020

BOGATAJ, Lucija, 2020, Vloga medicinske sestre pri zagotavljanju kakovostnega spanca pri kritično bolnih v enotah intenzivnega zdravljenja : diplomsko delo [online]. Bachelor’s thesis. Ljubljana : L. Bogataj. [Accessed 30 March 2025]. Retrieved from: https://repozitorij.uni-lj.si/IzpisGradiva.php?lang=eng&id=121413

Secondary language

• Language: English
• Title: Nurse's role in providing quality sleep for critically ill patients in intensive care units : diploma work

Abstract

Introduction: Critically ill patients during an intensive care unit treatment are likely to suffer from sleep deprivation. Sleep deprivation is considered a very important stressor during hospitalization. Lack of sleep is connected to many adverse effects on a patient's treatment and to the length of the hospitalization. Purpose: The purpose of this thesis is to introduce the problem of low-quality sleep and sleep deprivation of hospitalized patients in intensive care units and to investigate the important role of the nurses in providing high-quality sleep. Methods: We used a descriptive method of work and systematically reviewed several sources of domestic and foreign literature by searching for resources in the following databases: PubMed/Medline, CINAHL, DiKUL, COBIB. SI. With this method, and by checking the reference lists, we identified 875 publications, 13 of which were included in the final analysis. We used Eccles & Mason system to assess the quality of the analyzed articles. Results: Critically ill patients most often state noise as the main reason for disturbed sleep. Noise is followed by pain, which is the main factor for the sleep disturbance in the patients’ and health-care workers’ view. Critically ill patients also listed waking up during the night as a disturbing factor, which is often a consequence of routine activities of the health-care workers. Very important are also psychological factors, which have often a bigger impact on a patient's sleep than the external factors. With the use of ear plugs, sleep masks and letting the critically ill patients listen to music before sleep, researchers improved the depth of the patients’ sleep and observed lower heart rates. There was also less waking up during the night and critically ill patients reported an improvement in their sleep. We researched the most often viewed rating scales for critically ill patients’ sleep, which describe their subjective rating of sleep such as the Richard Campbell sleep scale, Verran and Snyder-Halpern sleep scale and The Sleep in the Intensive Care Unit Questionnaire. Discussion and conclusion: Performance of health-care workers has a significant impact on the quality of sleep of critically ill patients. Everyone present in an Intensive Care Unit has an effect on the sleep of critically ill patients. Nurses have a very important role in planning and performing the intensive care unit activities, as they can stimulate therapeutic environment and medical treatment that enable longer sleeping times and better-quality sleep of the critically ill patients. To further improve sleep of the critically ill patient it is important to have knowledge of diverse sleeping assessment tools. In Slovenia it would be good to introduce various sleeping assessment tools to the intensive care units to aid the overall nursing care of the critically ill patients.

• Keywords: diploma theses, nursing care, risk factors, disturbed sleep, sleep assessment, nursing care activities, sleep promotion