Sleep of older adults : a descriptive study of patients' perceptions regarding sleeping patterns in acute care surgical settings

Abstract

It is evident from various literature that although patients may appear to sleep in hospital, it may not be refreshing or restorative (Bowman, 1997; Ersser et al., 1999a, 1999b; Manabe, Matsui, Tamaya et al., 2000; Reid, 2001). The reasons for this can result from the interaction of external and/or internal related aetiologies. This study described and compared the sleep experience of surgical patients in an acute care hospital. Patients (N=IO) were interviewed using a face-valid tool constructed by the researcher on the third, or fourth, or fifth day postoperatively. Findings showed difference between male and female patients, age ascending order, and sleep effectiveness, sleep disturbance, and need for sleep supplementation. Sleep perceptions did not vary between the types of operation undertaken. Difference in length of stay in hospital showed that patients did not consider that they had sufficient sleep in hospital at night; that discomfort, worries, and pain had contributed to their wakefulness. The majority of patients, especially females mentioned a variety of sources of sleep disturbance. The internal factors disturbed patients' sleep less than the environmental factors. The ward environment and personal factors, foreign body objects including drains, intravenous cannulae and urinary catheters strongly influenced the sleep experience. Almost all patients felt that sleep helped them cope with their pain and believed that sleep enhanced recovery from surgery. Patients experienced frequent night-time awakenings postoperatively and males took longer to fall back to sleep during the night than females. Several recommendations for further understanding and tackling these problems are proposed.