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Войти в исследования International journal of orthopaedic and trauma nursing · 2025
The effect of a nurse-led multicomponent intervention on sleep quality and delirium in orthopedic surgery patients: A randomized clinical trial.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Sohrabi Mansureh, Gholami Mohammad, Foroughi Saeid, Younesi Elahe, Mokhayeri Yaser
Аннотация
BACKGROUND: Sleep disturbances and postoperative delirium (POD) impair recovery and adversely affect cognitive and physical outcomes among orthopedic trauma patients.
OBJECTIVE: This study aimed to evaluate the effects of a nurse-led multicomponent intervention on POD, sleep quality, and quality measures among orthopedic surgical patients.
METHOD: This double-blind randomized clinical trial was conducted on 96 orthopedic surgical patients who were assigned into intervention (n=48) and control (n=48) groups using stratified block randomization. The intervention group received a multicomponent care program including multimodal pharmacological pain management, music therapy, inspiratory muscle training (IMT), and a structured sleep enhancement protocol, initiated 24 hours before surgery and continued for 48 hours postoperatively. The control group received standard care. Sleep quality and POD were assessed using the richards-campbell sleep questionnaire (RCSQ) and the confusion assessment method (CAM), respectively. The data on length of hospital stay and 30-day mortality were collected through electronic health records and self-reports.
RESULTS: The mean total sleep quality score and its subscales were significantly higher in the intervention group compared to the control group (P < 0.001). The average length of hospital stay was significantly shorter in the intervention group (P = 0.047). There were no statistically significant differences between the two groups regarding the incidence of POD or 30-day mortality (P > 0.05).
CONCLUSION: Results show, a perioperative multicomponent nurse-led intervention can effectively enhance sleep quality and reduce the length of hospital stay among orthopedic surgical patients. Nevertheless, it did not show a significant effect on delirium incidence or short-term mortality.
OBJECTIVE: This study aimed to evaluate the effects of a nurse-led multicomponent intervention on POD, sleep quality, and quality measures among orthopedic surgical patients.
METHOD: This double-blind randomized clinical trial was conducted on 96 orthopedic surgical patients who were assigned into intervention (n=48) and control (n=48) groups using stratified block randomization. The intervention group received a multicomponent care program including multimodal pharmacological pain management, music therapy, inspiratory muscle training (IMT), and a structured sleep enhancement protocol, initiated 24 hours before surgery and continued for 48 hours postoperatively. The control group received standard care. Sleep quality and POD were assessed using the richards-campbell sleep questionnaire (RCSQ) and the confusion assessment method (CAM), respectively. The data on length of hospital stay and 30-day mortality were collected through electronic health records and self-reports.
RESULTS: The mean total sleep quality score and its subscales were significantly higher in the intervention group compared to the control group (P < 0.001). The average length of hospital stay was significantly shorter in the intervention group (P = 0.047). There were no statistically significant differences between the two groups regarding the incidence of POD or 30-day mortality (P > 0.05).
CONCLUSION: Results show, a perioperative multicomponent nurse-led intervention can effectively enhance sleep quality and reduce the length of hospital stay among orthopedic surgical patients. Nevertheless, it did not show a significant effect on delirium incidence or short-term mortality.