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A2725 - Individualized Sleep Promotion for Hospitalized Patients: Identification and Mitigating Factors that Disturb Sleep
Author Block: L. Ye1, R. L. Owens2, P. Dykes3; 1Northeastern University, Boston, MA, United States, 2ECOB, La Jolla, CA, United States, 3Brigham and Women's Hospital, Boston, MA, United States.
RATIONALE: Interventions to improve sleep for hospitalized patients should extend beyond simply prescribing pharmacological sleep aid but work to address multiple medical, behavioral and environmental factors that impact sleep quality. One major challenge of inpatient sleep promotion is that there is no “one-size-fits-all” intervention as patients’ sleep may be disturbed by different factors. In this study, we developed and psychometrically evaluated a brief assessment tool, the Inpatient Sleep Disturbing Factors (ISDF) Scale, which serves as a foundation for generating a personalized action plan to address the patient’s specific need for sleep. Strategies targeting both patients and clinicians to mitigate each sleep-disturbing factor were proposed, which may serve as customized education to support individualized sleep promotion. METHODS The ISDF item development and validation were completed by literature review, content analysis of interview data with clinicians and patients, and content validity test. A 40-item survey was collected from 105 hospitalized patients to select the most significant sleep disturbing factors. On the survey patients were asked to rate how much each factor disrupted their sleep during the current hospitalization on a numeric rating scale of 0 (not disturbing at all) to 10 (yes, the most disturbing it would be). Psychometric evaluation using the survey data included item analysis, principal components analysis, and internal consistency reliability. Focus groups were used to collect input from patients and clinicians for strategies mitigating the sleep disturbing factors. RESULTS A total of 105 patients completed the survey. The majority of the respondents were white (81.9%) male (56.7%) with the mean age of 61.5 years. Psychometric evaluation generated a final scale including 14 items with 3 subscales, including 1) emotional or physical impairment due to illness or hospitalization, 2) sleep disturbance due to discomfort or care plan schedule, and 3) sleep interruption due to hospital environment or medical care. The reliability estimate using Cronbach’s alpha coefficient to measure internal consistency for the confirmed 14-item scale was 0.87. The reliability of the subscales ranged from 0.72 to 0.81. CONCLUSIONS The ISDF scale has demonstrated psychometric adequacy and has great potential due to ease and rapidity of use. We recommend using this tool to evaluate the common disturbing factors for hospitalized patients. Routine assessment, open dialogue with the patient, collaborative care planning, and tailored interventions, are key to patient-centered care to improve sleep in acute care hospital.