Hospital Environmental Disruptors and Caregiver Sleep During Hospitalization.

PURPOSE: Caregivers must cope with a poor sleep environment when caring for someone admitted to the hospital. The aim was to study the environmental factors associated with a sleep disruption pattern in caregivers during hospitalization and to test their association with caregivers' insomnia symptoms. DESIGN: This was a cross-sectional study. METHODS: One hundred twenty-three caregivers completed the study. The effect of environmental stimuli on sleep disruption was measured on a scale from 1 to 10 (1 = no disruption, 10 = significant disruption). Type of room (single vs shared), insomnia symptoms, anxiety and depression, and patients' dependence (Barthel Index) were assessed as well. Caregiver and patient characteristics as well as identified hospital disruptors were compared with Student t test, χ2 test, and Fisher exact test according to the caregivers' type of room. A linear regression model using main caregiver and patient sociodemographic variables, questionnaires, and the sum of all hospital disruptors determined the factors associated with caregivers' insomnia symptoms. RESULTS: Of the caregivers and their care recipients, 51.2% shared a room with 1 to 2 other patients. Higher self-reported levels of sleep disruption due to environmental stimuli were found in shared rooms when compared with single rooms (eg, nursing care, noise, and light) (P < .05). Hospital sleep disruptors (adjusted regression coefficient, 0.15; 95% confidence interval, 0.06-0.24) and caregiver anxiety (adjusted regression coefficient, 0.57; 95% confidence interval, 0.33-0.81) were predictors for insomnia (P < .01). However, caregivers' type of room was not associated with insomnia severity symptoms (P > .05). CONCLUSIONS: Interventions are urgent to implement, such as relieving caregivers from patient needs during the night, providing them with single rooms, and conducting multiple nursing tasks in 1 visit to minimize night hospital noise.

Insomnia Symptoms and Associated Factors in Caregivers of Adult Hospitalized Patients.

Caregivers experience high levels of emotional stress and must cope with several clinical and hospital-related environmental factors that seriously impact their night's rest. The purpose of this study was to establish the prevalence of insomnia symptoms in a sample of caregivers of adult hospitalized patients and to examine the relationships between insomnia symptoms and patient and caregiver-associated factors. A total of 152 caregivers were enrolled from the two main hospitals in Granada, Spain. Sociodemographic, economic, and care-related data were collected. Insomnia symptoms, burden, anxiety and depression, social support, and resilience were assessed. Information on patients' hospital admission, dependence, and neuropsychiatric symptoms was also obtained. Most caregivers were middle-aged women caring for their spouses. Self-reported insomnia prevalence was set at 45.4%. Comparison analyses between caregivers suffering from insomnia symptoms and non-insomniacs showed significantly higher burden, anxiety and depression and patients' neuropsychiatric symptoms (p < 0.05) and lower resilience and social support in the former (p < 0.01). A regression analysis showed that anxiety (ORa = 1.15; p < 0.05) and higher caregiver education level (ORa = 5.50; p < 0.05) were factors significantly associated with insomnia symptoms. Patients' neuropsychiatric symptoms showed a trend toward statistical significance as well (ORa = 1.09; p = 0.06). There is an acute need to address, prevent and treat insomnia problems in caregivers.

[Evaluation of a functional plan for caregivers in hospital]. / Evaluación del plan funcional dirigido a personas cuidadoras en hospitalización.

BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011. RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change.