Haleh GHAVAMİ, Rasoul Ghare Aghaji ASL, Fahimeh SAFARZADEH

Koroner arter baypas greftleme yapılan hastalarda öz bakım girişimlerinin uyku kalitesi üzerine etkisi: Tek merkezli, randomize kontrollü çalışma

Amaç: Bu çalışmada koroner arter baypas greftleme sonrasında hastalarda uyku hijyeni uygulamaları, beslenme ve fiziksel aktivite temelli öz bakım girişimlerinin uyku kalitesi üzerine etkisi incelendi. Çalışma planı: Bu randomize kontrollü çalışmaya Eylül 2017 ve Mayıs 2018 tarihleri arasında Seyyed Al- Shohada Hastanesi’nde izole koroner arter baypas greftleme yapılan toplam 146 hasta (109 erkek, 37 kadın; ort. yaş 55.31 yıl; dağılım, 41-65 yıl) alındı. Hastalar öz bakım girişim grubu (n=73) ve kontrol grubu (n=73) olmak üzere iki gruba ayrıldı. Öz bakım girişim grubuna uyku hijyeni, beslenme ve fiziksel aktiviteye ilişkin altı eğitim kursu verildi. Ardından üç ay boyunca haftada bir kere olmak üzere bireysel danışmanlık verildi. Kontrol grubuna normal yaşamlarına ve rutin bakımlarına devam etmeleri söylendi ve herhangi bir eğitim verilmedi. Verilerin toplanmasında Demografik Bilgi Formu ve Pittsburgh Uyku Kalitesi İndeksi kullanıldı. Bulgular: Girişim sonrasında ortalama Pittsburgh Uyku Kalitesi İndeks skoru, öz bakım girişim grubunda 7.1±2.3'e geriler iken, kontrol grubunda 9.5±2.1’e yükseldi. İki grup arasında, çalışma öncesi ortalama Pittsburgh Uyku Kalitesi İndeks skoru açısından anlamlı bir fark bulunamadı (p=0.91); ancak, skorlar öz bakım girişimi sonrasında istatistiksel olarak anlamlı düzeyde daha yüksekti (p=0.001). Sonuç: Koroner arter baypas greftleme yapılan hastalar, uyku kalitelerini artırmak için uyku hijyeni, beslenme ve fiziksel aktivite temelli öz bakım girişimlerinden yarar elde edebilir.

Effect of self-care interventions on sleep quality in post-coronary artery bypass grafting patients: A single-center, randomized-controlled study

Background: This study aims to evaluate the effect of self-careinterventions based on sleep hygiene practices, nutrition, andphysical activity on sleep quality in post-coronary artery bypassgrafting patients.Methods: This randomized-controlled study included a total of146 patients (109 males, 37 females; mean age 55.31 years; range,41 to 65 years) who underwent isolated coronary artery bypassgrafting at Seyyed Al- Shohada Hospital of Urmia MedicalSciences University, between September 2017 and May 2018.The patients were divided into two groups as the self-careintervention group (n=73) and as the control group (n=73). Theself-care intervention group received six educational courses onsleep hygiene, nutrition, and physical activity. Then they receivedindividualized consulting weekly for three months. The controlgroup was instructed to continue their normal life and routinecare and received no education. The Demographic InformationForm and the Pittsburgh Sleep Quality Index were used for datacollection.Results: The mean Pittsburgh Sleep Quality Index scores inthe self-care intervention group decreased to 7.1±2.3 after theintervention, while it increased to 9.5±2.1 in the control group.There was no significant difference between the two groups interms of the mean global Pittsburgh Sleep Quality Index scoresbefore the study (p=0.91); however, the scores were statisticallysignificantly higher after the self-care intervention (p=0.001).Conclusion: Patients undergoing coronary artery bypass graftingmay benefit from self-care interventions based on sleep hygiene,nutrition, and physical activity to improve the quality of sleep.

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Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences. J Caring Sci 2016;5:153-60.
Ranjbaran S, Dehdari T, Sadeghniiat-Haghighi K, Majdabadi MM. Poor Sleep Quality in Patients after Coronary Artery Bypass Graft Surgery: An Intervention Study Using the PRECEDE-PROCEED Model. J Tehran Heart Cent 2015;10:1-8.
Koren D, Dumin M, Gozal D. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes 2016;9:281-310.
Tel H, Tel H, Esmek M. Quality of sleep in hemodialysis patients. Dial Transplant 2007;36:479-84.
Mousavi Malek N, Zakerimoghadam M, Esmaeili M, Kazemnejad A. Effects of nurse-led intervention on patients’ anxiety and sleep before coronary artery bypass grafting. Crit Care Nurs Q 2018;41:161-9.
Rosenfeldt F, Braun L, Spitzer O, Bradley S, Shepherd J, Bailey M, et al. Physical conditioning and mental stress reduction--a randomised trial in patients undergoing cardiac surgery. BMC Complement Altern Med 2011;11:20.
Kaya U, Çolak A, Becit N, Ceviz M, Koçak H. Intraoperative transit-time flow measurement in on-pump coronary artery bypass graft surgery: Single center experience. Turk Gogus Kalp Dama 2018;26:167-76.
Greve H, Pedersen PU. Improving sleep after open heart surgery: effectiveness of nursing interventions. J Nurs Educ Pract 2016;6:15-25.
Machado FS, Souza RCS, Poveda VB, Costa ALS. Nonpharmacological interventions to promote the sleep of patients after cardiac surgery: a systematic review. Rev Lat Am Enfermagem 2017;25:e2926.
Barroso LMM , Brito DMS , Galvão MTG , Oliveira Lopes MVO, Utility of the self-care theory to assist the bearer of human immunodeficiency virus/acquired immunodeficiency syndrome. Acta Paul Enferm 2010;23:562-7.
Malekshahi F, Aryamanesh F, Fallahi S. The effects of massage therapy on sleep quality of patients with end-stage renal disease undergoing hemodialysis. Sleep and Hypnosis 2018;20:91-5.
Del Rio João KA, Becker NB, de Neves Jesus S, Isabel Santos Martins R. Validation of the Portuguese version of the Pittsburgh Sleep Quality Index (PSQI-PT). Psychiatry Res 2017;247:225-9.
Ghavami H, Akyolcu N. The impact of lifestyle interventions in breast cancer women after completion of primary therapy: a randomized study. J Breast Health 2017;13:94-9.
Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath 2012;16:79-82.
Moeini M, Khadibi M, Bekhradi R, Mahmoudian SA, Nazari F. Effect of aromatherapy on the quality of sleep in ischemic heart disease patients hospitalized in intensive care units of heart hospitals of the Isfahan University of Medical Sciences. Iran J Nurs Midwifery Res 2010;15:234-9.
Khosravi A, Bolourchifard F, Ikhani M, Pourhoseingholi MA. The effect of massage therapy on sleep quality in cardiac care unit patients. Biosci Biotech Res Comm 2017;10:645-51.
Nerbass FB, Feltrim MI, Souza SA, Ykeda DS, LorenziFilho G. Effects of massage therapy on sleep quality after coronary artery bypass graft surgery. Clinics (Sao Paulo) 2010;65:1105-10.
Kashi MS, Goyaghaj NS, Hoseini MA, Shahbolaghi FM, Bakhshi E. Evaluation of the effect of jaw relaxation on sleep quality in patients with myocardial infarction. Medical - Surgical Nursing Journal 2016;4:49-55.
Yaghoubi A, Golfeshan E, Azarfarin R, Nazari A, Alizadehasl A , Ehasni A. Effects of acupressure on sleep quality after coronary artery bypass surgery. Iranian Heart Journal 2017;18;28-34.
Suna JM, Mudge A, Stewart I, Marquart L, O'Rourke P, Scott A. The effect of a supervised exercise training programme on sleep quality in recently discharged heart failure patients. Eur J Cardiovasc Nurs 2015;14:198-205.
Johansson A, Adamson A, Ejdebäck J, Edéll-Gustafsson U. Evaluation of an individualised programme to promote self-care in sleep-activity in patients with coronary artery disease -- a randomised intervention study. J Clin Nurs 2014;23:2822-34.
Akıncı B, Yeldan İ, Bayramoğlu Z, Belhhan Akpınar T. The effects of posture and relaxation training on sleep, dyspnea, pain and, quality of life in the short-term after cardiac surgery: a pilot study. Turk Gogus Kalp Dama 2016;24:258-65.
Atalan N, Sevim ME: Postoperative delirium associated with prolonged decline in cognitive function and sleep disturbances after cardiac surgery. Turk Gogus Kalp Dama 2013;21:358-63.