Sleep Quality and Related Factors in Patients with Heart Failure

Monday, 22 July 2013

Ai-Fu Chiou, PhD, RN1
Mei-Chih Lee, MSN2
Shu-Meng Cheng, MD2
Kuan-Chia Lin, PhD3
(1)School of Nursing, National Yang-Ming University, Taipei, Taiwan
(2)Tri-Service General Hospital, Taipei, Taiwan
(3)Department of Health Care Management,, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan

Learning Objective 1: The learner will be able to describe the sleep quality of patients with heart failure.

Learning Objective 2: The learner will be able to understand the related factors of sleep quality in patients with heart failure.

Purpose: Sleep disturbance was one common problem for the patients with heart failure and contribute to poor quality of life. The purpose of the present study is to explore sleeping quality and the related factors of sleep in the patients with heart failure.

Methods: This study used a descriptive, correlational design. A convenience sample of 104 patients with heart failure was recruited from cardiology clinic at a medical center in Northern Taiwan. Data collection includes biomedical measurement such as serum electrolytes, hematocrit, blood urea nitrogen, creatinine, and peripheral blood oxygen pressure, and a structured questionnaire including basic information, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Hospital Anxiety and Depression Scale, the Symptoms Distress Index, and Social Support Scale. Data analysis includes descriptive statistics, Pearson correlation coefficient, independent t-test, chi-square, one-way ANOVA, and multiple linear regression.

Results: The results of the study indicate that the means score of sleeping quality of the subjects was 9 (SD=4.03) and 76.9% of the patients have poor sleeping quality. The mean score of Epworth Sleepiness Scale was 5.52(SD=4.62) and 20.2% of the patients were distinctive sleepers. Significantly correlations were noted between poor sleep quality and gender, the use of hypnotics, symptom distress, smoking, drinking tea, napping, no walking habit, anxiety or depression, lacking the family support . Multiple regression showed that 30.0% total variance of sleep quality was explained by taking hypnotics (t=4.528, p<.001), depression (t=4.670, p<.001) and smoking (t=2.336,p=.022).

Conclusion: Nurses should recognize the related factors of sleep quality and provide proper psychological and social support to help patients improve their symptoms of heart failure and establish good sleep habits. Nursing intervention such as nurse-led education and exercise program should be developed for improving sleep quality of the patients with heart failure, as well as their quality of life and mental health.