• 한국보건간호학회지
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• 제33권2호
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• pp.163-174
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• 2019

Purpose: The purpose of this study was to identify the effects of job stress, depression and fatigue on sleep quality of care workers employed in long-term care facilities. Methods: The participants were 213 care workers who worked in 11 long-term care facilities. The collected data was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple linear regression with using the SPSS 23.0 program. Results: We found that patient-related job stress was the greatest stressor among care workers' job stresses. A significant difference in sleep quality was observed according to the self-perceived health status of the care workers. The care workers' sleep quality was negatively correlated with job stress (r=-.16, p=.018), depression (r=-.31, p<.001) and fatigue (r=-.29, p<.001). The influencing factors of sleep quality were depression (${\beta}=-0.22$, p=.001) and fatigue (${\beta}=-0.15$, p=.047). Conclusion: It is necessary to improve the health status and sleep quality of care workers by developing and applying health promotion programs to reduce the depression and fatigue of the care worker. This will ultimately improve the quality of service care for the patients.

• 중환자간호학회지
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• 제5권1호
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• pp.23-33
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• 2012

Purpose: The purpose of this study is to investigate the effect of eye-shields and sleep-inducing music application on sleep quality and incidence of delirium for intensive care unit (ICU) patients. Methods: This study was a untreated control group design with pretest and posttest. The data was collected in the ICU of D University Hospital in Busan, from June to September 2011. Thirteen subjects were assigned to eye-shields and sleep-inducing music intervention and 15 subjects were in the control group. Results: Eye-shields and sleep-inducing music application was effective for improving the quality of sleep in ICU patients. There was no statistically significant difference in the incidence of delirium between the two groups. Conclusion: The sleep improvement intervention with eye-shields and sleep-inducing music would be a meaningful part of nursing intervention programs to enhance the quality of sleep in ICU patients.

• 중환자간호학회지
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• 제15권3호
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• pp.115-127
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• 2022

Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (𝑥²=7.86, p =.049), a greater number of WASO (𝑥²=5.69, p =.128), and a longer WASO duration (𝑥²=8.75, p =.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권2호
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• pp.59-67
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• 2023

General anesthesia may influence the postoperative sleep cycle; however, no clinical studies have fully evaluated whether anesthesia causes sleep disturbances during the postoperative period. In this scoping review, we explored the changes in postoperative sleep cycles during surgical procedures or dental treatment under general anesthesia. We compared and evaluated the influence of general anesthesia on sleep cycles and sleep disturbances during the postoperative period in adult and pediatric patients undergoing surgery and/or dental treatment. Literature was retrieved by searching eight public databases. Randomized clinical trials, observational studies, observational case-control studies, and cohort studies were included. Primary outcomes included the incidence of sleep, circadian cycle alterations, and/or sleep disturbances. The search strategy yielded six studies after duplicates were removed. Finally, six clinical trials with 1,044 patients were included. In conclusion, general anesthesia may cause sleep disturbances based on alterations in sleep or the circadian cycle in the postoperative period in patients scheduled for elective surgery.

• 중환자간호학회지
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• 제13권3호
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• pp.1-10
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• 2020

Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses.

• 기본간호학회지
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• 제21권4호
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• pp.403-412
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• 2014

Purpose: Shift work disrupts the synchronization between the human biological clock and the environment. Sleep disturbances are common for shift work nurses, and may threaten patient safety. This study was done to investigate the sleep characteristics and medication errors (ME) of intensive care unit (ICU) nurses who work shifts, and ascertain if there is an association between these factors. Methods: Data were collected using a self-report questionnaire from 126 ICU nurses on three shifts. Collected data included their sleep characteristics including sleep patterns and sleep disturbances, and ME for the past 2 weeks. Results: There were significant differences in sleep duration and sleep latency according to shift. Day shift nurses had the shortest sleep duration, and their sleep latency was the longest (about 49 minutes) compared to nurses on evening and night shifts; 54% reported sleep disturbances, 16% experienced ME, and among these nurses 50% were on the night shift. Logistic regression analysis revealed significant associations between nurses' sleep duration and ME (adjusted OR 0.52 [95% CI 0.32-0.85]). Conclusions: The results confirmed that shift work nurses in the ICUs experience sleep disturbance, and that less sleep is associated with ME.

• Tuberculosis and Respiratory Diseases
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• 제76권3호
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• pp.131-135
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• 2014

Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

• Tuberculosis and Respiratory Diseases
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• 제85권2호
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• pp.202-204
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• 2022

• Tuberculosis and Respiratory Diseases
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• 제77권1호
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• pp.24-27
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• 2014

Takotsubo cardiomyopathy (TTC) is defined as a reversible, acute ventricular dysfunction without any evidence of coronary artery obstruction. There have been reports of TTC caused by emotional or physical stress, drug use, hormone imbalance, or medical conditions such as pulmonary disease, sepsis, and trauma, but a relationship between TTC and pulmonary tuberculosis has not previously been reported. From our knowledge, this is the first report of TTC caused by pulmonary tuberculosis.

• 중환자간호학회지
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• 제16권2호
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• pp.1-14
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• 2023

Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.