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Sleep as a topic in nursing education programs? A mixed method study of syllabuses and nursing students' perceptions
Sophiahemmet University.ORCID iD: 0000-0002-1372-7757
Sophiahemmet University.ORCID iD: 0000-0002-9512-3374
Sophiahemmet University.ORCID iD: 0000-0001-8101-9915
2019 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 79, p. 168-174, article id S0260-6917(18)30846-3Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Sleep is a basic human need and is considered important for maintaining health. It is even more important during illness due to its impact for example on our immune system. Nurses have an important role in identifying sleep deprivation. They are also in a unique position to promote and address sleep among patients. However, it is essential that they are provided with the appropriate knowledge during training.

AIM: To explore and describe nursing students' perceptions of preparedness to adress and support patients' sleep during hospitalization and to apply sleep-promoting interventions in a clinical context. Furthermore, the aim was to investigate if, and how, the topic of sleep is explicitly incorporated in nursing education programs.

DESIGN: A descriptive study based on a mixed method approach.

METHODS: Quantitative and qualitative data were collected from program and course syllabuses and intended learning outcomes from three universities. Twenty-one nursing students from the same universities were interviewed during their final year of education.

RESULTS: The results of both quantitative and qualitative data consistently show that education regarding sleep and patients' sleep is limited and, in some respects, absent in the Bachelor of Science Nursing programs investigated.

CONCLUSION: This study indicates that education about sleep and patients' sleep in the nursing programs studied is insufficient and limited. This gap in knowledge may lead to prospective registered nurses using their own experiences instead of evidence-based knowledge when assessing, supporting and applying sleep-promoting interventions.

Place, publisher, year, edition, pages
2019. Vol. 79, p. 168-174, article id S0260-6917(18)30846-3
Keywords [en]
Interviews, Mixed method, Nursing education, Preparedness, Sleep, Students' knowledge
National Category
Nursing
Identifiers
URN: urn:nbn:se:shh:diva-3332DOI: 10.1016/j.nedt.2019.05.030PubMedID: 31132729OAI: oai:DiVA.org:shh-3332DiVA, id: diva2:1319808
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-08-16Bibliographically approved
In thesis
1. Nursing perspectives on patients' sleep during hospital care
Open this publication in new window or tab >>Nursing perspectives on patients' sleep during hospital care
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sleep is crucial for all humans in terms of health, daily functioning and well-being. Previous research has shown that sleep is considered a stressor for patients during hospital care. The general aim of this thesis was to explore and describe, from a nursing perspective, patients’ sleep and how sleep is addressed, promoted and assessed during hospital care.

Methods: To cover the general aim of this thesis, various designs were chosen, and diverse methods of data collection were employed. In Study I, data were collected through qualitative interviews of ten consecutively recruited patients at an acute hospital. In Study II, data were collected through qualitative individual interviews and four focus groups, with a total of twenty-two registered nurses at four acute hospitals in an urban region. Study III was designed as a mixed method study and data were collected through twenty-one qualitative individual interviews as well as from program and course syllabuses and intended learning outcomes at three universities. Data from Studies I-II were analysed by qualitative content analysis with an inductive, latent approach. Data in Study III were analysed by qualitative content analysis with an inductive, manifest approach and collected documents were read word-for-word and scanned for the pre-set word, sleep. Study IV was a cross-sectional study and data were collected through a web-based survey. Acute hospitals in Sweden were subjected to stratified randomized sampling. Registered nurses, head nurses, nursing care developers and local training staff were included in the study. Data were analysed using descriptive statistics, and free-text answers were analysed by a thematic text analysis. Study V was performed as a non-experimental prospective study. Data from a group of twenty-five patients at two hospitals were collected by using the Richards-Campbell Sleep Questionnaire and actigraphy by Vivago® and were analysed with correlation and regression analysis.

Findings: Patients’ sleep during hospital care is affected by several different factors and patients’ sleep is described as an important but undermanaged area. Limited knowledge and education within the area and insufficient support from the organization can be seen as barriers. Study III reveals that several student nurses lack evidence-based knowledge about sleep and sleep-promotion and consider themselves only to be prepared to address and promote sleep to a limited extent. Furthermore, the word, sleep, occurred explicitly only three times in two different learning outcomes at one of three included universities. Study IV shows that the area of sleep is not highlighted in a clinical context; for example, there is an absence of training days and education about sleep, only a few departments actively address patients’ sleep, and the use of sleep-assessment is non-existent. Study V shows a relationship between individual Vivago® graphs and patients’ self-assessed sleep, but a significant correlation for all patients between mean values for the two assessments was only obtained for one of the two included nights.

Conclusions: This thesis indicates that sleep deprivation is common among patients during hospital care. Furthermore, education about patients’ sleep in the investigated nursing programs and in clinical practice seems to be deficient. Assessments with the Richards-Campbell Sleep Questionnaire and measurement with Vivago® capture different dimensions of sleep. In its present form, the RCSQ could have the potential to facilitate nursing actions to promote sleep amongst hospitalized patients in line with person-centred care. Furthermore, it is concluded that patients’ sleep during hospital care is an undermanaged and non-highlighted area. This thesis shows that there are several challenges for nurses, nursing managers and organizations at acute hospitals if better outcomes are to be achieved.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2019. p. 62
National Category
Nursing
Identifiers
urn:nbn:se:shh:diva-3335 (URN)978-91-7831-411-9 (ISBN)
Public defence
2019-05-24, Erforssalen, Sophiahemmet Högskola, Valhallavägen 91, Hus R, plan 2, Stockholm, 09:30 (Swedish)
Opponent
Supervisors
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-06-27Bibliographically approved

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