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Qualidade do sono numa unidade de cuidados intensivos pediátricos
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Introdução: O internamento hospitalar é uma alteração do ambiente que é perturbadora do sono, estando as crianças internadas em UCIP mais expostas a fatores que aumentam a sua disrupção. Sendo o sono essencial ao processo de cura, a qualidade do mesmo durante o internamento tem um impacto importante na recuperação da doença.
Objetivo: O objetivo deste estudo foi perceber de que forma a rotina noturna da UCIP permite cumprir os cuidados básicos de higiene do sono.
Material e Métodos: De 1 de dezembro de 2019 a 15 de março de 2020 foram aplicados dois questionários, um para recolha de dados relativos à higiene do sono e dinâmica noturna da UCIP e outro para crianças e acompanhantes sobre a perceção geral da qualidade do sono durante o internamento.
Resultados: Durante o período do estudo estiveram internadas 122 crianças, com uma idade média de 4,99 anos. O diagnóstico de internamento mais comum foi o de patologia do aparelho respiratório, com necessidade de ventilação mecânica em 62 crianças. A hora média de redução de iluminação foi às 2h21 min, de ligar as luzes às 7h49, existindo um período médio de redução de luminosidade de 5h28 min. Na maioria das noites, o ambiente foi interrompido menos que 3 vezes, sendo o motivo mais comum a prestação de cuidados. Não foi possível obter uma amostra significativa de respostas ao Questionário para crianças e acompanhantes.
Conclusão: Existiu maior dificuldade em aplicar rotinas de higiene do sono no início do período noturno, sendo o período de redução luminosa deficitário em relação às necessidades de sono das crianças para cada faixa etária. A patologia respiratória e o recurso à ventilação mecânica contribuíram para o número de disrupções noturnas. Apesar de instituídas rotinas de higiene do sono, aplicar as mesmas de forma sistemática é um desafio.
Introduction: The hospitalization is an environment alteration that is detrimental to sleep. Critically ill children are exposed to multiple factors that increase sleep disturbance. Sleep plays a major role in the process of cure, therefore its disruption during hospitalization has an important impact on recovery. Objective: The main goal of this study was to understand how the night routine of the PICU respects the basic rules of sleep hygiene. Material and Methods: The study was held between December 1st 2019 and March 15th 2020 and two questionnaires were applied, one to collect data about sleep hygiene and the nocturnal routine of the unit and another one for children and relatives or caregivers about their perception of sleep quality during hospitalization and the most disruptive factors. Results: During this period, 122 children, with an average age of 4,99 years old, were admitted to the PICU, mainly with respiratory problems and 62 children underwent mechanical ventilation. The average hour of luminosity reduction was at 2:21 a.m., and lights were switched at 7:49 a.m., with an average period of luminosity reduction per night of 5h28min. On most nights, the environment was disrupted less than 3 times, being care delivery the most common reason. It was not possible to obtain a significative sample for the children and companions’ questionnaire. Conclusion: It was more difficult to apply schedules and sleep hygiene routines in the beginning of the nocturnal period, being the period of luminosity reduction deficient in relation to the recommend amount of sleep to which age range. The respiratory pathology and the need for mechanical ventilation also contributed to the environment disruptions in the PICU. Despite having established sleep hygiene routines, their application in a systematic way is quite a challenge.
Introduction: The hospitalization is an environment alteration that is detrimental to sleep. Critically ill children are exposed to multiple factors that increase sleep disturbance. Sleep plays a major role in the process of cure, therefore its disruption during hospitalization has an important impact on recovery. Objective: The main goal of this study was to understand how the night routine of the PICU respects the basic rules of sleep hygiene. Material and Methods: The study was held between December 1st 2019 and March 15th 2020 and two questionnaires were applied, one to collect data about sleep hygiene and the nocturnal routine of the unit and another one for children and relatives or caregivers about their perception of sleep quality during hospitalization and the most disruptive factors. Results: During this period, 122 children, with an average age of 4,99 years old, were admitted to the PICU, mainly with respiratory problems and 62 children underwent mechanical ventilation. The average hour of luminosity reduction was at 2:21 a.m., and lights were switched at 7:49 a.m., with an average period of luminosity reduction per night of 5h28min. On most nights, the environment was disrupted less than 3 times, being care delivery the most common reason. It was not possible to obtain a significative sample for the children and companions’ questionnaire. Conclusion: It was more difficult to apply schedules and sleep hygiene routines in the beginning of the nocturnal period, being the period of luminosity reduction deficient in relation to the recommend amount of sleep to which age range. The respiratory pathology and the need for mechanical ventilation also contributed to the environment disruptions in the PICU. Despite having established sleep hygiene routines, their application in a systematic way is quite a challenge.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
Palavras-chave
Sono Crianças Hospitalização Cuidados intensivos Pediatria