The effect of nursing care provided to coronary intensive care patients according to their circadian rhythms on sleep quality, pain, anxiety, and delirium

INTRODUCTION AND AIM: In this study, it was aimed to develop a valid and reliable scale to measure the sleep quality of patients treated in the coronary intensive care unit and to examine the effects of nursing care given to coronary intensive care patients according to their circadian rhythms on sleep quality, pain, anxiety, and delirium. MATERIALS AND METHODS: The sample of the study, which was carried out in two stages, methodological and randomized controlled experimental, consisted of a total of 44 participants, 201 in the first stage, 22 interventions, and 22 controls in the second stage. In the second stage, the chronotypes of the participants were determined, and the patients in the intervention group were given nursing care in accordance with their circadian rhythms. Data were collected using "Patient Information Form, Sleep Quality Scale in Coronary Intensive Care Patients (SQ-CC), Sleep Questionnaire (RCSQ), Visual Analogue Scale (VAS), Morningness-Eveningness Questionnaire (MEQ), Hospital Anxiety and Depression Scale (HADS), Intensive Care Delirium Screening Checklist (ICDSC)". In addition, melatonin and cortisol measurements were made, and sleep data were taken with a smartwatch. Explanatory and confirmatory factor analysis, Cronbach's Alpha for reliability, Pearson correlation for similar test relationship, frequency distribution, dependent and independent sample t-test, Wilcoxon test, repeated measures analysis of variance, Mann Whitney U and chi-square analysis were used in the evaluation of the data. RESULTS: The Cronbach's Alpha coefficient of the developed scale was observed to be 0,816. There was a significant negative correlation between the RCSQ and the scale generally fitted well. It was determined that the mean SQ-CC Scale, HADS, and ICDSC scores of the intervention group were significantly lower than the control group, and there was no difference in the VAS scores. xiv CONCLUSION: The SQ-CC scale is valid and reliable. Nursing care given in accordance with the circadian rhythm increases sleep quality and reduces the risk of delirium and anxiety.