Gender differences in the relationships between sleep disturbances and academic performance among nursing students: A cross-sectional study

BackgroundSleep disturbances, such as insomnia, excessive daytime sleepiness, and poor-quality sleep, are common among nursing students and are closely linked with academic performance.ObjectivesTo examine the prevalence of sleep disturbances and academic performances in male and female nursing students and to determine gender-specific effects on the relationship between sleep disturbances and academic performance.DesignA cross-sectional study design was adopted.SettingsThis study was conducted in a school of nursing in Indonesia.ParticipantsA total of 492 undergraduate students (103 males and 389 females) were included.MethodsData pertaining to the biosociodemographic characteristics, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Morningness-Eveningness Questionnaire, and Beck Depression Inventory were collected from July 1, 2018 to September 30, 2018. Academic performance was measured using grade point average of the academic year 2017–2018. A multivariate logistic regression model was used for data analyses.ResultsThe prevalence of poor sleep quality, insomnia, and daytime sleepiness was 66.0%, 45.6%, and 24.3%, respectively, in male nursing students and 71.5%, 52.4%, and 28.8%, respectively, in female nursing students. For circadian rhythm preferences, 66% male and 51.7% female nursing students were categorized as intermediate- and morning-type people, respectively. Insomnia was the only variable among sleep disturbances that significantly correlated with the risk of poor academic performance in female nursing students even after adjustment of covariates.ConclusionsSleep disturbances were highly prevalent among female and male nursing students, and insomnia was substantially associated with poor academic performance in female nursing students. Identifying sleep disturbances among nursing students and designing effective interventions to specifically target them are required to improve academic performance of female nursing students.     

Effects of a pedometer-based walking intervention on young adults’ sleep quality,stress and life satisfaction: Randomized controlled trial

ObjectiveThe purpose of this study was to evaluate the effect of daily walking exercise on sleep quality, perceived stress and life satisfaction. It aimed to investigate the interaction between daily walking exercise and sleep components (sleep quality, sleep latency, sleep duration, sleep disturbance, sleep medication use, and daytime functioning).MethodsA four-week randomized control trial (RCT) was conducted by assigning 54 research volunteers into two groups randomly. The participants in the intervention group (IG) were asked to carry out a daily aerobic walking exercise (DAWE), and participants in the control group (CG) were requested to maintain a sedentary life style. Sleep quality, perceived stress and life satisfaction were assessed at the baseline and at the end of the intervention. All participants were equipped with Omron HJ-112 pedometer to record their daily exercise and to fulfil a daily diary sheet.ResultsBy the end of the intervention, 26 out of 54 participants (M_age = 24.96; SD = 5.13) completed the task. There was no statistical significance between the two groups when comparing global sleep quality, stress and life satisfaction. The within group comparison showed positive effect of DAWE on subjective sleep quality (p = 0.05), less sleep medication use (p < 0.05), positive effect on daytime function (p < 0.01) and improved life satisfaction (p = 0.05) after four weeks of intervention.ConclusionFindings suggested that incorporating daily aerobic walking exercise might be beneficial to sleep health. Further studies are suggested to ascertain the pedometer-based daily walking exercise's long-term effects and to unfold the biological mechanisms leading to its sleep quality improvement effect.     

Tailored educational supportive care programme on sleep quality and psychological distress in patients with heart failure: A randomised controlled trial

BackgroundUp to 74% of patients with heart failure report poor sleep in Taiwan. Poor symptom management or sleep hygiene may affect patients’ sleep quality. An effective educational programme was important to improve patients’ sleep quality and psychological distress. However, research related to sleep disturbance in patients with heart failure is limited in Taiwan.ObjectivesTo examine the effects of a tailored educational supportive care programme on sleep disturbance and psychological distress in patients with heart failure.Designrandomised controlled trial.Participants and settingEighty-four patients with heart failure were recruited from an outpatient department of a medical centre in Taipei, Taiwan. Patients were randomly assigned to the intervention group (n = 43) or the control group (n = 41).MethodsPatients in the intervention group received a 12-week tailored educational supportive care programme including individualised education on sleep hygiene, self-care, emotional support through a monthly nursing visit at home, and telephone follow-up counselling every 2 weeks. The control group received routine nursing care. Data were collected at baseline, the 4th, 8th, and 12th weeks after patients’ enrollment. Outcome measures included sleep quality, daytime sleepiness, anxiety, and depression.ResultsThe intervention group exhibited significant improvement in the level of sleep quality and daytime sleepiness after 12 weeks of the supportive nursing care programme, whereas the control group exhibited no significant differences. Anxiety and depression scores were increased significantly in the control group at the 12th week (p < .001). However, anxiety and depression scores in the intervention group remained unchanged after 12 weeks of the supportive nursing care programme (p > .05). Compared with the control group, the intervention group had significantly greater improvement in sleep quality (β = −2.22, p < .001), daytime sleepiness (β = −4.23, p < .001), anxiety (β = −1.94, p < .001), and depression (β = −3.05, p < .001) after 12 weeks of the intervention.ConclusionThis study confirmed that a supportive nursing care programme could effectively improve sleep quality and psychological distress in patients with heart failure. We suggested that this supportive nursing care programme should be applied to clinical practice in cardiovascular nursing.     

Persistent and new-onset daytime sleepiness in pregnant women: A prospective observational cohort study

BackgroundDaytime sleepiness is a frequent complaint in women during pregnancy. It has also been linked to negative obstetric consequences. Although high prevalence of excessive daytime sleepiness throughout pregnancy is well-documented, neither the causes of persistent daytime sleepiness nor new-onset daytime sleepiness during pregnancy have been investigated. Identifying predictive factors may play an important role in the management of daytime sleepiness in pregnant women and improve prenatal care and maternal-fetal outcomes.ObjectivesTo examine first-trimester maternal characteristics associated with the persistence and new-onset daytime sleepiness in pregnant women.DesignA longitudinal, prospective cohort design.SettingOne medical center in Taipei, Taiwan and participating women’s homes.ParticipantsA total of 204 pregnant women.MethodsFirst-trimester pregnant women recruited from an outpatient obstetric clinic at a medical center provided socio-demographic and health information, wore an actigraphy monitor for 7 days, and completed sleep, mood, and daytime sleepiness questionnaires. Data were collected again when the women were in the second and third trimester.ResultsThirty-one (15.2%) women experienced excessive daytime sleepiness that persisted across all three trimesters. Nulliparous women and women who snored in the first trimester were 2.28 and 2.10 times more at risk of being classified of persistent daytime sleepiness than multiparous women and women who did not snore in the first trimester, respectively. Thirty-one (15.2%) women developed new-onset daytime sleepiness with advancing gestation. Women were more likely to develop new-onset daytime sleepiness if they worked longer hours per week (OR = 1.04, p < 0.001), if they reported snoring (OR = 6.75, p < 0.001), and if they had elevated depressive symptoms in the first trimester of pregnancy (OR = 1.09, p = 0.01).ConclusionsSnoring in the first trimester is involved in both the persistence and new-onset of daytime sleepiness with elevated depressive symptoms related to new-onset daytime sleepiness in pregnant women. Findings suggest that intervention strategies for alleviating daytime sleepiness in pregnant women should focus on managing snoring and symptoms of depression in early trimesters with special attention to nulliparous and employed women.     

Sleep quality and its impact on glycaemic control in patients with type 2 diabetes mellitus

PurposeTo investigate the sleep quality of patients with type 2 diabetes (T2D) and its impact on glycaemic control.MethodsUsing a convenience sampling method, 220 patients with T2D were recruited. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep quality with threshold at PSQI ≥ 8. The glycosylated haemoglobin A1c (HbA1c) test was used to measure the glycaemic control with threshold at HbA1c < 7%.ResultsThe PSQI score was 8.30 ± 4.12. The sleep disorder incidence rate was 47.1%. Patients with HbA1c ≥ 7% had significantly lower PSQI global and factor scores (p < 0.01) versus the control group. Sleep latency, sleep disturbance, and daytime dysfunction were the risk factors for poor glycaemic control.ConclusionPatients with T2D have high sleep disorder rate negatively impacting glycaemic control. Health care providers should pay close attention to the sleep quality of T2D patients, and provide them with appropriate educational material.     

Cross-sectional and longitudinal associations between sleep and health-related quality of life in pregnant women: A prospective observational study

BackgroundSleep disturbances are common in women, especially during pregnancy. Previous studies have confirmed the importance of sleep disturbances as a risk factor of adverse pregnancy outcomes and the need for screening and treatment of inadequate sleep. These reports, however, did not examine health-related quality of life which may be affected by sleep long before adverse clinical consequences are detectable in women during pregnancy.ObjectivesTo examine the cross-sectional and longitudinal association between sleep and health-related quality of life in pregnant women.DesignA prospective observational study.SettingA university-affiliated hospital in Taiwan and participants’ homes.ParticipantsA total of 164 pregnant women completed questionnaires and wore a wrist actigraphy monitor for 7 days each trimester.MethodsObjective sleep was measured by actigraphy, subjective sleep was measured by the Pittsburgh Sleep Quality Index, and health-related quality of life was measured using the SF-12v2 questionnaire across three trimesters. Multiple linear regression analyses were performed to evaluate the cross-sectional and longitudinal associations between sleep and health-related quality of life.ResultsSixty-four (39.0%) women consistently had an average sleep efficiency < 85% by actigraphy and 40 (24.4%) had a Pittsburgh Sleep Quality Index global score > 5 in all three trimesters. Cross-sectionally, more actigraphic daytime sleep (p = 0.04) and better subjective sleep quality (p < 0.01) were associated with better physical health-related quality of life in first-trimester pregnant women. Better actigraphic sleep efficiency (p = 0.04) and better subjective sleep quality (p < 0.01) were associated with better mental health-related quality of life in second-trimester pregnant women. Longer actigraphic total nighttime sleep (p < 0.01) and better subjective sleep quality (p < 0.01) were associated with better mental health-related quality of life in third-trimester pregnant women. Longitudinally, first-trimester actigraphic total nighttime sleep (p < 0.05) and subjective sleep quality (p < 0.01) predicted mental health-related quality of life in the second and third trimester.ConclusionsSleep disturbances are a highly prevalent and persistent problem in pregnant women. Adequate sleep is essential for women at all pregnancy stages and improving nocturnal sleep quantity and quality in early gestation is of utmost importance for an optimal health-related quality of life later in pregnancy.     

The effect of smartphone addiction on physical activity level in sports science undergraduates

BackgroundSmartphones are thought to have many negative effects on interpersonal relationships, physical-mental health, and general functionality as well as bring many conveniences to our daily lives. This study aimed to determine the effect of smartphone addiction on physical activity level in sports science undergraduates. Secondly, comparing the physical activity level in students by gender was aimed.MethodA total of 300 (134 female, 166 male) healthy university students were included in this study. The mean age of the subjects was 21.36 ± 2.33 years. The universe of the study consisted of volunteer students (Coaching Education, Physical Education and Sports Teaching, Sports Management, Recreation Departments) at the Faculty of Sport Sciences. Participants' demographic information was obtained and their physical activity levels were questioned with International Physical Activity Questionnaires (IPAQ) and smartphone addictions with the Smartphone Addiction Scale- Short Version (SAS-SV). The significance level was accepted as p < .05 in statistical evaluations.ResultsAccording to IPAQ scores, physical activity levels of the participants were as follows; 65.3% were adequate, 32.7% low and 2% inactive. One-hundred and twenty-six participants (42%) were smartphone addicts according to the SAS-SV results. When the departments were examined within themselves, it was found that IPAQ and SAS-SV scores were negatively correlated for Physical Education and Sports Teaching (r = - 0.262; p = .021) and Sports management (r = - 0.295; p = .01).     

Translation of the short version of the Smartphone Addiction Scale into Brazilian Portuguese: cross-cultural adaptation and testing of measurement properties

BackgroundSmartphone use has been constantly increasing. Smartphone addiction can lead to changes in the emotional state and musculoskeletal system of users. To identify smartphone addicts, the Smartphone Addiction Scale-Short Version was developed; however, this scale has not been translated into Brazilian Portuguese and tested for its measurement properties.ObjectiveTo translate and cross-culturally adapt the Smartphone Addiction Scale-Short Version into Brazilian Portuguese; to assess the internal consistency, reliability and construct validity of the scale among university students.MethodsThe cross-cultural adaptation was performed following the guidelines for cross-cultural adaptation of self-report measures, and data were collected via online surveys administered to 59 university students over 18 years of age for test–retest. To test the measurement properties of the final version of the Smartphone Addiction Scale-Short Version, a convenience sample including 130 university students was used.ResultsThe Smartphone Addiction Scale-Short Version showed good reliability for test–retest scores (ICC_3,1 = 0.82; 95% CI = 0.70–0.89) and good internal consistency considering all 10 items (Cronbach's alpha = 0.95). The construct validity was calculated comparing the Smartphone Addiction Scale-Short Version score to data from a questionnaire prepared by the authors of this study, including frequency per day (r = 0.35; p < 0.001), leisure time on the smartphone (r = 0.33; p < 0.001), and time working on the smartphone (r = 0.18; p = 0.04) that were significantly positively associated with higher Smartphone Addiction Scale-Short Version scores. The results show a high prevalence of smartphone addiction among university students (33.1%).ConclusionIt can be concluded that the Brazilian Portuguese version of the Smartphone Addiction Scale-Short Version is a reliable and valid tool for screening smartphone addiction in university students.     

Effect of Benson and progressive muscle relaxation techniques on sleep quality after coronary artery bypass graft: A randomized controlled trial

ObjectiveThis study aimed to investigate the effect of Benson relaxation (BR) and progressive muscle relaxation (PMR) techniques on the sleep quality of patients undergoing coronary artery bypass graft (CABG) surgery.MethodThis study was a three-arm, parallel, randomized controlled trial. 120 patients who underwent CABG surgery at two academic hospitals in an urban area of Iran were randomly allocated into three groups (40 per group): the BR, PMR, and control groups. Patients in the BR and the PMR groups performed relevant exercises twice a day for four weeks. Sleep quality was measured before and immediately after the intervention using Pittsburgh Sleep Quality Index.ResultsWithin-group comparison in the BR (t = 3.51, p = 0.001) and the PMR (t = 4.58, p < 0.001) group showed that the overall sleep quality showed a significant improvement after the intervention when compared to baseline. The between-group comparison showed that both the BR and PMR groups showed significant improvements in subjective sleep quality (F = 3.75, p = 0.02), habitual sleep efficiency (F = 4.81, p = 0.01), and overall sleep quality (F = 5.53, p = 005) when compared to the control group after the intervention. However, no statistically significant differences were identified among the three study groups in terms of sleep latency, sleep duration, sleep disturbances, sleeping medication, and daytime dysfunction after the intervention (p > 0.05).ConclusionThe study showed that a four-week program of both PMR and BR can be effective in the overall improvement of sleep quality in patients following CABG. Further research is required to replicate the findings of the present study.     

Sleep and methods of assessment

Sleep is a complex behavior; adequate sleep is essential for healthy functioning and even for survival. Poor sleep quality and insufficient sleep have been linked to increased risk for various illnesses, as well as with an increased prevalence of excessive daytime sleepiness and reduced quality of life. Daytime sleepiness can lead to dangerous outcomes associated with drowsy driving and has become an important public health issue. Routine health examinations that include questions about sleep habits, daytime sleepiness, and problems with sleep at night can help to educate people about the importance of good sleep habits. They provide a way to identify sleep disorders so that appropriate therapies can be instituted or proper referrals to a sleep specialist can be given.     

The relationship of social status and social image with the choice of nursing career among the next generation of Turkish youth: A cross-sectional study

AimTo evaluate the nursing image and social status characteristics on young people’s decision to choose nursing as a career.BackgroundLow social status and social image threaten the nursing workforce.DesignA cross-sectional study.MethodsThe study was conducted with 745 high school students and 349 nursing students between 24 March and 10 May 2022. The data were collected through the Nursing Image Scale, Job Satisfaction Scale and Personal Form and analyzed using multiple regression and decision tree analysis.ResultsHigh school (43.1 %) and 73.6 % of nursing students expressed their intention to become a nurse. While the likelihood of choosing nursing as a career decreases among man high school students (p = 0.018) with a high occupation (p = 0.003) and income index (p = 0.003), it increases among low-income female students (p = 0.012), perceiving occupational status more positively (p = 0.002). The possibility of continuing in the profession increases among nursing students who have a higher opinion of the profession's status (p = 0.010) and job satisfaction increases as the image perception improves (r = 0.385, p < 0.01).Conclusion and recommendationsPerception of professional image guides career choice in nursing. The choice of nursing as a future profession differs according to gender and is influenced by social status. The glass ceiling effect should be evaluated in nurses coming from low status.     

Dynamic prevalence of sleep disturbance among critically ill patients in intensive care units and after hospitalisation: A systematic review and meta-analysis

BackgroundSleep disturbance is a common complaint among critically ill patients in intensive care units and after hospitalisation. However, the prevalence of sleep disturbance among critically ill patients varies widely.ObjectiveTo estimate the prevalence of sleep disturbance among critically ill patients in the intensive care unit and after hospitalisation.MethodsElectronic databases were searched from their inception until 15 August 2022. Only observational studies with cross-sectional, prospective, and retrospective designs investigating sleep disturbance prevalence among critically ill adults (aged ≥ 18 years) during intensive care unit stay and after hospitalisation were included.ResultsWe found 13 studies investigating sleep disturbance prevalence in intensive care units and 14 investigating sleep disturbance prevalence after hospitalisation, with 1,228 and 3,065 participants, respectively. The prevalence of sleep disturbance during an ICU stay was 66 %, and at two, three, six and ≥ 12 months after hospitalisation was 64 %, 49 %, 40 %, and 28 %, respectively. Studies using the Richards–Campbell Sleep Questionnaire detected a higher prevalence of sleep disturbance among patients in intensive care units than non-intensive care unit specific questionnaires; studies reported comparable sleep disturbance prevalence during intensive care stays for patients with and without mechanical ventilation.ConclusionSleep disturbance is prevalent in critically ill patients admitted to an intensive care unit and persists for up to one year after hospitalisation, with prevalence ranging from 28 % to 66 %. The study results highlight the importance of implementing effective interventions as early as possible to improve intensive care unit sleep quality.     

The accuracy of simple,feasible alternatives to polysomnography for assessing sleep in intensive care: An observational study

BackgroundSleep disturbance is common in intensive care patients. Understanding the accuracy of simple, feasible sleep measurement techniques is essential to informing their possible role in usual clinical care.ObjectiveThe aim of the study was to investigate whether sleep monitoring techniques such as actigraphy (ACTG), behavioural assessments, and patient surveys are comparable with polysomnography (PSG) in accurately reporting sleep quantity and quality among conscious, intensive care patients.MethodsAn observational study was conducted in 20 patients admitted to the intensive care unit (ICU) for a minimum duration of 24 h, who underwent concurrent sleep monitoring via PSG, ACTG, nursing-based observations, and self-reported assessment using the Richards–Campbell Sleep Questionnaire.ResultsThe reported total sleep time (TST) for the 20 participants measured by PSG was 328.2 min (±106 min) compared with ACTG (362.4 min [±62.1 min]; mean difference = 34.22 min [±129 min]). Bland–Altman analysis indicated that PSG and ACTG demonstrated clinical agreement and did not perform differently across a number of sleep variables including TST, awakening, sleep-onset latency, and sleep efficiency. Nursing observations overestimated sleep duration compared to PSG TST (mean difference = 9.95 ± 136.3 min, p > 0.05), and patient-reported TST was underestimated compared to PSG TST (mean difference = −51.81 ± 144.1 7, p > 0.05).ConclusionsAmongst conscious patients treated in the ICU, sleep characteristics measured by ACTG were similar to those measured by PSG. ACTG may provide a clinically feasible and acceptable proxy approach to sleep monitoring in conscious ICU patients.     

Trajectories of Sleep Disturbance and Daytime Sleepiness in Women Before and After Surgery for Breast Cancer

ContextSleep disturbance is a problem for oncology patients.ObjectivesTo evaluate how sleep disturbance and daytime sleepiness (DS) changed from before to six months following surgery and whether certain characteristics predicted initial levels and/or the trajectories of these parameters.MethodsPatients (n = 396) were enrolled prior to surgery and completed monthly assessments for six months following surgery. The General Sleep Disturbance Scale was used to assess sleep disturbance and DS. Using hierarchical linear modeling, demographic, clinical, symptom, and psychosocial adjustment characteristics were evaluated as predictors of initial levels and trajectories of sleep disturbance and DS.ResultsAll seven General Sleep Disturbance Scale scores were above the cutoff for clinically meaningful levels of sleep disturbance. Lower performance status; higher comorbidity, attentional fatigue, and physical fatigue; and more severe hot flashes predicted higher preoperative levels of sleep disturbance. Higher levels of education predicted higher sleep disturbance scores over time. Higher levels of depressive symptoms predicted higher preoperative levels of sleep disturbance, which declined over time. Lower performance status; higher body mass index; higher fear of future diagnostic tests; not having had sentinel lymph node biopsy; having had an axillary lymph node dissection; and higher depression, physical fatigue, and attentional fatigue predicted higher DS prior to surgery. Higher levels of education, not working for pay, and not having undergone neo-adjuvant chemotherapy predicted higher DS scores over time.ConclusionSleep disturbance is a persistent problem for patients with breast cancer. The effects of interventions that can address modifiable risk factors need to be evaluated.     

The effect of a brief mindfulness-based stress reduction program on strengthening awareness of medical errors and risks among nursing students

InformationHealthcare professionals' awareness of medical errors and risks results in effective medical error reporting and patient safety. Mindfulness has positive effects on strengthening attention and awareness. However, little is known about the use of mindfulness in patient safety education among nursing students. This study aimed to examine if a brief mindfulness-based stress reduction program would have a beneficial impact on (a) medical error attitudes, (b) the number of medical errors and risks in a simulation environment, and (c) self-confidence and satisfaction among nursing students.MethodsA quasi-experimental design with a control group was conducted with 78 third-year nursing students at a private, accredited, nursing program in Istanbul, Türkiye.ResultsThere was a statistically significant improvement in the intervention group between the pre-test and post-test for medical error attitudes (p < 0.001), and the number of medical errors and risks in a simulation environment (p < 0.001). There was no statistical difference in the intervention and control groups for self-confidence and satisfaction (p > 0.05).ConclusionThese results suggest that a brief mindfulness-based stress reduction program positively strengthens nursing students' awareness of medical errors and risks.