Volume 4, Issue 2 (Spring 2018 -- 2018)                   JCCNC 2018, 4(2): 112-121 | Back to browse issues page

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Samimi R, Shoghi M. Sleep Quality in Burn Patients After Hospital Discharge. JCCNC 2018; 4 (2) :112-121
URL: http://jccnc.iums.ac.ir/article-1-164-en.html
Sleep Quality in Burn Patients After Hospital Discharge
Roghaye Samimi1 , Mahnaz Shoghi * 2
1- Shahid Motahari Burn Hospital, Iran University of Medical Sciences, Tehran, Iran.
2- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran. , shoghi.m@iums.ac.ir
Abstract:   (2674 Views)
Background: Sleep, as a reversible phenomenon, is vital for maintaining energy and enhancing the quality of life. Sleep disorders after burn accidents may have biopsychological effects on burn patients, years after the initial injury. This study evaluated the quality of sleep in patients with chronic burns. 
Methods: A descriptive cross-sectional study was conducted on 100 patients referred to the Subspecialty Hospital for Burns in Tehran, Iran 6 months after their discharge for reconstructive surgery. Pittsburgh Sleep Quality Index was used to collect the study data. The participants were recruited by convenience sampling method. The obtained data were analyzed by Chi-square test using SPSS. 
Results: According to the results, 38% of the participants had experienced good sleep quality (Mean±SD: 3.3±0.9), but 62% reported poor sleep quality (Mean±SD: 9.96±3.2). There were statistically significant associations between sleep quality and gender (P=0.039), material status (P=0.003), occupational status (P=0.000), educational level (P=0.04), burn surface (P=0.02), and duration after burn (P=0.028). No statistically significant association was found between sleep quality and patients’ age, burn surface, and monthly income.
Conclusion: Evaluation of sleep adequacy should be a routine component of outpatient assessment in patients with burn, with the consideration of referral to a sleep specialist, as needed. 
Keywords: Chronic burn, Burn injury, Sleep disorder, Sleep quality
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● Majority of burn patients had sleep disorders after discharge.
● Frequent nighttime awakenings, sleep latency, and sleepiness during the day were the most common sleep disorders.
● Sleep quality is associated with gender, educational level, marital status, and burn area.
Plain Language Summary
Sleep problems are common after burn injury and during the healing and recovery periods. Insomnia can come and go over the years and may require different solutions at different times. It is important to get treatment for poor sleep because it can be harmful in a number of ways. For some, it can even be extremely distressing and debilitating, and actually interfere with patient's recovery from the burn injury.

Type of Study: Research | Subject: General
Received: 2018/10/23 | Accepted: 2018/02/10 | Published: 2018/05/1
References
1. Asghari, A., et al., 2012. [Severity of depression and anxiety in obstructive sleep apnea syndrome (Persian)]. European Archives of Oto-Rhino-Laryngology, 269(12), pp. 2549-53. [DOI:10.1007/s00405-012-1942-6] [PMID] [DOI:10.1007/s00405-012-1942-6]
2. Backhaus, J., et al., 2002. Test–retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia. Journal of Psychosomatic Research, 53(3), pp. 737-40. [DOI:10.1016/S0022-3999(02)00330-6] [DOI:10.1016/S0022-3999(02)00330-6]
3. Baur, K. M., Hardy, P. E. & Van Dorsten, B., 1998. Posttraumatic stress disorder in burn populations: A critical review of the literature. The Journal of Burn Care & Rehabilitation, 19(3), pp. 230-40. [DOI:10.1097/00004630-199805000-00009] [DOI:10.1097/00004630-199805000-00009]
4. Bayuo, J., Agbenorku, P. & Amankwa, R., 2016. Study on acute burn injury survivors and the associated issues. Journal of Acute Disease, 5(3), pp. 206-9. [DOI:10.1016/j.joad.2016.03.006] [DOI:10.1016/j.joad.2016.03.006]
5. Berg, L., et al., 2017. Psychosocial distress at different time intervals after burn injury. Psychotherapie, Psychosomatik, Medizinische Psychologie, 67(6), pp. 231-9. [PMID] [PMID]
6. Boeve, S. A., et al., 2002. Sleep disturbance after burn injury. The Journal of Burn Care & Rehabilitation, 23(1), pp. 32-8. [DOI:10.1097/00004630-200201000-00007] [DOI:10.1097/00004630-200201000-00007]
7. Buysse, D. J., et al., 1989. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), pp. 193-213. [DOI:10.1016/0165-1781(89)90047-4] [DOI:10.1016/0165-1781(89)90047-4]
8. Carter, D. W., Carrougher, G. J. & Pham, T. N., 2016. Pain management. In D. G. Greenhalgh (eds), Burn Care for General Surgeons and General Practitioners. Berlin: Springer. [DOI:10.1007/978-3-319-29161-1_19]
9. Chatburn, A., et al., 2017. The effects of sleep restriction and sleep deprivation in producing false memories. Neurobiology of Learning and Memory, 137, pp. 107-13. [PMID] [DOI:10.1016/j.nlm.2016.11.017] [PMID]
10. Ciofi Silva, C. L., et al., 2010. The life impact of burns: The perspective from burn persons in Brazil during their rehabilitation phase. Disability and Rehabilitation, 32(6), pp. 431-7. [DOI:10.3109/09638280802532555] [PMID] [DOI:10.3109/09638280802532555]
11. Cooper, L. N., 2016. Effects of Sleep Fragmentation on the Immune System of Zebra Finches Using Cytokine Gene Expression [MSc. thesis]. Bowling Green, Kentucky: Western Kentucky University.
12. Cuesta, M., et al., 2016. Simulated night shift disrupts circadian rhythms of immune functions in humans. The Journal of Immunology, 196(6), pp. 2466-75. [DOI:10.4049/jimmunol.1502422] [PMID] [DOI:10.4049/jimmunol.1502422]
13. Devita, M., et al., 2017. Obstructive sleep apnea and its controversial effects on cognition. Journal of Clinical and Experimental Neuropsychology, 39(7), pp. 659-69. [DOI:10.1080/13803395.2016.1253668] [PMID]
14. Doǧan, O., Ertekin, Ş. & Doǧan, S., 2005. Sleep quality in hospitalized patients. Journal of Clinical Nursing, 14(1), pp. 107-13. [DOI:10.1111/j.1365-2702.2004.01011.x] [PMID] [DOI:10.1111/j.1365-2702.2004.01011.x]
15. Frighetto, L., et al., 2004. An assessment of quality of sleep and the use of drugs with sedating properties in hospitalized adult patients. Health and Quality of Life Outcomes, 2(1), p. 17. [DOI:10.1186/1477-7525-2-17] [PMID] [PMCID]
16. Gauffin, E., et al., 2016. Health-related Quality of life (EQ-5D) early after injury predicts long-term pain after burn. Burns, 42(8), pp. 1781-8. [DOI:10.1016/j.burns.2016.05.016] [PMID]
17. Giannoni-Pastor, A., et al., 2016. Prevalence and predictors of posttraumatic stress symptomatology among burn survivors: A systematic review and meta-analysis. Journal of Burn Care & Research, 37(1), pp. e79-e89. [DOI:10.1097/BCR.0000000000000226] [PMID] [DOI:10.1097/BCR.0000000000000226]
18. Grandner, M. A., et al., 2012. Sleep disturbance is associated with cardiovascular and metabolic disorders. Journal of Sleep Research, 21(4), pp. 427-33. [DOI:10.1111/j.1365-2869.2011.00990.x] [PMID] [PMCID] [DOI:10.1111/j.1365-2869.2011.00990.x]
19. Guertler, D., et al., 2015. The association between physical activity, sitting time, sleep duration, and sleep quality as correlates of presenteeism. Journal of Occupational and Environmental Medicine, 57(3), pp. 321-8. [DOI:10.1097/JOM.0000000000000355] [PMID] [PMCID] [DOI:10.1097/JOM.0000000000000355]
20. Itani, O., et al., 2017. Short sleep duration and health outcomes: A systematic review, meta-analysis, and meta-regression. Sleep Medicine, 32, pp. 246-56. [DOI:10.1016/j.sleep.2016.08.006] [DOI:10.1016/j.sleep.2016.08.006]
21. Jeddi, S., et al., 2016. The effect of sleep deprivation on cardiac function and tolerance to ischemia-reperfusion injury in male rats. Arquivos Brasileiros de Cardiologia, 106(1), pp. 41-8. [PMID] [PMCID] [PMID] [PMCID]
22. Kendzerska, T., et al., 2014. Obstructive sleep apnea and risk of cardiovascular events and all-cause mortality: A decade-long historical cohort study. PLoS Medicine, 11(2), p. e1001599. [DOI:10.1371/journal.pmed.1001599] [DOI:10.1371/journal.pmed.1001599]
23. Kheyri, A., Bastani, F. & Haghani, H., 2016. Effects of reflexology on sleep quality of elderly women undergoing abdominal surgery. Journal of Client-Centered Nursing Care, 2, 11-18. [DOI:10.32598/jccnc.2.1.11]
24. Kim, S. Y., et al., 2015. Sleep deprivation is associated with bicycle accidents and slip and fall injuries in Korean adolescents. PLoS One, 10(8), p. e0135753. [DOI:10.1371/journal.pone.0135753] [PMID] [PMCID] [DOI:10.1371/journal.pone.0135753]
25. Koljonen, V., et al., 2013. Treatment of patients with severe burns-costs and health-related quality of life outcome. Journal of Burn Care & Research, 34(6), pp. e318-25. [DOI:10.1097/BCR.0b013e3182779c90] [PMID] [DOI:10.1097/BCR.0b013e3182779c90]
26. Lee, A. F., et al., 2017. Quantifying risk factors for long-term sleep problems after burn injury in young adults. Journal of Burn Care & Research, 38, e510-e520. [DOI:10.1097/BCR.0000000000000315] [PMID]
27. Legault, G., et al., 2017. Cognitive consequences of sleep deprivation, shiftwork, and heat exposure for underground miners. Applied Ergonomics, 58, pp. 144-50. [DOI:10.1016/j.apergo.2016.06.007] [PMID] [DOI:10.1016/j.apergo.2016.06.007]
28. Liang, C. Y., et al., 2012. Predictors of health-care needs in discharged burn patients. Burns, 38(2), pp. 172-9. [DOI:10.1016/j.burns.2011.09.010] [PMID] [DOI:10.1016/j.burns.2011.09.010]
29. Metlaine, A., Leger, D. & Choudat, D., 2005. Socioeconomic impact of insomnia in working populations. Industrial Health, 43, pp. 11-19. [DOI:10.2486/indhealth.43.11] [PMID]
30. Mayes, T., et al., 2013. A pilot review of the long-term impact of burn injury on sleep architecture in children. Journal of Burn Care & Research, 34, e15-e21. [DOI:10.1097/BCR.0b013e318272178e] [PMID]
31. Marin, J. M., et al., 2012. Association between treated and untreated obstructive sleep apnea and risk of hypertension. The Latest Medical Research, Reviews, and Guidelines, 307(20), pp. 2169-76. [DOI:10.1001/jama.2012.3418] [PMID] [PMCID] [DOI:10.1001/jama.2012.3418]
32. Matheson, J., Clayton, J. & Muller, M., 2001. The reduction of itch during burn wound healing. Journal of Burn Care & Research, 22(1), pp. 76-81. [DOI:10.1097/00004630-200101000-00017] [DOI:10.1097/00004630-200101000-00017]
33. Mcneil, J., et al., 2016. The effects of partial sleep restriction and altered sleep timing on appetite and food reward. Appetite, 109, pp. 48-56. [DOI:10.1016/j.appet.2016.11.020] [PMID] [DOI:10.1016/j.appet.2016.11.020]
34. Morris, J. L., Rohay, J. & Chasens, E. R., 2018. Sex differences in the psychometric properties of the Pittsburgh sleep quality index. Journal of Women's Health, 27(3), pp. 278-82. [DOI:10.1089/jwh.2017.6447] [PMID] [DOI:10.1089/jwh.2017.6447]
35. Ohayon, M. M., 2002. Epidemiology of insomnia: What we know and what we still need to learn. Sleep Medicine Reviews, 6(2), pp. 97-111. [DOI:10.1053/smrv.2002.0186] [PMID] [DOI:10.1053/smrv.2002.0186]
36. Ohayon, M. M., 2005. Relationship between chronic painful physical condition and insomnia. Journal of Psychiatric Research, 39(2), pp. 151-9. [DOI:10.1016/j.jpsychires.2004.07.001] [PMID] [DOI:10.1016/j.jpsychires.2004.07.001]
37. Ohayon, M. M., Reynolds III, C. F. & Dauvilliers, Y., 2013. Excessive sleep duration and quality of life. Annals of Neurology, 73(6), pp. 785-94. [DOI:10.1002/ana.23818] [PMID] [PMCID] [DOI:10.1002/ana.23818]
38. Peppard, P. E., et al., 2000. Prospective study of the association between sleep-disordered breathing and hypertension. New England Journal of Medicine, 342(19), pp. 1378-84. [DOI:10.1056/NEJM200005113421901] [PMID] [DOI:10.1056/NEJM200005113421901]
39. Pishnamazi, Z., et al., 2012. Quality of life in burn patients. Payesh Journal, 11(1), pp. 103-10.
40. Polak, J., Beamer, B. A. & Punjabi, N. M., 2016. Obstructive sleep apnea and glucose metabolism. In: A. I. Pack (eds), Sleep Apnea: Pathogenesis, Diagnosis and Treatment. London: Informa.
41. Raymond, I., et al., 2001. Quality of sleep and its daily relationship to pain intensity in hospitalized adult burn patients. Pain, 92(3), pp. 381-8. [DOI:10.1016/S0304-3959(01)00282-2] [DOI:10.1016/S0304-3959(01)00282-2]
42. Reimer, M. A. & Flemons, W. W., 2003. Quality of life in sleep disorders. Sleep Medicine Reviews, 7(4), pp. 335-349. [DOI:10.1053/smrv.2001.0220] [PMID] [DOI:10.1053/smrv.2001.0220]
43. Richardson, P. & Mustard, L., 2009. The management of pain in the burns unit. Burns, 35(7), pp. 921-36. [DOI:10.1016/j.burns.2009.03.003] [PMID] [DOI:10.1016/j.burns.2009.03.003]
44. Seyyed-Rasooli, A., et al., 2016. Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns, 42(8), pp. 1774-80. [DOI:10.1016/j.burns.2016.06.014] [PMID] [DOI:10.1016/j.burns.2016.06.014]
45. Shanahan, L., et al., 2014. Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 53(5), pp. 550-8. [DOI:10.1016/j.jaac.2013.12.029] [PMID] [PMCID] [DOI:10.1016/j.jaac.2013.12.029]
46. Smith, M. T., et al., 2008. Sleep onset insomnia symptoms during hospitalization for major burn injury predict chronic pain. Pain, 138(3), pp. 497-506. [DOI:10.1016/j.pain.2008.01.028] [PMID] [PMCID] [DOI:10.1016/j.pain.2008.01.028]
47. Summer, G. J., et al., 2007. Burn injury pain: The continuing challenge. The Journal of Pain, 8(7), pp. 533-48. [DOI:10.1016/j.jpain.2007.02.426] [PMID] [DOI:10.1016/j.jpain.2007.02.426]
48. Tang, N. K., et al., 2014. Impact of musculoskeletal pain on insomnia onset: A prospective cohort study. Rheumatology, 54(2), pp. 248-56. [DOI:10.1093/rheumatology/keu283] [DOI:10.1093/rheumatology/keu283]
49. Troxel, W. M., et al., 2009. Marital happiness and sleep disturbances in a multi-ethnic sample of middle-aged women. Behavioral Sleep Medicine, 7(1), pp. 2-19. [DOI:10.1080/15402000802577736] [PMID] [PMCID] [DOI:10.1080/15402000802577736]
50. Van der Does, A. J. W., 1989. Patients' and nurses' ratings of pain and anxiety during burn wound care. Pain, 39(1), pp. 95-101. [DOI:10.1016/0304-3959(89)90179-6] [DOI:10.1016/0304-3959(89)90179-6]
51. Van Dyke, M. E., et al., 2016. Socioeconomic status discrimination is associated with poor sleep in African-Americans, but not Whites. Social Science & Medicine, 153, pp. 141-7. [DOI:10.1016/j.socscimed.2016.02.012] [PMID] [PMCID] [DOI:10.1016/j.socscimed.2016.02.012]
52. Vetrichevvel, T. P., et al., 2016. Burn injury and long-term nervous system morbidity: A population-based cohort study. BMJ Open, 6(9), p. e012668. [DOI:10.1136/bmjopen-2016-012668] [DOI:10.1136/bmjopen-2016-012668]
53. Wasiak, J., et al., 2017. Female patients display poorer burn-specific quality of life 12 months after a burn injury. Injury, 48(1), pp. 87-93. [PMID] [DOI:10.1016/j.injury.2016.07.032] [PMID]
54. Wheaton, A. G., 2016. Sleep duration and injury-related risk behaviors among high school students—United States, 2007–2013. Morbidity and Mortality Weekly Report, 65(13), pp. 337-41. [DOI:10.15585/mmwr.mm6513a1] [PMID] [DOI:10.15585/mmwr.mm6513a1]
55. Wiechman, S., Kalpakjian, C. Z. & Johnson, K. L., 2016. Measuring depression in adults with burn injury: A systematic review. Journal of Burn Care & Research, 37(5), pp. e415-26. [DOI:10.1097/BCR.0000000000000384] [PMID] [DOI:10.1097/BCR.0000000000000384]
56. Wurzer, P., et al., 2017. Two-year follow-up of outcomes related to scarring and distress in children with severe burns. Disability and rehabilitation, 39, 1639-43. [DOI:10.1080/09638288.2016.1209579] [PMID] [PMCID]
57. Xie, B., et al., 2012. Evaluation of long term health-related quality of life in extensive burns: A 12-year experience in a burn center. Burns, 38(3), pp. 348-55. [DOI:10.1016/j.burns.2011.09.003] [DOI:10.1016/j.burns.2011.09.003]
58. Yangzom, N., et al., 2015. The effect of diphenhydramine on sleep in pediatric burn patients: A secondary analysis. Journal of Burn Care & Research, 36(2), pp. 266-71. [DOI:10.1097/BCR.0000000000000066] [PMID] [DOI:10.1097/BCR.0000000000000066]
59. Yarnell, A. M. & Deuster, P., 2016. Sleep As A Strategy For Optimizing Performance. Special Operations Medical Journal, 16(1), pp. 81-5. [PMID]
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