Relação entre a qualidade de sono autodeclarada e o tratamento de pacientes em um centro de terapia intensiva (CTI) coronariano: desde a internação até após a alta

Abstract

OBJECTIVES: 1) to investigate the sleep quality reported by coronary patients in the intensive care unit (ICU) at the time of admission, after treatment, and following discharge; 2) to identify whether there was a change in the patient's perception of sleep quality and when it was perceived. METHOD: This was a prospective exploratory study with a quantitative approach. It included patients hospitalized in the coronary ICU of the Santa Casa Hospital in Belo Horizonte due to Acute Coronary Syndrome (Acute Myocardial Infarction [AMI] with and without ST-segment elevation, and Unstable Angina), aged over 18 years, of both sexes, who were invited and agreed to participate in the study. Questionnaires were used to collect sociodemographic and clinical variables, as well as instruments to control for confounding variables (pain, anxiety, and mental state assessment), and to assess sleep quality. Descriptive analysis was conducted, with results presented as means and standard deviations or medians and interquartile ranges for sample characterization. RESULTS: A total of 30 volunteers with an average age of 60.46 years (SD = 9.50), the majority of whom were male (56.7%), participated in the study. Most participants had at least one comorbidity, with hypertension (84.6%) being the most commonly observed. Statistical analysis considered a significance level of p < 0.05. A statistically significant difference was found when comparing data from phase I (admission–pre-treatment) to phase II (post-treatment), and from phase I (pretreatment) to phase III (post-hospitalization), regarding insomnia, anxiety, and sleep quality. It was found that 60% of patients reported having good sleep quality when asked directly, but according to the obtained scores, 80% actually had poor sleep quality. CONCLUSION: The study showed that patients' sleep quality was worse during the acute phase of the illness (Phase I – admission), and improved in Phases II (posttreatment) and III (post-hospital discharge). Similarly, anxiety and insomnia were worse in Phase I (admission) and improved in Phase III (post-discharge). Regarding patients' self-reports of sleep quality, the study showed that their perception of sleep was worse in Phase I (admission), with improvement in Phases II (post-treatment) and III (post-discharge). It is important to develop multidisciplinary and integrated actions to consolidate care and reduce disturbances, both environmental and those caused by the healthcare team, as a means of promoting proper sleep in the ICU. Furthermore, it is essential to raise awareness among healthcare professionals about the influence of sleep on the body's recovery, accompanied by practices that prevent the interruption of this process.