- ICH GCP
- Registr klinických studií v USA
- Klinická studie NCT04995263
A Multicomponent Intervention for Prevention and Treatment of Sleep Disturbances in a Psychiatric Intensive Care Unit (SUEÑA-SM)
A Multicomponent Intervention for Prevention and Treatment of Sleep Disturbances in a Psychiatric Intensive Care Unit: A Before-After, Randomized, Controlled Trial
Přehled studie
Postavení
Podmínky
Intervence / Léčba
- Behaviorální: Sueña component 1: Sleep Hygiene Promotion
- Behaviorální: Sueña component 2: Periodic Anxiety and Pain Screening
- Behaviorální: Sueña component 3: Hypnotics and Caffeine Regulation
- Behaviorální: Sueña component 4: Sleep Masks and Ear Plugs
- Jiný: Sueña component 5: Personalized Psychoeducation
- Přístroj: Sueña component 6: Sleep Reports
Typ studie
Zápis (Očekávaný)
Fáze
- Nelze použít
Kontakty a umístění
Studijní kontakt
- Jméno: Constanza Caneo Robles, MD
- Telefonní číslo: +56 9 4290 9250
- E-mail: cmcaneo@uc.cl
Studijní záloha kontaktů
- Jméno: Juan C Rodríguez, MD
- Telefonní číslo: +56 9 4448 9732
- E-mail: jcrtjcrt@gmail.com
Studijní místa
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Región Metropolitana
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Santiago de Chile, Región Metropolitana, Chile, 7550000
- Nábor
- Clínica San Carlos de Apoquindo UC
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Dílčí vyšetřovatel:
- Pedro Letelier Camus, MD
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Dílčí vyšetřovatel:
- Simón Medina, MD
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Dílčí vyšetřovatel:
- Matías Paredes Gálvez, BE
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Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Popis
Inclusion Criteria:
- Hospitalized in the last 72 hours.
- Capacity to consent
- Approval by treating physician
Exclusion Criteria:
- Active psychosis
- Active eating disorder
- Delirium
- Major cognitive disorder
Studijní plán
Jak je studie koncipována?
Detaily designu
- Primární účel: Prevence
- Přidělení: Randomizované
- Intervenční model: Sekvenční přiřazení
- Maskování: Singl
Zbraně a zásahy
Skupina účastníků / Arm |
Intervence / Léčba |
---|---|
Žádný zásah: Pre-intervention, control group
A basal measurement of primary and secondary outcomes of the target population, prior to the implementation the intervention.
Estimated duration 3 months, n = 30.
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Experimentální: Post-intervention, SUEÑA half bundle, active group 1
Post-intervention, environmental and behavioral modifications in patient care interventions. Implementation of components 1 through 4 of SUEÑA intervention in the entire PICU unit. All participants will be exposed to the intervention. Estimated duration: 3 months, n = 30. |
The nursery staff will be instructed to promote sleep hygiene.
Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy.
Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e.
blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM.
A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.
Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one.
If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.
The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM.
Caffeinated drinks will be prohibited after 15:00 PM.
Sleep masks and ear plugs will be available to all patients if they wish to use them.
The nursery team will reinforce its use between 23:00 PM and 07:00 AM.
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Experimentální: Post-intervention, randomization for SUEÑA half bundle plus, active group 2
Randomization for full SUEÑA bundle: environmental and behavioral modifications in patient care interventions plus sleep informed treatment. Participants will be randomized to receive SUEÑA components 1 through 5 Estimated duration: 6 months, n = 30 |
The nursery staff will be instructed to promote sleep hygiene.
Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy.
Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e.
blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM.
A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.
Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one.
If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.
The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM.
Caffeinated drinks will be prohibited after 15:00 PM.
Sleep masks and ear plugs will be available to all patients if they wish to use them.
The nursery team will reinforce its use between 23:00 PM and 07:00 AM.
Two individualized, nurse-led psychoeducation PowerPoint presentations on sleep hygiene will be presented to patients, supported by educational material aimed at the patient and their families.
|
Experimentální: Post-intervention, randomization for SUEÑA full bundle, active group 3
Randomization for full SUEÑA bundle: environmental and behavioral modifications in patient care interventions plus sleep informed treatment and personalized psychoeducation. . Participants will be randomized to receive SUEÑA components 1 through 6. Estimated duration: 6 months, n = 30 |
The nursery staff will be instructed to promote sleep hygiene.
Nurse technicians will: inform patients of the efforts to ensure a healthy sleep environment, verify the minimization of light and noise after 23:00 PM, favour natural light after 07:00 AM, and foment patient's activities and participation in group therapy.
Nurses will: reduce sleep interruptions to a minimum, to only perform actions (i.e.
blood testing, clinical controls, medicine administration) deemed strictly necessary between 23:00 PM and 07:00 AM.
A list of commonly used medications with their pharmacodynamic and pharmacokinetic properties tailored by a pharmaceutical chemist will be provided, to ensure optimal medication administration while protecting the guaranteed sleep hours, to be coordinated with the treating physician.
Every night, nursery staff will include anxiety and pain screenings as part of vital signs assessments, using visual analog scales for each one.
If any screening is altered, clinical actions will be performed to alleviate symptomatology if deemed necessary, using clinical judgement.
The use of hypnotics will be standardized to be administered no later than at 22:00 PM; in the case of melatonin, its administration will be suggested at sundown, at 20:00 PM.
Caffeinated drinks will be prohibited after 15:00 PM.
Sleep masks and ear plugs will be available to all patients if they wish to use them.
The nursery team will reinforce its use between 23:00 PM and 07:00 AM.
Two individualized, nurse-led psychoeducation PowerPoint presentations on sleep hygiene will be presented to patients, supported by educational material aimed at the patient and their families.
Objective and subjective reports of sleep quality will be handed to attending psychiatrist, using data gathered with wearable devices (Fitbit Charge 4) and self-report questionnaires regarding perceived sleepiness and overall sleep.
The psychiatrist in charge uses said information in the routine case management
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Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Change in Total Sleep Time
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in hours and minutes, using objective data obtained via Fitbit Charge 4 devices, and subjective data obtained directly from the patient using the Sleep Diary, a consensus tool for the self report of different standardized sleep variables.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
---|---|---|
Change in Mean Number and Total Duration of Nocturnal Awakenings
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in integer numbers for mean number and minutes for duration, using subjective data obtained directly from the patient using the Sleep Diary, and objective data obtained via Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Mean Number and Total Duration of Naps During the Day
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in integer numbers for mean number and minutes for duration, using subjective data obtained directly from the patient using the Sleep Diary, and objective data obtained via Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Average Time of Falling Sleep and Awakening
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in time of day in 24-hour notation, using subjective data obtained directly from the patient using the Sleep Diary, and objective data obtained via Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Sleep Architecture
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in minutes of total duration for each sleep phase (awake, light sleep, deep sleep and REM) and as a relative value of the total sleep time, using objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Sleep Onset Latency Mean Duration
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in minutes of total time spent awake from the time of going to bed with the intention of falling asleep to the time of the first registered sleep phase, using subjective data from the Sleep Diary and objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in REM Onset Latency Mean Duration
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in minutes of total time spent awake from the time of going to bed with the intention of falling asleep to the time of the first registered REM phase, using subjective data from the Sleep Diary and objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Wake After Sleep Onset Mean Duration
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in minutes of total time spent awake from the time of the first registered sleep phase to the time of the last registered awakening, using objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Sleep Efficiency
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in percentage of total time spent sleeping at night, calculated as total sleep time divided by total time spent in bed, using subjective data from the Sleep Diary and objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Mean Heart Rate
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in integer numbers, using objective data measured by Fitbit Charge 4 devices, considering the heart rate during the day and while in bed.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Mean Number of Steps
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in integer numbers, using objective data measured by Fitbit Charge 4 devices.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Mean Level of Sound
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in decibels, using objective data registered by a decibel meter placed in the participant's rooms.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Change in Mean Level of Light
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in lux, using objective data registered by a lux meter placed in the participant's rooms.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Changes in Sleep Quality Perception
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured using the Richard Campbell Sleep Questionnaire (RCSQ), which considers 5 domains in Likert scales, and registers a mean score of all domains.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Changes in Daytime Sleepiness
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured using the Epworth Sleepiness Scale (ESS), which considers 8 hypothetical situations and scores the likelihood of falling asleep from 0 to 3, and registers a total aggregated score (with a maximum total score of 24).
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Changes in Subjective Perception of Sleep-Disturbing Factors
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured using complementary questions regarding the presence/absence of factors (either environmental, symptomatological, or other) and their identification using predefined options: excessive light, excessive noise, interactions with health personnel, pain, anxiety, or others.
In case of selecting "others", a text field will be available for its description.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Changes in Pharmacological Indications and Need of SOS Medication
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Registered using extensive charts of common use medications during hospitalization, obtaining data registered in the participant's daily medical chart.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Changes in Systolic and Diastolic Blood Pressure
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Measured in millimetres of mercury (mmHg), using morning data registered in the participant's daily medical chart.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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Level of Pain
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge. To be measured from the second branch onward, after the environmental interventions implementation.
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Measured with a Visual Analog Scale for Pain (scores ranging from 0 - 10 points), using data registered at 20:00 PM, in the participant's daily medical chart.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge. To be measured from the second branch onward, after the environmental interventions implementation.
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Level of Anxiety
Časové okno: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge. To be measured from the second branch onward, after the environmental interventions implementation.
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Measured with a Visual Analog Scale for Anxiety (scores ranging from 0 - 10 points), using data registered at 20:00 PM, in the participant's daily medical chart.
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From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge. To be measured from the second branch onward, after the environmental interventions implementation.
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Change in Mean Length of Stay
Časové okno: From day 1 of hospitalization until discharge
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Measured in days, using data from the participant's medical record.
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From day 1 of hospitalization until discharge
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Change in 30-day Readmission Rate
Časové okno: 30 days after the participant's discharge.
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Measured as a proportion, using data from the participant's medical record and telephonic follow-up.
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30 days after the participant's discharge.
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Change in Participant Satisfaction Regarding Sleep During Hospitalization
Časové okno: 7 days after the participant's discharge.
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Measurement of the subjective experience of the participant, using telephone surveys.
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7 days after the participant's discharge.
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Participant Satisfaction Regarding the Intervention
Časové okno: 7 days after the participant's discharge.
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Measurement of the subjective experience of participants, using telephone surveys.
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7 days after the participant's discharge.
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Health Personnel Satisfaction and Agreeability Regarding the Intervention
Časové okno: Every 3 months through study completion, an average of 1.5 years
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Measurement of the subjective experience of treating physicians and nursery team, using web-based surveys.
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Every 3 months through study completion, an average of 1.5 years
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Spolupracovníci a vyšetřovatelé
Spolupracovníci
Vyšetřovatelé
- Ředitel studie: Constanza Caneo Robles, MD, Pontifica Universidad Catolica de Chile
- Ředitel studie: Juan C Rodríguez, MD, Pontifica Universidad Catolica de Chile
- Studijní židle: María Rodríguez Fernández, PhD, Pontifica Universidad Catolica de Chile
- Studijní židle: Marcela Babul, MD, Pontifica Universidad Catolica de Chile
Publikace a užitečné odkazy
Obecné publikace
- Kanji S, Mera A, Hutton B, Burry L, Rosenberg E, MacDonald E, Luks V. Pharmacological interventions to improve sleep in hospitalised adults: a systematic review. BMJ Open. 2016 Jul 29;6(7):e012108. doi: 10.1136/bmjopen-2016-012108.
- Tembo AC, Parker V. Factors that impact on sleep in intensive care patients. Intensive Crit Care Nurs. 2009 Dec;25(6):314-22. doi: 10.1016/j.iccn.2009.07.002. Epub 2009 Oct 31.
- Hu RF, Jiang XY, Chen J, Zeng Z, Chen XY, Li Y, Huining X, Evans DJ. Non-pharmacological interventions for sleep promotion in the intensive care unit. Cochrane Database Syst Rev. 2015 Oct 6;2015(10):CD008808. doi: 10.1002/14651858.CD008808.pub2.
- Bano M, Chiaromanni F, Corrias M, Turco M, De Rui M, Amodio P, Merkel C, Gatta A, Mazzotta G, Costa R, Montagnese S. The influence of environmental factors on sleep quality in hospitalized medical patients. Front Neurol. 2014 Dec 11;5:267. doi: 10.3389/fneur.2014.00267. eCollection 2014.
- Bernhofer EI, Higgins PA, Daly BJ, Burant CJ, Hornick TR. Hospital lighting and its association with sleep, mood and pain in medical inpatients. J Adv Nurs. 2014 May;70(5):1164-73. doi: 10.1111/jan.12282. Epub 2013 Oct 27.
- Bourne RS, Mills GH. Sleep disruption in critically ill patients--pharmacological considerations. Anaesthesia. 2004 Apr;59(4):374-84. Review.
- Denkinger MD, Lindemann U, Nicolai S, Igl W, Jamour M, Nikolaus T. Assessing Physical Activity in Inpatient Rehabilitation: validity, practicality, and sensitivity to change in the physical activity in inpatient rehabilitation assessment. Arch Phys Med Rehabil. 2011 Dec;92(12):2012-7. doi: 10.1016/j.apmr.2011.06.032.
- Horne S, Hay K, Watson S, Anderson KN. An evaluation of sleep disturbance on in-patient psychiatric units in the UK. BJPsych Bull. 2018 Oct;42(5):193-197. doi: 10.1192/bjb.2018.42.
- Lawrence G, Muza R. Assessing the sleeping habits of patients in a sleep disorder centre: a review of sleep diary accuracy. J Thorac Dis. 2018 Jan;10(Suppl 1):S177-S183. doi: 10.21037/jtd.2017.12.127.
- Milani RV, Bober RM, Lavie CJ, Wilt JK, Milani AR, White CJ. Reducing Hospital Toxicity: Impact on Patient Outcomes. Am J Med. 2018 Aug;131(8):961-966. doi: 10.1016/j.amjmed.2018.04.013. Epub 2018 May 3.
- Pilkington S. Causes and consequences of sleep deprivation in hospitalised patients. Nurs Stand. 2013 Aug 7-13;27(49):35-42. Review.
- Rodriguez JC, Dzierzewski JM, Alessi CA. Sleep problems in the elderly. Med Clin North Am. 2015 Mar;99(2):431-9. doi: 10.1016/j.mcna.2014.11.013. Epub 2014 Dec 30. Review.
- Sandoval-Rincón M, Alcalá-Lozano R, Herrera-Jiménez I, Jiménez-Genchi A. [Validation of the Epworth sleepiness scale in Mexican population]. Gac Med Mex. 2013 Jul-Aug;149(4):409-16. Spanish.
- Stewart NH, Arora VM. Sleep in Hospitalized Older Adults. Sleep Med Clin. 2018 Mar;13(1):127-135. doi: 10.1016/j.jsmc.2017.09.012. Epub 2017 Nov 10. Review.
- Tamrat R, Huynh-Le MP, Goyal M. Non-pharmacologic interventions to improve the sleep of hospitalized patients: a systematic review. J Gen Intern Med. 2014 May;29(5):788-95. doi: 10.1007/s11606-013-2640-9. Epub 2013 Oct 10.
- Tullmann DF, Dracup K. Creating a healing environment for elders. AACN Clin Issues. 2000 Feb;11(1):34-50; quiz 153-4. Review.
- Wesselius HM, van den Ende ES, Alsma J, Ter Maaten JC, Schuit SCE, Stassen PM, de Vries OJ, Kaasjager KHAH, Haak HR, van Doormaal FF, Hoogerwerf JJ, Terwee CB, van de Ven PM, Bosch FH, van Someren EJW, Nanayakkara PWB; "Onderzoeks Consortium Acute Geneeskunde" Acute Medicine Research Consortium. Quality and Quantity of Sleep and Factors Associated With Sleep Disturbance in Hospitalized Patients. JAMA Intern Med. 2018 Sep 1;178(9):1201-1208. doi: 10.1001/jamainternmed.2018.2669.
- Novak C, Packer E, Paterson A, Roshi A, Locke R, Keown P, Watson S, Anderson KN. Feasibility and utility of enhanced sleep management on in-patient psychiatry wards. BJPsych Bull. 2020 Dec;44(6):255-260. doi: 10.1192/bjb.2020.30.
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia (Aktuální)
Primární dokončení (Očekávaný)
Dokončení studie (Očekávaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Aktuální)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Aktuální)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další relevantní podmínky MeSH
- Duševní poruchy
- Nemoci nervového systému
- Poruchy spánku a bdění
- Dysomnie
- Parasomnie
- Fyziologické účinky léků
- Neurotransmiterové látky
- Molekulární mechanismy farmakologického působení
- Depresiva centrálního nervového systému
- Inhibitory enzymů
- Purinergní antagonisté
- Purinergní činidla
- Inhibitory fosfodiesterázy
- Antagonisté purinergního P1 receptoru
- Stimulanty centrálního nervového systému
- Kofein
- Hypnotika a sedativa
Další identifikační čísla studie
- Institute of Psychiatry
Plán pro data jednotlivých účastníků (IPD)
Plánujete sdílet data jednotlivých účastníků (IPD)?
Popis plánu IPD
Časový rámec sdílení IPD
Kritéria přístupu pro sdílení IPD
Typ podpůrných informací pro sdílení IPD
- Protokol studie
- Plán statistické analýzy (SAP)
- Formulář informovaného souhlasu (ICF)
- Zpráva o klinické studii (CSR)
Informace o lécích a zařízeních, studijní dokumenty
Studuje lékový produkt regulovaný americkým FDA
Studuje produkt zařízení regulovaný americkým úřadem FDA
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