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A Multicomponent Intervention for Prevention and Treatment of Sleep Disturbances in a Psychiatric Intensive Care Unit (SUEÑA-SM)

29 de setembro de 2022 atualizado por: Constanza Caneo, Pontificia Universidad Catolica de Chile

A Multicomponent Intervention for Prevention and Treatment of Sleep Disturbances in a Psychiatric Intensive Care Unit: A Before-After, Randomized, Controlled Trial

Hospitalized adult patients suffer from sleep deprivation, which has been associated with multiple negative consequences, both in short and in the long term. Many factors have been attributed to poor sleep quality, including excessive noise, inappropriate lighting, interactions with the healthcare team, administration of drugs, patients' symptoms, among others. There is scarce evidence reporting multicomponent interventions aimed at ensuring and improving sleep quality in hospitalized patients. The following before-after, randomized controlled trial will evaluate and determine the feasibility, acceptability and effectivity of a multicomponent intervention in improving sleep quality and reducing the consequences of poor sleep in a psychiatric intensive care unit (PICU). The intervention is comprised of changes in health personnel habits, improvements in the PICU environment, patient's psychoeducation and continuous sleep and activity monitoring through a validated wearable device.

Visão geral do estudo

Tipo de estudo

Intervencional

Inscrição (Antecipado)

120

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

  • Nome: Constanza Caneo Robles, MD
  • Número de telefone: +56 9 4290 9250
  • E-mail: cmcaneo@uc.cl

Estude backup de contato

  • Nome: Juan C Rodríguez, MD
  • Número de telefone: +56 9 4448 9732
  • E-mail: jcrtjcrt@gmail.com

Locais de estudo

    • Región Metropolitana
      • Santiago de Chile, Región Metropolitana, Chile, 7550000
        • Recrutamento
        • Clínica San Carlos de Apoquindo UC
        • Subinvestigador:
          • Pedro Letelier Camus, MD
        • Subinvestigador:
          • Simón Medina, MD
        • Subinvestigador:
          • Matías Paredes Gálvez, BE

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Tudo

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Prevenção
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição sequencial
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Sem intervenção: 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.
Experimental: 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.
Experimental: 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.
Experimental: 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

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Change in Total Sleep Time
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Change in Mean Number and Total Duration of Nocturnal Awakenings
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Mean Number and Total Duration of Naps During the Day
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Average Time of Falling Sleep and Awakening
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Sleep Architecture
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Sleep Onset Latency Mean Duration
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in REM Onset Latency Mean Duration
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Wake After Sleep Onset Mean Duration
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Sleep Efficiency
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Mean Heart Rate
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured in integer numbers, using objective data measured by Fitbit Charge 4 devices, considering the heart rate during the day and while in bed.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Mean Number of Steps
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured in integer numbers, using objective data measured by Fitbit Charge 4 devices.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Mean Level of Sound
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured in decibels, using objective data registered by a decibel meter placed in the participant's rooms.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Change in Mean Level of Light
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured in lux, using objective data registered by a lux meter placed in the participant's rooms.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Changes in Sleep Quality Perception
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured using the Richard Campbell Sleep Questionnaire (RCSQ), which considers 5 domains in Likert scales, and registers a mean score of all domains.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Changes in Daytime Sleepiness
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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).
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Changes in Subjective Perception of Sleep-Disturbing Factors
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
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.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Changes in Pharmacological Indications and Need of SOS Medication
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Registered using extensive charts of common use medications during hospitalization, obtaining data registered in the participant's daily medical chart.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Changes in Systolic and Diastolic Blood Pressure
Prazo: From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Measured in millimetres of mercury (mmHg), using morning data registered in the participant's daily medical chart.
From enrollment, during the first 72 hours of hospitalization, for up to 14 days or discharge.
Level of Pain
Prazo: 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.
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.
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.
Level of Anxiety
Prazo: 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.
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.
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.
Change in Mean Length of Stay
Prazo: From day 1 of hospitalization until discharge
Measured in days, using data from the participant's medical record.
From day 1 of hospitalization until discharge
Change in 30-day Readmission Rate
Prazo: 30 days after the participant's discharge.
Measured as a proportion, using data from the participant's medical record and telephonic follow-up.
30 days after the participant's discharge.
Change in Participant Satisfaction Regarding Sleep During Hospitalization
Prazo: 7 days after the participant's discharge.
Measurement of the subjective experience of the participant, using telephone surveys.
7 days after the participant's discharge.
Participant Satisfaction Regarding the Intervention
Prazo: 7 days after the participant's discharge.
Measurement of the subjective experience of participants, using telephone surveys.
7 days after the participant's discharge.
Health Personnel Satisfaction and Agreeability Regarding the Intervention
Prazo: Every 3 months through study completion, an average of 1.5 years
Measurement of the subjective experience of treating physicians and nursery team, using web-based surveys.
Every 3 months through study completion, an average of 1.5 years

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Colaboradores

Investigadores

  • Diretor de estudo: Constanza Caneo Robles, MD, Pontifica Universidad Catolica de Chile
  • Diretor de estudo: Juan C Rodríguez, MD, Pontifica Universidad Catolica de Chile
  • Cadeira de estudo: María Rodríguez Fernández, PhD, Pontifica Universidad Catolica de Chile
  • Cadeira de estudo: Marcela Babul, MD, Pontifica Universidad Catolica de Chile

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

22 de junho de 2021

Conclusão Primária (Antecipado)

1 de dezembro de 2022

Conclusão do estudo (Antecipado)

1 de agosto de 2023

Datas de inscrição no estudo

Enviado pela primeira vez

22 de julho de 2021

Enviado pela primeira vez que atendeu aos critérios de CQ

31 de julho de 2021

Primeira postagem (Real)

6 de agosto de 2021

Atualizações de registro de estudo

Última Atualização Postada (Real)

30 de setembro de 2022

Última atualização enviada que atendeu aos critérios de controle de qualidade

29 de setembro de 2022

Última verificação

1 de setembro de 2022

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

Sim

Descrição do plano IPD

We are available to be contacted by researchers aiming to conduct secondary analyses based on our study, after providing a study protocol based on international guidelines, in order to ensure adequate use of our data.

Prazo de Compartilhamento de IPD

January 2024

Critérios de acesso de compartilhamento IPD

contact to responsable researcher C Caneo

Tipo de informação de suporte de compartilhamento de IPD

  • Protocolo de estudo
  • Plano de Análise Estatística (SAP)
  • Termo de Consentimento Livre e Esclarecido (TCLE)
  • Relatório de Estudo Clínico (CSR)

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

Essas informações foram obtidas diretamente do site clinicaltrials.gov sem nenhuma alteração. Se você tiver alguma solicitação para alterar, remover ou atualizar os detalhes do seu estudo, entre em contato com register@clinicaltrials.gov. Assim que uma alteração for implementada em clinicaltrials.gov, ela também será atualizada automaticamente em nosso site .

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