published_or_final_version / Pharmacology / Master / Master of Philosophy

Bakgrund: Sömn är ett mänskligt grundläggande behov och bör därför tillgodoses hos patienter som vårdas på sjukhus. Patienter som vårdas på intensivvårdsavdelningar upplever dock ofta upprepade avbrott på sömnen och sömnbrist vilket kan leda till både fysiska och psykiska negativa konsekvenser. Intensivvårdsmiljön med dess oljud, starka belysning och frekventa vårdrelaterade interaktioner leder ofta till oförmåga hos patienterna att få en adekvat sömn. Syfte: Att belysa olika interventioner sjuksköterskan kan tillämpa för att förbättra sovmiljön och sömnkvaliteten hos patienter som vårdas på en intensivvårdsavdelning. Metod: En litteraturöversikt med grund i analys av kvantitativ forskning. Resultat: I resultatet framkom sju interventioner som delades in i tre olika kategorier: skapa en bättre sovmiljö, avskärmning från ljud och ljus samt förbereda patienten för sömn. De sju interventionerna som identifierades var: tysta/störningsfria perioder, riktlinjer/ramverk innefattande aktiviteter för att kontrollera yttre störande faktorer, utbildning, öronproppar och ögonmask, adderat "white noise", musik samt akupressur. Slutsats: Genom att tillämpa en eller fler av de sju interventionerna kan sovmiljön och sömnkvalitet förbättras för patienter som vårdas på intensivvårdsavdelningar. Dock krävs ytterligare forskning inom området då vissa interventioner ger motstridiga resultat. Klinisk betydelse: Sömn är ett nödvändigt behov och har en stor betydelse för återhämtning från sjukdom och bör därför tillgodoses av sjuksköterskan. Resultatet i denna litteraturöversikt kan ge en ökad förståelse för vilka interventioner sjuksköterskan kan tillämpa i sitt omvårdnadsarbete för att förbättra sovmiljön och sömnkvalitet för patienter som vårdas på intensivvårdsavdelningar. / Background: Sleep is a basic human need and should be addressed in patients being treated in hospital. Patients cared for in intensive care units often experience repeated interruptions of sleep and sleep deprivation, which can lead to both physical and psychological adverse consequences. The intensive care environment with its noise, strong lighting and frequent care-related interaction often leads to the inability of patients to get adequate sleep. Aim: To illustrate the various interventions the nurse can implement to improve the sleep environment and quality of sleep in patients who are cared for in an intensive care unit. Methods: A literature review with its basis in an analysis of quantitative research. Results: The result emerged in seven interventions that were divided into three different categories: creating a better sleep environment, shielding from light and sound, and preparing the patient for sleep. The seven interventions identified were: quiet/non-disturbance periods, guidelines/framework including activities to control disturbing environmental factors, education, ear plugs and eye mask, added "white noise", music and acupressure. Conclusion: By applying one or more of the seven interventions the sleep environment and sleep quality for patients cared for in intensive care units may improve. However, as some interventions produced conflicting results, further research in the area is required. Clinical significance: Sleep is an essential requirement and has great importance in the recovery from illness and should therefore be carefully understood by the nurse. Findings from the literature review can provide a better understanding of which interventions nurses can apply in their work to improve the sleep environment and sleep quality for patients cared for in intensive care units.

Night shift or non-standard work continues to grow throughout the economy (Beers, 2000). Women's roles in society are changing as they find themselves having to join the work force due to economic need. South African women most of whom are mothers are no exception in this regard. Many of these mothers are obliged to do night shift work. Sectors like manufacturing and public-oriented industries often use shift work to ensure efficient continuous operation and uninterrupted response to the needs of society. This article aims to explore the role that night shift work plays in the relationships between mothers and their adolescent children; whether the mutual perceptions of night shift working mothers and their adolescent children regarding their relationships differ from those of non-shift working mothers and their adolescent children; and whether there is a difference between the night shift working group and the non-shift working group with regard to the perceptions of their relationships. Lastly, the article aims to determine the reliability of the measuring instrument that was used in this study, namely the Parent-Adolescent-Relationship-Questionnaire (PARQ). Available literature shows that shift work has a negative impact on health, for example stress-related illnesses due to lack of sleep (Akerstedt, 1998, 2003; Fletcher & Dawson, 1997, 2001; Presser, 2005). Family life is also affected and relationship difficulties have been reported (Chang, Wang, & Liu, 1993; Holland, 2004; Grosswald, 2003, 2004; Presser, 1995, 2000, 2003, 2005), while shift work is seen as a threat to family cohesion. Adolescence is a critical developmental stage and mothers have an important role to enhance healthy adolescent development in terms of issues like self-identity and autonomy. The mother's unusual working hours can have a negative impact on the mother-adolescent relationship. A cross-sectional design was used in this study. There were two groups: 35 night shift working mothers and their adolescent children, and 35 non-shift working mothers and their adolescent children. Participants were requested to complete a PARQ questionnaire. Data was analysed by means of SAS and SPSS programmes. Descriptive statistic methods such as central tendency, mean and median, variability, range and standard deviation, skewness and kurtosis were used to explore data. Independent and dependent t-tests were used to determine differences between the mean scores of the night shift working and non-shift working mothers and their adolescent children. The effect size was used to provide an objective measure of a practical effect. The findings indicate that PARQ is a reliable measure for this study as it showed good internal consistency. The skewness and kurtosis indicate acceptable normality. Adolescent children of non-shift working mothers perceive communication with their mothers as more efficient than adolescent children of night shift working mothers, and there is an indication of a significant practical effect. Adolescent children of non-shift working mothers have a more positive perception of the Mothers' Problem Solving than adolescent children of night shift working mothers, with indications of a significant practical effect between the two groups. There is no statistically significant difference between and no significant practical effect in any of the variables concerning the two groups of mothers, as reflected in Table 4. However, Table 5 shows a difference between the perceptions of the two groups of adolescents. There is a statistically significant difference between Cohesion for non-shift working mothers and for their adolescent children, with an indication of a significant practical effect. Tables 5 and 6 show a statistically significant difference between Conventionalisation of the two groups, with an indication of a significant practical effect. Both night shift working and non-shift working mothers have a more positive perception of Conventionalisation than their adolescent children. Findings also indicate a statistically significant difference in Global Distress between night shift working mothers and their adolescent children, with an indication of a significant practical effect. Night shift working mothers experience higher levels of Global Distress than their adolescent children. For both groups -night shift working mothers and their adolescent children; and non-shift working mothers and their adolescent children there is a statistically significant difference between the mothers' and the adolescents' perception of Ruination. This study has several limitations and it is recommended that future studies use a larger sample size and include longitudinal studies. Future research should also explore the construct of the night shift working mother's parenting style and their coping strategies. Father-adolescent relationships should also be a research focus. In some families in both groups, the study created a platform for dialogue between adolescents and their mothers. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2010.

Night shift or non-standard work continues to grow throughout the economy (Beers, 2000). Women's roles in society are changing as they find themselves having to join the work force due to economic need. South African women most of whom are mothers are no exception in this regard. Many of these mothers are obliged to do night shift work. Sectors like manufacturing and public-oriented industries often use shift work to ensure efficient continuous operation and uninterrupted response to the needs of society. This article aims to explore the role that night shift work plays in the relationships between mothers and their adolescent children; whether the mutual perceptions of night shift working mothers and their adolescent children regarding their relationships differ from those of non-shift working mothers and their adolescent children; and whether there is a difference between the night shift working group and the non-shift working group with regard to the perceptions of their relationships. Lastly, the article aims to determine the reliability of the measuring instrument that was used in this study, namely the Parent-Adolescent-Relationship-Questionnaire (PARQ). Available literature shows that shift work has a negative impact on health, for example stress-related illnesses due to lack of sleep (Akerstedt, 1998, 2003; Fletcher & Dawson, 1997, 2001; Presser, 2005). Family life is also affected and relationship difficulties have been reported (Chang, Wang, & Liu, 1993; Holland, 2004; Grosswald, 2003, 2004; Presser, 1995, 2000, 2003, 2005), while shift work is seen as a threat to family cohesion. Adolescence is a critical developmental stage and mothers have an important role to enhance healthy adolescent development in terms of issues like self-identity and autonomy. The mother's unusual working hours can have a negative impact on the mother-adolescent relationship. A cross-sectional design was used in this study. There were two groups: 35 night shift working mothers and their adolescent children, and 35 non-shift working mothers and their adolescent children. Participants were requested to complete a PARQ questionnaire. Data was analysed by means of SAS and SPSS programmes. Descriptive statistic methods such as central tendency, mean and median, variability, range and standard deviation, skewness and kurtosis were used to explore data. Independent and dependent t-tests were used to determine differences between the mean scores of the night shift working and non-shift working mothers and their adolescent children. The effect size was used to provide an objective measure of a practical effect. The findings indicate that PARQ is a reliable measure for this study as it showed good internal consistency. The skewness and kurtosis indicate acceptable normality. Adolescent children of non-shift working mothers perceive communication with their mothers as more efficient than adolescent children of night shift working mothers, and there is an indication of a significant practical effect. Adolescent children of non-shift working mothers have a more positive perception of the Mothers' Problem Solving than adolescent children of night shift working mothers, with indications of a significant practical effect between the two groups. There is no statistically significant difference between and no significant practical effect in any of the variables concerning the two groups of mothers, as reflected in Table 4. However, Table 5 shows a difference between the perceptions of the two groups of adolescents. There is a statistically significant difference between Cohesion for non-shift working mothers and for their adolescent children, with an indication of a significant practical effect. Tables 5 and 6 show a statistically significant difference between Conventionalisation of the two groups, with an indication of a significant practical effect. Both night shift working and non-shift working mothers have a more positive perception of Conventionalisation than their adolescent children. Findings also indicate a statistically significant difference in Global Distress between night shift working mothers and their adolescent children, with an indication of a significant practical effect. Night shift working mothers experience higher levels of Global Distress than their adolescent children. For both groups -night shift working mothers and their adolescent children; and non-shift working mothers and their adolescent children there is a statistically significant difference between the mothers' and the adolescents' perception of Ruination. This study has several limitations and it is recommended that future studies use a larger sample size and include longitudinal studies. Future research should also explore the construct of the night shift working mother's parenting style and their coping strategies. Father-adolescent relationships should also be a research focus. In some families in both groups, the study created a platform for dialogue between adolescents and their mothers. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2010.

Thesis (M.Phil.)--Murdoch University, 2003. / Thesis submitted to the Division of Social Sciences, Humanities and Education. Bibliography: leaves 309-378.

Thesis (M.A.)--Northern Kentucky University, 2008. / Made available through ProQuest. Publication number: AAT 1457014. ProQuest document ID: 1594487381. Includes bibliographical references (p. 49-50)

Thesis--Auburn University, 2009. / Abstract. Vita. Includes bibliographical references (p. 82-93).

Thesis (M.S. in Operations Research)--Naval Postgraduate School, December 2004. / Thesis advisor(s): Nita Lewis Miller. Includes bibliographical references (p. 87-89). Also available online.

Thesis (Ph.D.)--Marshall University, 2009. / Title from document title page. Includes abstract. Document formatted into pages: contains xi, 116 p. Includes bibliographical references p. 104-116.

Thesis (M.S.)--Rochester Institute of Technology, 2009. / Typescript. Includes bibliographical references (leaves 52-59).