A descriptive study to assess the impact of surgical stomas on individuals' sleep perceptions & response to sleep...

Multiple factors affect the sleep quality of individuals with surgically created stomas. Using Rogers' Diffusion of Innovation as the theoretical framework, a study was conducted to: 1) assess subjective sleep quality perceptions and objective sleep measurement in adults with stomas, 2) determine if there is a correlation between subjective and objective measurement of sleep in this group, and 3) implement a stoma-specific sleep hygiene intervention to improve these sleep quality perceptions. Subjective assessment focused on sleep subset questions from the Stoma Quality of Life Index (SQOLI) and the Pittsburgh Sleep Quality Index (PSQI). Respondents' (n = 26) subjective sleep scores were 7.23 mean global score on seven questions (PSQI, range: 0 [no difficulty sleeping] to 3 [severe difficulty sleeping], total 0 to 21) with a mean score of 7.32 on three questions (SQOLI, range 1 [severe difficulty sleeping] to 4 [no difficulty sleeping], total 0 to 12) on sleep subset questions; composite scores of 5 or greater (PSQI) and 3 or less (SQOLI) indicating sleep problems. Scores showed that adults with stomas have increased sleep disruption and poor sleep quality. Five respondents who met intervention enrollment criteria participated in an objective sleep assessment using actigraphy, overnight oxygenation studies, and a 4-week sleep hygiene intervention. Mean PSQI score improved by 1.20 but the difference was not statistically significant. Because the results of this study confirm that sleep problems are common in older adults with a stoma, larger sample size studies of >4 weeks' duration are warranted. Until additional research results are available, the existence of sleep quality and overnight pouching concerns should be recognized and use of the low-cost, easy-to-use, stoma-specific sleep hygiene intervention considered.