Exploring Nursing Team Perceptions of Sleep in Critically Ill Pediatric Patients: A Mixed-Methods Study

To explore nursing team perceptions of sleep and sleep-disrupting factors in critically ill pediatric patients.

Convergent mixed-methods study comprising an exploratory qualitative and descriptive cross-sectional quantitative. For the qualitative component, the population consisted of the PICU nursing team with ≥3 years of experience until theoretical saturation was reached. Semi-structured interviews were conducted regarding their perceptions of sleep in critically ill children. Data were analyzed using transcription, immersive reading, and coding. For the quantitative component, the population was selected using convenience sampling without exclusion. The variables were years of experience, professional category, and factors affecting rest. Data were collected using an ad hoc Likert-type questionnaire. For the analysis, the median and interquartile range were calculated for quantitative variables, and frequencies and percentages were calculated for categorical variables. Bivariate analysis was performed using the Mann-Whitney U test.

Ten interviews were conducted, revealing three main categories: "Factors Affecting Sleep," with noise, nighttime interventions, and light as the most frequent codes; "Consequences of Sleep Disturbances," with delirium and recovery as the most frequent codes; and "Perception of Sleep in the PICU and Need for Professional Awareness". For the quantitative results, 78.3% (n = 65) of the nursing team participated. Among the factors affecting rest, the most relevant were "Inadequately controlled pain," identified as "Highly relevant" by 84.6%, and "Delirium," "Withdrawal syndrome," "Light," "Nocturnal environmental noise," and "Nighttime interventions/procedures," identified as "Highly relevant" by over 70%. In contrast, "Continuous nocturnal glucose administration" was identified as "Slightly/Not relevant" by almost 40%. Differences between nurses and nursing assistants were observed regarding the perceived relevance of nocturnal environmental noise, delirium, physical restraints and continuous nocturnal glucose administration (p ≤ 0.05).

Qualitative and quantitative results concur in identifying, from the perspective of nursing professionals in a single PICU, noise, light, interventions, and delirium as negative factors for rest.