Patients with myocardial infarction hospitalized in intensive care units showed a median Richard Campbell Sleep Questionnaire score of 66.6, with qualitative findings revealing that poor sleep quality was influenced by multiple factors including noise and privacy concerns, while good sleepers reported consistently high sleep quality both in the ICU and daily life.
Key Findings
Results
The median sleep quality score for myocardial infarction patients in the ICU was 66.6 on the Richard Campbell Sleep Questionnaire.
The median Richard Campbell Sleep Questionnaire (RCSQ) score was 66.6 with an interquartile range (IQR) of 25.83–78.33.
Higher scores on the RCSQ generally indicate better sleep quality.
The wide IQR (25.83–78.33) suggests considerable variability in sleep quality among patients.
The study was conducted using a cross-sectional design in the quantitative phase.
Results
Quantitative analyses did not reveal any statistically significant associations between patient characteristics and sleep quality.
Statistical methods used included descriptive statistics, normality tests, and the Mann-Whitney U test.
Cronbach's alpha coefficient was calculated to determine the reliability of the RCSQ scale.
No specific patient demographic or clinical variables were found to be significantly associated with RCSQ scores.
The study used an explanatory sequential mixed methods design, with the qualitative phase intended to explain the quantitative findings.
Results
Three main themes of sleep quality experience were identified in the qualitative phase: 'poor sleep quality,' 'normal sleep quality,' and 'good sleep quality.'
Content analysis was employed in the qualitative phase, conducted using a descriptive approach.
Patients with poor sleep quality were influenced by multiple factors simultaneously.
Patients with normal sleep quality focused on specific unmet needs affecting their sleep.
Good sleepers reported consistently high sleep quality both in the ICU and in their daily lives prior to hospitalization.
The qualitative phase was reported according to COREQ guidelines.
Results
The qualitative phase explained the 'why' behind the quantitative findings by revealing specific environmental and personal factors influencing sleep in the ICU.
Poor sleep quality was associated with multiple simultaneous influencing factors.
Environmental factors such as noise and lack of privacy were identified as contributors to poor sleep.
Patients' pre-existing sleep habits were relevant to their ICU sleep experience, particularly among good sleepers.
The study was conducted between June 01 and October 01, 2023, with patients hospitalized in the ICU.
Data were collected using a Patient Information Form, the Richard Campbell Sleep Questionnaire, and a Semi-structured Interview Form.
Background
Sleep disturbances in myocardial infarction survivors may impair quality of life and potentially influence recurrence risk and overall prognosis.
The study authors frame sleep quality assessment as 'of critical importance' in this population.
The study context situates sleep disturbances as potentially linked to recurrence risk, not only quality of life.
The study was planned specifically to evaluate sleep quality in myocardial infarction patients hospitalized in the ICU.
The study was reported according to STROBE guidelines for the quantitative component.
Conclusions
Nurses were identified as key agents in improving ICU sleep quality through environmental and care-practice modifications.
Recommended nursing interventions included noise control in the ICU environment.
Increasing patients' privacy was identified as an important nursing action.
Enabling patients to maintain their individual sleep habits was highlighted as a practical recommendation.
These recommendations emerged from the integration of both quantitative and qualitative findings.
What This Means
This research suggests that patients recovering from heart attacks (myocardial infarction) in intensive care units (ICUs) experience widely varying sleep quality, as measured by the Richard Campbell Sleep Questionnaire, with a median score of 66.6 out of 100 and a wide spread of individual scores. While the statistical analyses did not find specific patient characteristics that clearly predicted who would sleep better or worse, the qualitative interviews with patients provided deeper insight into why sleep quality differed so much from person to person. Patients who slept poorly tended to be affected by several problems at once, those with average sleep had particular unmet needs, and those who slept well in the ICU also tended to report good sleep in their everyday lives before hospitalization.
The study used a 'mixed methods' approach — combining numerical data with in-depth patient interviews — conducted over four months in 2023. This combination allowed researchers to go beyond just measuring sleep scores and understand the real-life experiences behind those numbers. Environmental issues in the ICU, such as noise and lack of privacy, emerged as important factors disrupting sleep for some patients.
This research suggests that nurses working in ICUs can play a meaningful role in improving patient sleep by reducing noise, providing more privacy, and helping patients maintain their usual sleep routines as much as possible. Better sleep in the ICU may matter beyond comfort alone, as the researchers note that sleep disturbances after a heart attack could affect patients' quality of life and potentially their risk of future cardiac events.
Ziyai N, Dogu O, Yildiz B. (2026). Evaluation of Sleep Quality of Hospitalized Patients in Intensive Care Units With Myocardial Infarction: A Mixed Method Study.. Nursing in critical care. https://doi.org/10.1111/nicc.70223