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Multicenter Study
. 2018 Dec 22;17(1):131.
doi: 10.1186/s12904-018-0385-2.

Non-pharmacological solutions to sleep and circadian rhythm disruption: voiced bedside experiences of hospice and end-of-life staff caregivers

Rana Sagha Zadeh  1 , Elizabeth Capezuti  2 , Paul Eshelman  3 , Nicole Woody  4 , Jennifer Tiffany  5 , Ana C Krieger  6
Affiliations
Multicenter Study

Non-pharmacological solutions to sleep and circadian rhythm disruption: voiced bedside experiences of hospice and end-of-life staff caregivers

Rana Sagha Zadeh et al. BMC Palliat Care. .

Abstract

Background: Sleep disturbance is a significant issue, particularly for patients with advanced terminal illness. Currently, there are no practice-based recommended approaches for managing sleep and circadian disruptions in this population. To address this gap, a cross-sectional focus group study was performed engaging 32 staff members at four hospices/end-of-life programs in three demographically diverse counties in New York State.

Methods: Participants responded to structured open-ended questions. Responses were transcribed and subjected to qualitative content analysis. The themes and recommendations for improved practice that emerged were tabulated using Atlas TI qualitative software.

Results: This report details the experiences of hospice and end-of-life care staff in managing sleep and circadian disruptions affecting patients and analyzes their recommendations for improving care. Caregivers involved in the study described potential interventions that would improve sleep and reduce circadian disruptions. They particularly highlighted a need for improved evaluation and monitoring systems, as well as sleep education programs for both formal and informal caregivers.

Conclusions: The voiced experiences of frontline hospice and end-of-life caregivers confirmed that disruption in sleep and circadian rhythms is a common issue for their patients and is not effectively addressed in current research and practice. The caregivers' recommendations focused on management strategies and underscored the need for well-tested interventions to promote sleep in patients receiving end-of-life care. Additional research is needed to examine the effectiveness of systematic programs that can be easily integrated into the end-of-life care process to attenuate sleep disturbances.

Keywords: Advanced terminal illness; Caregiver experiences; Palliative end-of-life care; Sleep disruption; Sleep/wake cycle; Symptom management.

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Conflict of interest statement

Ethics approval and consent to participate

Institutional Review Board (IRB) for Human Subjects at Cornell University as well as the leadership board at all the participating healthcare providers approved the undertaking of this study. Participation in the study was voluntarily. Prior to the initiation of the study, the participants were provided with the study information verbally and in written form via a Study Information Sheet. Participants provided verbal consent in accordance with IRB requirements, because the participants’ signature on the consent form would be the only identifier present in the study.

Consent for publication

Not applicable.

Competing interests

The author declares that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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