Date Presented 4/9/2016

Occupational therapy sleep tool intervention demonstrates a positive effect on pain reduction associated with sleep deprivation. To improve patient outcomes, hospital-based occupational therapist roles should routinely include sleep education as part of their domain.

Primary Author and Speaker: Kristen Clore

Additional Authors and Speakers: Mary Whitehouse Barber, Melissa Johnson, Christelle David

Contributing Authors: Steven Heidt, Julia Meireles, Brittany Gappy, Bridget Higgy, Zainab Rasheed, Ryan Scott, Giancarlo Vanini, Peter Farrehi

PURPOSE: Our current understanding of sleep deprivation in the hospitalized patient has been linked to poor outcomes. We hypothesize that use of sleep aids will lead to improved survey response scores regarding sleep disturbance, fatigue, and pain.

BACKGROUND: Sleep is an important part of the healing process and is linked with impaired health. During a hospital stay, patients complain of poor sleep. Occupational therapy has a distinct role in sleep and can be a cost-effective resolution to this problem.

DESIGN: Double blinded, randomized controlled trial, pilot study

PARTICIPANTS: Convenience sample, N = 120. Patients must have a 24-hr stay in the general medicine and cardiac units, between ages 18 and 75 yr.

METHOD: Interview style: Canadian Occupational Performance Measure, FIM, Patient Reported Outcome Measurement Information System survey: Fatigue, Physical Functioning, Sleep Disturbance, Wake Disturbance, Brief Pain Inventory Short Form.

ANALYSIS: Group differences analysis performed with T test, p value .05, measuring differences between Day 1 to Day 3 as a primary outcome.

RESULTS: The primary change is a decrease in pain in those who received the intervention versus the control. Further data examination is currently underway.

DISCUSSION: The team experienced difficulty with enrollment due to staffing and initial study design. Changes to the study to liberalize the group and adding additional team members for support resulted in the successful completion of the study. With these changes, not all participants received FIM scores and the Canadian Occupational Performance Measure, therefore the N is significantly smaller and would warrant future studies where these are the primary measures.

IMPACT STATEMENT: Our aging population more commonly has illness that requires hospitalization. Self-care and sleep promotion become secondary to medical intervention. Our study indicates improved sleep results in decreased pain. This supports that occupational therapy staffing is necessary for inpatient acute care needs.