Abstract:

Objective To explore the latent classes and influencing factors of sleep trajectories in cardiac surgery patients before and after they are transferred out of the ICU. Methods A total of 210 patients undergoing cardiovascular surgery from March to September of 2023 were selected by convenience sampling. The General Information Questionnaire，Richards-Campbell Sleep Questionnaire，Social Support Rating Scale，Pre-hospitalization Sleep Quality Score，Chinese version of Environment Stressors Questionnaire，the 10-item Kessler Psychological Distress Scale，and Numeric Rating Score were used before surgery and on the day of ICU transfer，1 week and 1 month after ICU transfer. The growth mixed model was used to identify the latent classes of patients’ sleep trajectories，and the influencing factors were analyzed by multivariate logistic regression. Results The sleep trajectory could be divided into severely impaired-remission group（28.1%），severely impaired-persistent group（21.4%），and mildly impaired-remission group（50.5%）. Logistic regression analysis showed that per capita monthly income，length of hospital stay，objective social support，pain，noise，ICU environmental stressors，and psychological status could affect patients’ sleep trajectory（P<0.05）. Conclusion There is heterogeneity in the sleep trajectories of cardiac surgery patients before and after they are transferred out of the ICU，and nursing staff should pay attention to the sleep changes of patients with long hospital stay，persistent and severe pain，high environmental stress，psychological distress and low social support，and give targeted interventions.

Key words: Cardiac Surgical Procedures, Intensive Care Units, Sleep Quality, Trajectory, Growth Mixed Model, Nursing Care