Page 507 - Encyclopedia of Nursing Research

474 n Sleep SCIenCe

pregnancy and postpartum and menopausal first time mothers using an intervention of a
transition (Woods & mitchell, 2010). Also, a 45-minute meeting with a nurse to discuss
S variety of nursing scientists and clinicians sleep information and strategies, an 11-page
have studied sleep in older adults (Richards booklet to take away, and a weekly phone
& Sawyer, 2010) and in the context of living contact for 5 weeks to reinforce information
in long-term care facilities (Cole et al., 2009) and help problem solve.
and being in intensive care units (Tembo & In summary, sleep as a health-related
parker, 2009). lifestyle behavior influenced by behavioral
The vast majority of nursing science and environmental therapeutics fits well with
remains descriptive, and less is addressed the essence of nursing practice. In the future,
to therapies that promote sleep, for exam- nursing science will benefit from (1) deriving
ple, behavioral therapies or environmen- stronger, validated theoretical/conceptual
tal manipulations. Studies of therapeutics perspectives of sleep quality, sleeplessness,
related for improving sleep are emerging and sleepiness and its relationship to overall
and consistent with the nursing mission to health status and function; (2) creating and
“assist people to lead their lives in the con- testing novel therapies based on validated
text of disease (actual or threatened) or major theoretical perspectives; and (3) understand-
life transitions.” In the sleep field, the use of ing better the complexity, burden, and cost (of
pharmacological interventions for improv- either poor sleep patterns or interventions). It
ing sleep is deemed limited by potential side is imperative for the development of nursing
effects and reduced sleep promotion effects sleep science that sustained study is done to
over time. Therefore, behavioral therapies are predict those at high risk for negative conse-
seen to be an important adjunct or alternative quences within vulnerable populations, par-
to long-term pharmacological interventions ticularly underadvantaged individuals, the
for insomnia. The development and study of very young, the older adults, and the chroni-
cognitive and behavioral interventions, such cally ill; those suffering from sleep disorders
as sleep cognitive behavioral therapy (S-CBT), for which behavioral treatments are promi-
mindful relaxation, stimulus control, sleep nent (e.g., insomnia); and those in high-risk
restriction, and sleep hygiene techniques are environments (e.g., hospitals, high life-strain
prominent, often with combinations of these situations).
techniques to strengthen sleep outcomes. Because sleep is a behavior responsive
Because behavioral change for health- to behavioral interventions, more study is
promoting self-care is core to nursing science needed, which clarifies timing and expo-
and practice, sleep behavioral therapeutics sure (dose) responses, titration, personal-
represents this dimension. Although fewer ized or tailoring dimensions, individualized
interventional than descriptive nursing sci- response types and the factors affecting
ence programs of research are evident, tests behavioral choice and adherence, and the
of sleep therapeutics are emerging. As an effects of improved or optimal sleep on health
example, nursing scientist Berger (2009) and outcomes such as tissue healing or cognitive/
her team (Barsevick et al., 2010), for improv- emotional improvement. From a human eco-
ing sleep and fatigue in women undergoing logical perspective, benefits would be accrued
breast cancer adjuvant chemotherapy, have from testing more interventions with rele-
seen positive results from a personalized vant behavioral modification in concert with
plan intervention that incorporates modified modulation of environments or contextual
stimulus control, modified sleep restriction, factors. The application of emerging wear-
relaxation therapy, and sleep hygiene dimen- able technologies for monitoring and biobe-
sions. Another example is Stremler et al. havioral methods that combine physiological
(2006), who have reported improved sleep in and perceptual measures will do much to