The Impact of Sleep Position Preferences on the Sleep Quality, Comfort and Catheter Care Quality in Patients After Endoscopic Nasobiliary Drainage: A Cross-Sectional Study.

Abstract

Aims and objectives: This study aimed to investigate the impact of sleep position preferences (SPP) on sleep quality, comfort and catheter care quality in patients after endoscopic nasobiliary drainage (ENBD).

Design: This was an observational prospective study.

Methods: This study included 167 participants with common bile duct stones (CBDS) who underwent ENBD from the gallstone ward of a hospital as a convenience sample. Data were collected between June 2022 and August 2023. The study utilised the Pittsburgh Sleep Quality Index, Athens Insomnia Scale, comfort level, medical device-related pressure injuries (MDRPI), catheter displacement, bile drainage volume and a self-designed questionnaire on demographic and clinical data for data collection. Data analysis included chi-square tests and one-way analysis of variance, with differences between two groups assessed using the LSD-t test. The STROBE checklist was followed.

Results: The postoperative sleep quality of ENBD patients was rated at (8.65 ± 2.91) points. Significant variations in sleep quality were evident among ENBD patients with different SPPs (p < 0.01). Patients favouring left-side and supine positions demonstrated differences in sleep quality compared to those favouring the right-side position (t = 1.45, p < 0.05; t = 1.72, p < 0.01). However, when comparing patients favouring the supine position to those favouring the left-side position, the difference in sleep quality was not statistically significant (t = 0.26, p > 0.05). The postoperative comfort score of ENBD patients was recorded at (5.67 ± 1.54) points. Significant variances in comfort levels were observed among ENBD patients with different SPPs (p < 0.01). Patients favouring left-side and supine positions exhibited differences in comfort levels compared to those favouring the right-side position (t = 1.02, p < 0.05; t = 0.78, p < 0.01). Nevertheless, when comparing patients favouring the supine position to those favouring the left-side position, the difference in comfort level was not statistically significant (t = -0.24, p > 0.05). Among ENBD patients with different SPPs, there were no statistically significant differences in the occurrence of MDRPI, catheter displacement and 24-h bile drainage volume (p > 0.05).

Conclusions: The sleep quality and comfort of patients following ENBD are suboptimal, warranting increased attention from healthcare providers. Nasobiliary tube conversion and fixation via the right nostril can negatively impact the sleep quality and comfort of patients with a preference for right-side sleeping. Preoperative training focusing on adjusting sleep positions is recommended, particularly for these patients. Alternatively, personalised modifications in the positioning and fixation of the nasal catheter could be made based on patients' sleeping position preferences. A multidisciplinary team, including nurses and surgeons, should collaboratively develop tailored nasobiliary drainage plans.

Relevance to clinical practice: This study highlights the importance of addressing sleep quality and comfort in patients undergoing nasobiliary drainage. It is recommended that patients with a preference for the right lateral sleeping position receive preoperative training to adjust their sleep posture. Alternatively, the nasobiliary tube's exit and fixation points should be customised based on individual sleep preferences. A multidisciplinary team, including nurses and surgeons, should collaborate to develop personalised nasobiliary drainage plans.