title: Interactive relationships between hospital patients' noise-induced stress and other stress with sleep.
abstract: OBJECTIVE
  The purpose of this study was to test the hypothesis that hospital noise-induced subjective stress would interact with other subjective environmental and personal stress in a relationship with poorer patient sleep.
  
  
  METHODS
  A secondary data analysis was done using correlations and hierarchical multiple regression. Ninety-seven cardiac patients participated after transfer from critical care to a general unit. The independent variables were assessed with Topf's 24-item Disturbance Due to Hospital Noise Scale and 5-point items for other environmental stress (ie, bed, lights) and personal stress (ie, pain, anxiety). Sleep was evaluated with the Verran and Snyder-Halpern Sleep Scale.
  
  
  RESULTS
  Hierarchical multiple regression led to a multiple R of 0.435 (P <.01). An interaction term, subjective noise stress x subjective bed stress x subjective pain x subjective anxiety accounted for a significant amount of sleep variance (12%, F = 13.63, P =.000). Subjective bed stress x subjective pain accounted for an additional 5% (F = 6.4, P =.013).
  
  
  CONCLUSIONS
  Studies using research designs that assess relationships between multiple patient stress variable interactions and sleep or other stress-related outcomes may produce more accurate results than studies on the independent effects of different types of stress.
authors.affiliation: School of Nursing, University of Colorado Health Sciences Center, Denver 80262, USA.
authors.forename: M
authors.initials: M
authors.lastname: Topf
authors.forename: S
authors.initials: S
authors.lastname: Thompson
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D002300:Cardiac Care Facilities / Q000706:statistics & numerical data; D020920:Dyssomnias / Q000209:etiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008029:Lighting / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D015205:Northwestern United States; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D010362:Patients' Rooms / Q000706:statistics & numerical data*; D012044:Regression Analysis; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*