title: Theory of Inpatient Circadian Care (TICC): A Proposal for a Middle-Range Theory.
abstract: The circadian system controls the daily rhythms of a variety of physiological processes. Most organisms show physiological, metabolic and behavioral rhythms that are coupled to environmental signals. In humans, the main synchronizer is the light/dark cycle, although non-photic cues such as food availability, noise, and work schedules are also involved. In a continuously operating hospital, the lack of rhythmicity in these elements can alter the patient's biological rhythms and resilience. This paper presents a Theory of Inpatient Circadian Care (TICC) grounded in circadian principles. We conducted a literature search on biological rhythms, chronobiology, nursing care, and middle-range theories in the databases PubMed, SciELO Public Health, and Google Scholar. The search was performed considering a period of 6 decades from 1950 to 2013. Information was analyzed to look for links between chronobiology concepts and characteristics of inpatient care. TICC aims to integrate multidisciplinary knowledge of biomedical sciences and apply it to clinical practice in a formal way. The conceptual points of this theory are supported by abundant literature related to disease and altered biological rhythms. Our theory will be able to enrich current and future professional practice.
authors.affiliation: Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia.
authors.forename: Andrés
authors.initials: A
authors.lastname: Camargo-Sanchez
authors.affiliation: Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia.
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Niño
authors.affiliation: Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Sánchez
authors.affiliation: Nursing Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Echeverri
authors.affiliation: Division of Internal Medicine at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia.
authors.forename: Diana P
authors.initials: DP
authors.lastname: Gutiérrez
authors.affiliation: Surgical Department at Marly Clinic, Bogotá, Colombia.
authors.forename: Andrés F
authors.initials: AF
authors.lastname: Duque
authors.affiliation: School of Medicine at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia.
authors.forename: Oscar
authors.initials: O
authors.lastname: Pianeta
authors.affiliation: Cell Death Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Jaramillo-Gómez
authors.affiliation: School of Medicine at the Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Martin A
authors.initials: MA
authors.lastname: Pilonieta
authors.affiliation: School of Nursing at the Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Nhora
authors.initials: N
authors.lastname: Cataño
authors.affiliation: Neurosciences Research Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia.
authors.forename: Humberto
authors.initials: H
authors.lastname: Arboleda
authors.affiliation: Laboratorio de Cronobiología, Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes/CONICET, Buenos Aires, Argentina.
authors.forename: Patricia V
authors.initials: PV
authors.lastname: Agostino
authors.affiliation: Department of Neuroscience, University of Wisconsin - Madison, Wisconsin, USA.
authors.forename: Claudia P
authors.initials: CP
authors.lastname: Alvarez-Baron
authors.affiliation: School of Medicine at the Pontificia Universidad Javeriana, Bogotá, Colombia.
authors.forename: Rafael
authors.initials: R
authors.lastname: Vargas
keywords: Biological rhythms; chronobiology; circadian rhythms; hospital; middle-range theory; nursing