The Effect of an Improved Environment According To Watson's Theory of Human Care on Sleep, Anxiety, and Depression in Patients Undergoing Open Heart Surgery: a Randomized Controlled Trial

Abstract

Background/Objectives: According to Watson's Human Care Theory, an improved environment influences patients' care processes. The purpose of this study was to examine the effect of an improved environment, according to Watson's Human Care Theory, on sleep quality, anxiety, and depression in patients undergoing open heart surgery. Methods: Upon admission to the ward from the postoperative intensive care unit, the experimental group underwent environmental remediation for three days. The environmental arrangements ensured that the patient's room maintained an appropriate temperature range of 18-26 degrees C and humidity values of 30-50%. Monitoring took place at 21:00, 22:00, and 23:00 on Days 1, 2, and 3, at which times, the brightness of the patient rooms gradually decreased. On the morning of the fourth day, the patients were interviewed face to face, and research questionnaires were filled out (ClinicalTrials.gov identifier of the manuscript: NCT06744023). Results: After the implementation of an improved environment in accordance with Watson's Human Care Theory, the sleep duration of the patients in the experimental group (5.91 h) was higher than that of the control group (4.1 h). At the same time, the mean sleep quality score was measured as 300 +/- 15.33 in the experimental group and 116.33 +/- 14.94 in the control group. In addition, anxiety and depression levels were lower in the experimental group (5.63 +/- 0.59; 4.53 +/- 0.42) compared with the control group (12.03 +/- 0.85; 10.03 +/- 0.82). Conclusions: We recommend implementing improved environmental arrangements in accordance with Watson's Human Care Theory to improve sleep quality and reduce anxiety and depression levels in patients undergoing open heart surgery.