Anxiety Levels and Sleep Quality Among Palestinian Patients in Adult Critical Care Units: A Descriptive Study on The Use of Non-invasive Ventilation رسالة ماجستير

Abstract

Introduction: Worldwide, respiratory disorders are a major cause of morbidity and mortality, frequently requiring treatments like non-invasive ventilation (NIV). While its respiratory benefits are well-documented, its psychological and sleep-related effects remain underexplored, particularly in Palestinian critical care settings where unique environmental and systemic factors may influence patient outcomes. This study aims to evaluate the effect of NIV on the anxiety level and sleep quality of Palestinian patients in adult critical care units. Methodology: A descriptive, cross-sectional, non-experimental design was conducted on 83 Palestinian adult patients in critical care units in three governmental hospitals in the West Bank. The Hamilton Anxiety Rating Scale (HAM-A) was used to assess anxiety levels, and the Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. Data were analyzed using descriptive and inferential statistics, including Chi-square tests, one-way ANOVA tests, and linear regression analyses to determine associations between key variables. Results: Findings showed that 74.7% of patients had mild anxiety, 12% had moderate, and 13.2% had severe to very severe anxiety. Frequent hospitalizations were significantly associated with higher anxiety scores (p < 0.001). Reinforcing the psychological burden of prolonged critical care stays. Overall, 85.5% of patients reported good sleep quality, indicating that NIV effectively alleviates respiratory distress. Notably, against early expectations, there was no discernible correlation between age and sleep quality (p=0.68). Conclusion: NIV plays a crucial role in improving sleep quality and alleviating severe anxiety in critically ill patients. However, specific patient subgroups, particularly those with frequent hospitalizations, remain at high risk for increased anxiety. Integrating personalized NIV strategies with psychological support is essential to optimizing patient care in critical care settings. Further research should explore long-term psychological effects and the impact of tailored interventions.