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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">sechenov</journal-id><journal-title-group><journal-title xml:lang="en">Sechenov Medical Journal</journal-title><trans-title-group xml:lang="ru"><trans-title>Сеченовский вестник</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2218-7332</issn><issn pub-type="epub">2658-3348</issn><publisher><publisher-name>Сеченовский Университет</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.47093/2218-7332.2025.16.4.31-40</article-id><article-id custom-type="elpub" pub-id-type="custom">sechenov-1458</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>SURGERY</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ХИРУРГИЯ</subject></subj-group></article-categories><title-group><article-title>Development and validation of an environmental protocol to enhance sleep and pain outcomes in intensive care unit patients</article-title><trans-title-group xml:lang="ru"><trans-title>Разработка и валидация протокола модификации окружающей среды, влияющей на качество сна и интенсивность боли у пациентов отделения интенсивной терапии</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6813-270X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Валадани</surname><given-names>Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Waladani</surname><given-names>B.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Валадани Барках, ассистент кафедры сестринского дела в анестезиологии и реаниматологии факультета здравоохранения и естественных наук</p><p>ул. Йос Сударсо, д. 461, г. Гомбонг, Кебумен, 54412</p></bio><bio xml:lang="en"><p>Barkah Waladani, Assistant Professor, Department of Critical Care Nursing, Faculty of Health and Science</p><p>461, Yos Sudarso str., Gombong, Kebumen, 54412</p></bio><email xlink:type="simple">barkah.waladani@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0005-3265-5364</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сетианингсих</surname><given-names>Э.</given-names></name><name name-style="western" xml:lang="en"><surname>Setianingsih</surname><given-names>E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Сетианингсих Энда, старший преподаватель кафедры сестринского дела в анестезиологии и реаниматологии факультета здравоохранения и естественных наук </p><p>ул. Йос Сударсо, д. 461, г. Гомбонг, Кебумен, 54412</p></bio><bio xml:lang="en"><p>Endah Setianingsih, Senior Lecturer, Department of Critical Care Nursing, Faculty of Health and Science</p><p>461, Yos Sudarso str., Gombong, Kebumen, 54412</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7258-287X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Хидая</surname><given-names>М. Н.В.</given-names></name><name name-style="western" xml:lang="en"><surname>Hidayah</surname><given-names>M. N.W.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Хидая Мухаммад Нур Вахью, старший преподаватель кафедры промышленной инженерии факультета естественных и гуманитарных наук </p><p>ул. Йос Сударсо, д. 461, г. Гомбонг, Кебумен, 54412</p></bio><bio xml:lang="en"><p>Muhammad N.W. Hidayah, Senior Lecturer, Department of Industrial Engineering, Faculty of Science and Humanities</p><p>461, Yos Sudarso str., Gombong, Kebumen, 54412</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Университет Мухаммадия в Гомбонге (UNIMUGO)</institution><country>Индонезия</country></aff><aff xml:lang="en"><institution>Universitas Muhammadiyah Gombong (UNIMUGO)</institution><country>Indonesia</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>30</day><month>12</month><year>2025</year></pub-date><volume>16</volume><issue>4</issue><fpage>31</fpage><lpage>40</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Waladani B., Setianingsih E., Hidayah M.N., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Валадани Б., Сетианингсих Э., Хидая М.Н.</copyright-holder><copyright-holder xml:lang="en">Waladani B., Setianingsih E., Hidayah M.N.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.sechenovmedj.com/jour/article/view/1458">https://www.sechenovmedj.com/jour/article/view/1458</self-uri><abstract><sec><title>Aim</title><p>Aim. To develop a multimodal environmental modification protocol for the intensive care unit (ICU) and evaluate its feasibility and preliminary associations with sleep quality and pain intensity in patients.</p></sec><sec><title>Materials and methods</title><p>Materials and methods. A quasi-experimental, single-arm study involving 152 adult patients was conducted from June to August 2025 in the ICU of a Type B hospital in Central Java, Indonesia. Environmental modifications included six interventions: earplugs, eye masks, music therapy, lavender aromatherapy, lighting adjustments, and noise reduction measures, which were applied daily for three consecutive nights (content validity = 0.94). Sleep quality was measured using the Richards-Campbell Sleep Questionnaire (RCSQ), and pain intensity was measured using the numeric rating scale (NRS). Paired t-tests, 95% confidence intervals (CI), and Cohen's d were used to describe intervention effectiveness. Normality of distribution was tested using the Shapiro–Wilk test.</p></sec><sec><title>Results</title><p>Results. All 152 ICU participants completed the three-day protocol, with overall adherence being 94%. Mean RCSQ scores improved from 34.6 with 11.3 to 51.8 with 10.6 (95% CI: 15.46–18.94; paired t-test, p &lt; 0.001; Cohen's d = 1.57). Mean NRS scores decreased from 4.7 with 1.8 to 2.8 with 1.3 (95% CI: −2.15 to −1.65; paired t-test, p &lt; 0.001; Cohen's d = 1.21). No adverse events were noted. Objective environmental monitoring (subsample n = 40) showed a mean reduction in noise and lighting levels at the patient's bedside during the intervention.</p></sec><sec><title>Conclusion</title><p>Conclusion. The protocol for creating a positive environment in the ICU was feasible, acceptable, and resulted in subjective improvements in sleep quality and pain intensity in patients.</p></sec></abstract><trans-abstract xml:lang="ru"><sec><title>Цель</title><p>Цель. Разработать мультимодальный протокол модификации окружающей среды для отделения реанимации и интенсивной терапии (ОРИТ), провести оценку его осуществимости и предварительных связей с качеством сна и интенсивностью боли у пациентов.</p></sec><sec><title>Материалы и методы</title><p>Материалы и методы. Квазиэкспериментальное одногрупповое исследование с участием 152 взрослых пациентов проводилось с июня по август 2025 года в ОРИТ больницы типа B в провинции Центральная Ява, Индонезия. Модификация окружающей среды включала 6 инструментов: беруши, маски для глаз, музыкотерапия, ароматерапия с лавандой, регулировка освещения и меры по снижению шума, которые применялись ежедневно в течение трех последовательных ночей (содержательная валидность = 0,94). Качество сна измерялось с помощью опросника сна Ричардса – Кэмпбелла (RCSQ, Richards – Campbell Sleep Questionnaire), а интенсивность боли – с помощью числовой рейтинговой шкалы (NRS, numeric rating scale). Для описания эффективности вмешательства использовались парные t-критерии, 95% доверительные интервалы (ДИ) и стандартное отклонение d Коэна. Нормальность распределения проверялась с помощью критерия Шапиро – Уилка.</p></sec><sec><title>Результаты</title><p>Результаты. Все 152 участника ОРИТ завершили трехдневный протокол, общая приверженность составила 94%. Средние баллы по шкале RCSQ улучшились с 34,6 ± 11,3 до 51,8 ± 10,6 (95% ДИ: 15,46–18,94; парный t-критерий, p &lt; 0,001; коэффициент Коэна d = 1,21). Нежелательных явлений не отмечено. Объективный мониторинг окружающей среды (подвыборка n = 40) показал среднее снижение уровня шума и освещения у постели больного в часы проведения вмешательства.</p></sec><sec><title>Заключение</title><p>Заключение. Протокол по созданию благоприятной среды в ОРИТ оказался осуществимым, приемлемым и обеспечил субъективное улучшение качества сна и снижение интенсивности боли у пациентов.</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>отделение интенсивной терапии</kwd><kwd>модификация окружающей среды</kwd><kwd>качество сна</kwd><kwd>обезболивание</kwd><kwd>анализ осуществимости</kwd></kwd-group><kwd-group xml:lang="en"><kwd>intensive care unit</kwd><kwd>environmental modification</kwd><kwd>sleep quality</kwd><kwd>pain management</kwd><kwd>feasibility study</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Исследование было поддержано грантом Министерства образования, культуры, исследований и технологий Республики Индонезия (Kemendiktisaintek), грант № 0070/C3/AL.04/2025.</funding-statement><funding-statement xml:lang="en">The study was supported by a research grant from the Ministry of Education, Culture, Research, and Technology of the Republic of Indonesia (Kemendiktisaintek), Grant No. 0070/C3/AL.04/2025.</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Bolin M.C., Sweetman M.M. 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