Scarpa, M., Pinto, E., Saraceni, E., Cavallin, F., Parotto, M., Alfieri, R., . . . QOLEC Group. (2017). Randomized clinical trial of psychological support and sleep adjuvant measures for postoperative sleep disturbance in patients undergoing oesophagectomy. British Journal of Surgery, 104, 1307–1314.

The purpose was to evaluate the effects of psychological counseling and sleep adjuvant measures on postoperative qualify of life and sleep in patients undergoing an esophagectomy.

Four groups were included: (a) psychological counseling plus sleep measures during the intensive care unit (ICU) stay, (b) psychological counseling alone, (c) sleep adjuvant measures alone during the ICU stay, or (d) standard care. Psychological interventions were performed by a psychologist in four or more sessions during the hospital stay according to a cognitive-interactive model. Sleep adjuvant measures included being in a quiet corner of the ICU provided earplugs and eye masks. Patients were instructed on the use of each but were free to use them as needed. Nurses concentrated their routine assessment when possible.

• N = 74; 16, 19, 19, and 20 in each group   
• AGE: 61–67 years (average). Range was 51–75.
• MALES/FEMALES: Given in ratios 15:1, 17:2, 15:4, and 16:4  (male:female)  
• CURRENT TREATMENT: Other
• KEY DISEASE CHARACTERISTICS: Patients undergoing esophagectomy for resectable esophageal cancer

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Site: ICU, Setting: Hospital, Location: Italy

PHASE OF CARE: Active antitumor treatment

Randomized four-group trial

EORTC C30, PSQI

Psychological counseling reduced the decline in quality of life (odds ratio [OR] 0.23) and sleep quality (OR 0.27). The study was stopped early because of changes in the ICU setting.

Psychological counseling was beneficial in reducing the decline in quality of life and sleep impairment following esophagectomy. This is a labor-intense intervention, and consideration of the nursing factors in the sleep adjuvant measures is important.

• Small sample (< 100)
• Other limitations/explanation: The study was stopped early. It is not known how closely patients followed the sleep adjuvant measures.

Following esophagectomy, patients are at high risk of quality-of-life impairments and sleep problems. This study identified benefits to psychological counseling as well as adjuvant sleep measures. The sleep measures could be incorporated into clinical care for any surgical patient and show promise to impact sleep problems. Additional research is warranted.