運用實證探討白噪音的介入對成人加護病房病人睡眠品質的影響

Exploring the Impact of White Noise Intervention on Sleep Quality in Adult Intensive Care Patients: An Evidence- Based Approach

形成臨床提問
加護病房環境噪音對病人產生許多嚴重的身心影響，約50%的病人在入住ICU期間會出現睡眠障礙。研究指出促進睡眠的方法很多，其中「白噪音」是一種由不同頻率的聲音組成、具有平穩特性的聲音，能有效屏蔽環境中的噪音，因其簡單且低成本的特性，逐漸受到重視。然而，白噪音的實證研究結果尚存分歧。因此本研究藉由實證的方式，探討白噪音對成人加護病房病人睡眠品質改善的成效。
文獻搜尋的方法與分析
本研究方法於Airiti Libray、CINAHL、Cochrane Library、Embase、PubMed資料庫中進行文獻搜尋，文章以系統性文獻回顧及隨機對照試驗為主，設定關鍵字為「IntensiveCare Unit adult patient」、「white noise」、「sleep quality」，運用布林邏輯（OR、AND及NOT），刪除重複、與PICO主題不符文章後，最終選定兩篇文獻納入評讀。
文獻的品質評讀
運用The Joanna Briggs Institute（JBI）（2020）進行類實驗及實驗性文章評讀。依照英國牛津大學實證醫學中心Oxford CEBM（2011）證據等級進行分類，納入的兩篇研究分別屬於類實驗型研究設計（為level III）、RCT（為level I）。
結果、結論與建議
綜合實證結果，白噪音對於改善ICU病人之睡眠品質結果不一致，但「白噪音」是一種簡易、低成本，沒有傷害的方式，可減少因ICU環境噪音造成的身心影響。本文建議可以運用白噪音於嘗試過其他促進睡眠方式後，睡眠品質仍不佳的加護病房病人。另因搜尋條件設定後搜尋相關研究只有兩篇，對研究結果證據力較不足，未來將針對此議題持續搜尋相關研究進行評讀尋求更好的實證結果，最為未來改善加護病房病人睡眠品質之參考。

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Noise in the intensive care unit (ICU) environment has significant physical and psychological impacts on patients, with about 50% of ICU patients experiencing sleep disturbances during their stay. Among the many methods proposed to promote sleep, ''white noise''-a sound composed of different frequencies with steady characteristics-has been recognized for its ability to effectively mask environmental noise. Due to its simplicity and low cost, white noise has gained attention. However, existing evidence on the effects of white noise remains inconsistent. Therefore, this study aimed to explore the effectiveness of white noise in improving sleep quality among adult ICU patients through an evidence-based approach.
The Method and Analysis of Literature Review
A literature search was conducted in databases such as Airiti Library, CINAHL, Cochrane Library, Embase, and PubMed. The search focused on systematic review and randomized controlled trials (RCTs), with keywords including ''Intensive Care Unit adult patient'', ''white noise'', and ''sleep''. Boolean logic (OR, AND, NOT) was employed to refine the search, and duplicate articles or those unrelated to the PICO topic were excluded. Ultimately, two studies were selected for appraisal.
Critical Appraisal
The Joanna Briggs Institute (JBI, 2020) critical appraisal tools were used to evaluate quasi-experimental and experimental studies. Evidence levels were categorized based on the Oxford Centre for Evidence-Based Medicine (CEBM, 2011). The two included studies comprised one quasi-experimental study (level III) and one RCT (level I).
Results, Conclusions, and Recommendations
The evidence suggests inconsistent results regarding the effectiveness of white noise in improving sleep quality among ICU patients. Nevertheless, white noise is a simple, low-cost, and non-invasive method that may help mitigate the physical and psychological impacts of ICU environmental noise. This study recommends using white noise for ICU patients whose sleep quality remains poor after trying other sleep-promoting methods. Given that only two relevant studies were identified under the set search criteria, the evidence strength is limited. Future efforts should continue to search for and critically appraise additional studies on this topic to provide more robust evidence, serving as a reference for improving sleep quality among ICU patients.