Characteristics of the Nighttime Hospital Bedside Care Environment (Sound, Light, and Temperature) for Children With Cancer

Background: Children with cancer must cope not only with their disease and its treatment but also with the environment in which treatment is given. The intensities of sound and light levels required to perform necessary patient care may result in a disruptive nighttime care environment. Objective: The purpose of this study was to describe nighttime patterns of environmental factors, sound, light, and temperature levels, at the bedside of children with cancer receiving inpatient chemotherapy. Methods: Participants were 15 school-aged children receiving chemotherapy on an inpatient pediatric oncology unit. Sound, light, and temperature in the child's room were measured continuously using a digital-sound pressure-level meter and an external channel data logger. Results: Mean nighttime sound levels were 49.5 (SD, 3.1) dB (range, 34.6-84.8 dB). Sound and light intensities were greatest early in the shift and decreased through the night. A basic mixed linear model identified significant main effects of time of night for both sound (F = 50.42, P < .01) and light (F = 12.43, P < .01). Conclusions: Study findings identified a bedside care environment with persistently elevated sound levels and abrupt increases in sound intensity throughout the night. Such a disruptive nighttime environment is not conducive to restful nighttime sleep and may serve as an additional source of physiological and psychological stress for hospitalized children with cancer. Implications for Practice: Efforts are needed to identify modifiable sources of nighttime sound and develop interventions to reduce nighttime sound. Collaborative efforts to organize clinical care to minimize nighttime disruptions may lead to reduced bedside sound levels.