Publication Search

Work stress is a condition often experienced by nurses, especially those working in the Intensive Care Unit (ICU) due to the high demands of the job and the responsibility of caring for critically ill patients. Work stress that is not managed properly can have an impact on nurses' health, one of which is sleep quality. Poor sleep quality can reduce concentration and performance and increase work fatigue. This study aims to determine the relationship between work stress and sleep quality among nurses in the ICU of Ulin Regional General Hospital in Banjarmasin. This study uses a quantitative method with a cross-sectional design. The research sample consists of ICU nurses selected using total sampling technique. The research instruments used are the Expanded Nursing Stress Scale (ENSS) to measure work stress and the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality. Data analysis was performed using statistical tests to determine the relationship between the two variables. The results showed that most nurses experienced moderate work stress. In addition, many nurses still had five to six hours of sleep per night and experienced sleep disturbances. The analysis results showed a significant relationship between work stress and sleep quality among ICU nurses.

Intracerebral Hemorrhage (ICH) is one of the types of stroke with the highest rates of mortality and morbidity. This condition is often accompanied by decreased levels of consciousness and hemodynamic instability, particularly in patients undergoing intensive care in the ICU. The application of murottal (Qur’anic recitation) therapy is expected to contribute to the stabilization of patients’ hemodynamic, physical, and physiological conditions. The purpose of this study was to explore the effect of Qur’anic murottal therapy on the hemodynamic stability of ICU patients at RSUD Prof. Dr. Margono Soekarjo Purwokerto. This study used a case study design in the form of a nursing care report involving one patient diagnosed with ICH and a nursing problem of decreased intracranial adaptive capacity. The intervention consisted of listening to the recitation of Surah Ar-Rahman for 20 minutes once per shift over three consecutive days. The observed hemodynamic parameters included blood pressure, heart rate, respiratory rate, body temperature, oxygen saturation, and the Glasgow Coma Scale (GCS). The results showed that after the administration of the murottal therapy of Surah Ar-Rahman, the patient experienced improvement and stabilization in hemodynamic parameters, including blood pressure, pulse rate, respiration, and oxygen saturation. Qur’anic murottal therapy of Surah Ar-Rahman has a positive effect on the hemodynamic stability of ICH patients in the ICU at RSUD Prof. Dr. Margono Soekarjo Purwokerto. This intervention has the potential to serve as a non-pharmacological approach to support holistic recovery and improvement in critically patients.

Intracerebral Hemorrhage (ICH) is one of the types of stroke with the highest rates of mortality and morbidity. This condition is often accompanied by decreased levels of consciousness and hemodynamic instability, particularly in patients undergoing intensive care in the ICU. The application of murottal (Qur’anic recitation) therapy is expected to contribute to the stabilization of patients’ hemodynamic, physical, and physiological conditions. The purpose of this study was to explore the effect of Qur’anic murottal therapy on the hemodynamic stability of ICU patients at RSUD Prof. Dr. Margono Soekarjo Purwokerto. This study used a case study design in the form of a nursing care report involving one patient diagnosed with ICH and a nursing problem of decreased intracranial adaptive capacity. The intervention consisted of listening to the recitation of Surah Ar-Rahman for 20 minutes once per shift over three consecutive days. The observed hemodynamic parameters included blood pressure, heart rate, respiratory rate, body temperature, oxygen saturation, and the Glasgow Coma Scale (GCS). The results showed that after the administration of the murottal therapy of Surah Ar-Rahman, the patient experienced improvement and stabilization in hemodynamic parameters, including blood pressure, pulse rate, respiration, and oxygen saturation. Qur’anic murottal therapy of Surah Ar-Rahman has a positive effect on the hemodynamic stability of ICH patients in the ICU at RSUD Prof. Dr. Margono Soekarjo Purwokerto. This intervention has the potential to serve as a non-pharmacological approach to support holistic recovery and improvement in critically patients.

The ICU is one of the largest clinical cost centers in hospitals due to its high demand for human resources, medical equipment, and operational costs. This situation emphasizes that intensive care unit efficiency is a multidimensional issue that cannot be assessed solely from a single aspect. This study aims to analyze the efficiency of the intensive care unit at Ciremai Hospital, Cirebon City, using the Data Envelopment Analysis (DEA) model to determine resource optimization. Analytical quantitative study with a cross-sectional design. The population in this study consisted of personnel in the ICU of Ciremai Hospital from 2023 to 2025, with total sampling applied. The input variables included the number of physicians, nurses, beds, monitors, and ventilators, while the output variables consisted of BOR, LOS, and recovered patients. The ICU input variables remained stable during the study period, while output variables fluctuated with a declining trend in BOR and LOS. The results of the Data Envelopment Analysis (DEA) indicated that all study periods achieved an efficiency score of 1.00 (efficient), with a slack value of 0.00 across all input variables.

Background: The management of hemorrhagic shock in obstetrics typically involves aggressive fluid resuscitation, often leading to iatrogenic fluid overload and pulmonary edema. Implementing a timely fluid de-escalation (deresuscitation) strategy is critical to facilitate ventilator weaning and achieve early extubation. Case Illustration: A 31-year-old female (G5P3A1) was admitted to the ICU following emergency Re-Cesarean Section due to Grade IV hemorrhagic shock caused by postpartum hemorrhage (PPH) and placenta previa totalis. Intraoperative aggressive resuscitation triggered iatrogenic fluid overload, manifesting as bilateral pulmonary edema and severe gas exchange impairment (initial AaDO2 of 459 mmHg and lactate level of 2.8 mmol/L). Management and Results: Following initial hemodynamic stabilization, an active fluid de-escalation strategy was initiated on Post-Operative Day 1 (POD 1) using continuous furosemide infusion at 10 mg/hour targeting a negative fluid balance. The patient achieved a negative fluid balance of -1485 mL within 24 hours, accompanied by a significant increase in urine output (7.8 mL/kg/hour). This approach successfully reduced the AaDO2 to 162 mmHg and improved lactate clearance to 1.8 mmol/L without compromising hemodynamic stability. The patient was successfully extubated within 18 hours of ICU admission. Conclusion: Early transition from resuscitation to fluid de-escalation, guided by perfusion targets (lactate) and oxygenation markers (AaDO2), is safe in critical obstetric cases. This strategy effectively resolves pulmonary edema and accelerates early extubation.

Pneumonia caused by extensively drug-resistant (XDR) Pseudomonas aeruginosa is still  clinicaly chalenging, particularly among geriatric patients with neurological comorbidities such as stroke. This report presents a case of XDR P. aeruginosa pneumonia complicated by sepsis in a 73-year-old patient, characterized by persistent leukocytosis until the tenth day of hospitalization despite empirical meropenem therapy. This evidence-based case report aims to analyze clinical outcomes, specifically 28-day and 30-day mortality rates, and to identify mortality predictors in the adult population through a systematic literature search of the PubMed and Google Scholar databases for the 2019–2026 period. Synthesized evidence from six core studies indicates that XDR P. aeruginosa infections carry a profoundly high 28-day mortality rate, ranging from 41% to 51% in cohorts receiving antibiotic monotherapy. Key mortality predictors identified include the presence of sepsis or septic shock, a delay in initiating adequate therapy exceeding 52 hours, advanced age, and the requirement for Intensive Care Unit (ICU) admission. The phenomenon of persistent or worsening leukocytosis during treatment, as observed in this case, serves as a critical clinical indicator associated with antimicrobial response failure and a dismal prognosis. Ultimately, XDR P. aeruginosa pneumonia is associated with poor clinical outcomes, where therapeutic success is strictly contingent upon the timely administration of antibiotic regimens with proven activity against these highly resistant isolates.

Chronic Kidney Disease (CKD) is a structural or functional abnormality of the kidneys that lasts ≥3 months with the criteria of eGFR <60 mL/min/1.73 m² or the presence of kidney damage such as albuminuria and urinary abnormalities (Kidney International, 2024). CKD patients, especially those treated in intensive care units, often experience gastrointestinal disorders such as increased volume of gastric residues. Giving enteral nutrition to patients with NGT can increase the volume of gastric residue which is at risk of causing complications. One of the non-pharmacological interventions that can be carried out is abdominal massage, which is a light massage technique in the abdominal area that can stimulate intestinal peristalsis and improve gastrointestinal motility. The purpose of this case study was to determine the effect of  giving abdominal massage on reducing the volume of gastric residue in CKD patients in the ICU. This scientific paper uses a case study design using abdominal mass therapy. The number of respondents was 3 people, the intervention was carried out for 3 days with a time of 10-15 minutes. The application of abdominal massage therapy in the three respondents showed a decrease in the volume of gastric residue after admixture was carried out  for three consecutive days with an average decrease in the volume of gastric residue, which was 50 cc - 75 cc. Abdominal massage is a safe and effective nonpharmacological nursing intervention to help reduce gastric residue volume and support enteral nutrient tolerance in CKD patients in the ICU.

Nursing documentation is an essential part of healthcare services, playing a key role in communication, care continuity, and serving as legal evidence. The introduction of the Hospital Management Information System (SIMRS) aims to improve the efficiency of documentation processes. However, high workloads in critical areas such as the Emergency Department (IGD) and Intensive Care Unit (ICU) may influence nurse compliance with documentation protocols. This study investigates the relationship between workload and nursing documentation compliance during the implementation of SIMRS at RSUD Haji Makassar's IGD and ICU. A quantitative cross-sectional design was used, with 30 nurses participating (total sampling). The workload was assessed using the NASA Task Load Index (NASA-TLX), while compliance was evaluated through a questionnaire. The data were analyzed using Chi-Square and Fisher’s Exact Test. The results showed that the majority of respondents experienced heavy workloads (83.3%), and most had compliant documentation (96.7%). However, the statistical analysis yielded a p-value of 1.000, indicating no significant relationship between workload and documentation compliance. Based on these findings, the study recommends optimizing SIMRS usage and providing ongoing training to ensure improved compliance with nursing documentation practices.

Head injury remains a leading cause of mortality, increasing intracranial pressure and requiring craniectomy. Postoperative patients on ventilators are at risk of respiratory distress due to secretion accumulation, which can lead to decreased oxygen saturation. This study aimed to determine the effect of suction on oxygen saturation in post-craniectomy patients on ventilators in the ICU of Dadi Regional General Hospital, South Sulawesi Province. This study used a quasi-experimental design with a one-group pretest-posttest approach. The sampling technique used purposive sampling. Oxygen saturation measurements were taken before and after suctioning and analyzed statistically. The results showed that the average oxygen saturation before suctioning was 94.14% and after suctioning increased to 99.81%. Most respondents experienced an increase in oxygen saturation after the intervention. The results of this statistical test indicate a significant effect between suctioning on increasing oxygen saturation (p = 0.000) with an effect size indicating a large impact. It is hoped that this action will be an effective intervention in increasing oxygen saturation in post-craniectomy patients who are on ventilators in the ICU.

Combined spinal epidural (CSE) is a regional anesthesia technique that combines the rapid onset of spinal anesthesia with the flexibility and prolonged analgesia of epidural anesthesia, making it a valuable option for major surgery in elderly patients with comorbidities. We report a case of a 76-year-old man with ASA physical status III diagnosed with multiple nephrolithiasis accompanied by bilateral hydronephrosis, who underwent open right nephrolithotomy under CSE anesthesia. The patient had a history of hypertension and mild renal function impairment, placing him at increased perioperative risk. Intraoperatively, hemodynamic parameters remained stable without significant hypotension, vasopressor requirement, or conversion to general anesthesia. Estimated blood loss was approximately 500 mL and was managed with crystalloid replacement without transfusion. Prophylactic antibiotic and adjuvant medications were administered according to surgical standards. Postoperatively, the patient was monitored in the ICU with stable vital signs and adequate pain control achieved through continuous epidural analgesia. This case highlights that CSE can be a safe and effective anesthetic approach for open nephrolithotomy in selected high-risk geriatric patients, providing satisfactory hemodynamic stability and postoperative recovery.

Anxiety among family member in the Intensive Care Unit (ICU) is a common psychological issue. This situation arises from the uncertainty about the patient’s condition. Effective therapeutic communication by nurses is one of the key strategies to help reduce anxiety. This study was conducted from June 4 to July 20, 2025. This study aims to analyze the relationship between nurses’ therapeutic communication and the anxiety levels of family members in the ICU of RSUD Meuraxa, Banda Aceh. This research employed a quantitative, correlational design. The population consisted of 66 family members of ICU patients, with a sample of 57 respondents selected using a purposive sampling technique. The results showed that most families received therapeutic communication at a moderate level (50.9%) and a good level (49.1%). The anxiety levels experienced by the families were mostly moderate (54.4%) and mild (45.6%). The analysis revealed a p-value of 0.003, indicating a statistically significant relationship between nurses’ therapeutic communication and the anxiety levels of family member. These findings prove that therapeutic communication given by nurses plays a vital role in influencing the anxiety levels of patients’ families in the ICU. Therefore, the hospital management is encouraged to improve nurses’ therapeutic communication skills and establish supportive communication policies to enhance services and reduce anxiety among the family members in the ICU.

The admission of patients to the Intensive Care Unit (ICU) or Intensive Cardiology Care Unit (ICCU) often occurs suddenly and under critical conditions, causing family members to experience psychological pressure such as anxiety, stress, and fear of losing their loved ones. This study aims to analyze the relationship between family knowledge and the level of anxiety among family members of patients treated in the ICU at Meuraxa General Hospital, Banda Aceh. The research employed a quantitative method with a descriptive correlational design and a cross-sectional approach. The population consisted of 114 patient families, with 35 respondents selected through purposive sampling. The instrument used was the Hamilton Anxiety Rating Scale (HARS), which demonstrated high reliability (α = 0.897). Data were collected from June 18 to July 5, 2025, and analyzed using univariate and bivariate methods with the chi-square test. The results showed that 19 respondents (54.3%) experienced moderate anxiety, while 14 respondents (40%) had low knowledge regarding ICU/ICCU care. Statistical analysis revealed a p-value of 0.005, indicating a significant relationship between family knowledge and anxiety levels. These findings highlight the importance of healthcare professionals in providing education to family members to improve understanding and help reduce anxiety during the patient’s treatment period in the ICU or ICCU.

Cellulitis is a bacterial skin and subcutaneous infection caused by the disruption of the skin barrier, immune dysfunction, and/or circulation disorders. It has various risk factors, one of which is uncontrolled diabetes mellitus. Hygiene is also crucial for prevention and long-term management to prevent reinfection. A 52-year-old male presented with decreased consciousness 2 days prior admission. He also had bulla, edema, and pain in his right lower limbs. He had a history of uncontrolled diabetes mellitus. He appeared severely ill with a Glasgow Coma Scale (GCS) of 8 (E2M4V2), hypotension, and tachycardia. At 1/3 distal right cruris and right dorsum of the foot, there were erythematous and ill-defined red-to-purplish black hyperpigmentation with multiple plaque-sized bullae with irregular margins and warmth on palpation. The laboratory examination demonstrated hyperglycemia (733 mg/dL). He was treated in the Intensive Care Unit (ICU) with multidisciplinary therapy. Cellulitis is a significant health burden because it is associated with increased hospitalization rates and medical costs. If prompt treatment is not given, it can lead to severe infection or sepsis. A holistic therapy is required, including controlling the predisposing factors, maintaining hygiene, symptomatic therapies, and antibiotics to prevent reinfection and improve the outcomes of cellulitis. Risk factor control and hygiene maintenance are crucial since they are effective preventive measures and long-term management of cellulitis, leading to patients’ improved health conditions and quality of life, also lowering the incidence of cellulitis and health burdens.

Patients who are admitted to the Intensive Care Unit (ICU) often require mechanical ventilation due to respiratory failure. One of the common problems that arises in patients with mechanical ventilation is the buildup of sputum, which can interfere with the ventilation process as well as lower the tidal volume. To overcome this, a combination of clapping and suction interventions are used as a therapeutic method with the aim of helping to clear the airways and improve ventilation function. This study aims to determine the effect of the combination of clapping and suction on tidal volume in patients with respiratory failure using mechanical ventilation. The research design used a pre-experiment with a one-group pretest-posttest approach on 43 respondents in the ICU room. Interventions in the form of clapping and suction are given in a structured manner according to standard nursing procedures. The results showed that the majority of respondents were female (53.5%), with the most medical diagnosis being SNH (23.3%). Most of the respondents were in the late adult age category (32.6%) and used PCV ventilation mode (51.2%). Before the intervention, most respondents had a low tidal volume (72.1%), while after the intervention the majority had an increase to the normal category (90.7%). The Wilcoxon test showed a value of p = 0.001, which means that there is a significant effect of the combination of clapping and suction on the increase in tidal volume. Thus, it can be concluded that the combination of clapping and suction is an effective intervention in increasing tidal volume in patients with respiratory failure with mechanical ventilation at the ICU of RSI Sultan Agung Semarang.

The Intensive Care Unit (ICU) is a specialized unit in a hospital that provides intensive care and close monitoring for critically ill patients. This unit is equipped with advanced medical equipment such as ventilators and hemodynamic monitors, and has a high staffing ratio to ensure optimal care (Smith & Jones, 2020; Brown et al., 2019; Williams & Green, 2021).  The multidisciplinary team in the ICU, including specialist physicians and trained nurses, works together to meet the medical and psychological needs of patients (Taylor, 2022; Miller & Adams, 2018). According to the WHO (2023), 10–20% of hospital patients require ICU care. In Indonesia, ICU patients account for approximately 15% of total hospital patients (Kusuma, 2021). Data from Dr. Moewardi Regional Hospital (RSUD) shows an increasing trend in ICU patients, primarily due to infectious diseases (Ministry of Health, 2021). Meanwhile, in the ICU of Sultan Agung Islamic Hospital (RSI Sultan Agung Semarang), 1,278 patients were admitted between January and October 2024, with the most cases being respiratory failure (143 patients). This study used a quantitative design with a cross-sectional approach. The sample consisted of conscious patients treated in the ICU and met the inclusion criteria, with 71 respondents.  The research instrument used a validated questionnaire to measure family support, therapeutic communication, and anxiety levels. Data analysis was performed using the Spearman test. Based on the Spearman test, the 71 respondents were found to have the following characteristics: the highest age group was early elderly (36.6%), the highest gender was male (64.8%), the highest education level was high school (45.1%), the highest occupation was 80.3%, high family support (74.6%), good therapeutic communication (90.1%), and mild anxiety (59.2%). There is a significant relationship between family support and patient anxiety levels. Furthermore, therapeutic communication also significantly reduced patient anxiety levels in the ICU at Sultan Agung Islamic Hospital, Semarang.

Stroke patients often experience mobility impairments, which increase the risk of developing pressure ulcers (decubitus). Pressure ulcers are a common complication for patients with limited mobility, especially in the ICU. One intervention that can be used to reduce the risk of pressure ulcers is back massage using olive oil. This study aims to analyze the effect of back massage using olive oil on reducing the risk of pressure ulcers in stroke patients in the ICU at Sultan Agung Hospital. This study used a pre-experimental design with a one-group pretest-posttest approach, involving 17 respondents who received back massage using olive oil. The results showed that most respondents were aged 56-65 years (35.3%), the majority were male (70.6%), with comorbidities such as diabetes mellitus (52.9%), and the length of hospitalization was 3-5 days. Before the intervention, most respondents were categorized as being at moderate risk based on the Braden scale; however, after the intervention, the majority were no longer at risk of pressure ulcers. The Wilcoxon test showed a p-value of 0.001, indicating that back massage using olive oil had a significant effect on reducing the risk of pressure ulcers. In conclusion, back massage using olive oil is effective in reducing the risk of pressure ulcers in stroke patients in the ICU. Therefore, this technique can be used as an alternative intervention to prevent the occurrence of pressure ulcers in stroke patients.

Craniotomy is a medical procedure to open the skull in order to repair and assess damage to the brain, which can cause fever due to thermoregulatory disturbances in the central nervous system. Monitoring the body temperature of post-craniotomy patients is crucial, as hyperthermia can increase the risk of complications. One non-pharmacological therapy to reduce fever is the use of ice gel compresses. This study aims to compare the effect of ice gel compress placement between the chest and armpit on body temperature changes in post-craniotomy patients in the ICU of RSI Sultan Agung Semarang. This research uses a pre-experimental design with a two-group pretest-posttest design, involving 22 respondents selected through total sampling technique. Data were collected using observation sheets, and statistical analysis was performed using the Paired Samples Test. The analysis results showed that the p-value for the chest was 0.867 (p > 0.05) and for the armpit was 0.199 (p > 0.05), indicating no significant difference in body temperature before and after the ice gel compress at both locations in relation to the body temperature changes of post-craniotomy patients. In conclusion, the application of ice gel compresses to the chest and armpit locations did not show a significant effect on reducing body temperature in post-craniotomy patients.

Families of terminal patients often experience anxiety triggered by the deterioration of the patient’s condition, limited information received, and feelings of loss due to facing separation from their loved ones in a critical situation. This anxiety may occur at varying levels, ranging from mild to panic, and if not properly managed, it can affect the psychological well-being of family members as well as their ability to support the patient. Therefore, appropriate interventions are needed to help reduce the psychological burden of families. One approach that can be applied is mindfulness combined with dhikr, which integrates full awareness with spiritual practice to calm thoughts and emotions. This study employed a quasi-experimental design with a one-group pretest–posttest approach without a control group, involving 20 respondents who were family members accompanying terminal patients in the ICU. Respondents were selected using total sampling according to the inclusion criteria. The research instrument consisted of an anxiety observation questionnaire, and data were analyzed using the Wilcoxon test. The results showed that before the intervention, all respondents experienced anxiety at different levels. After the intervention, there was a significant reduction, with 14 respondents (70%) in the mild anxiety category and 6 respondents (30%) reporting no anxiety. The Wilcoxon test yielded a p-value of 0.000 (<0.05), indicating a statistically significant difference between pre- and post-intervention. In conclusion, mindfulness and dhikr interventions were effective in reducing anxiety among family members accompanying terminal patients in the ICU. This method can be recommended as a spiritually based psychological support strategy to help families cope with critical situations more calmly and adaptively.

Coronary heart disease is one of the major health problems that not only affects the physical condition of patients but also impacts their psychological state, particularly anxiety. Anxiety levels in patients with coronary heart disease usually increase when they are about to undergo invasive medical procedures such as Percutaneous Coronary Intervention (PCI). Anxiety can be influenced by several factors, including age, gender, educational level, and occupation. High levels of anxiety may worsen the patient’s clinical condition, making appropriate non-pharmacological interventions highly necessary to help reduce anxiety. This study aims to determine the effect of spiritual support in the form of dzikir on the anxiety levels of patients with coronary heart disease. The research design used was a true experimental design with a pretest-posttest control group design. The sample consisted of 30 respondents who were evenly divided into two groups: 15 respondents in the intervention group and 15 respondents in the control group. The sampling technique used was total sampling. The instrument for measuring anxiety was the Hamilton Anxiety Rating Scale (HARS). The results showed that providing spiritual support in the form of dzikir was effective in reducing patient anxiety, with a p-value of 0.001. In addition, there was a significant difference in post-therapy anxiety levels between the control and intervention groups, with a p-value of 0.019 (p < 0.05). These findings demonstrate that dzikir, as a form of spiritual support, can be used as a non-pharmacological intervention to reduce anxiety in patients with coronary heart disease. Thus, spiritual support can be an important component of nursing care for patients in the ICU.

Patients admitted to the Intensive Care Unit (ICU) often experience physiological disturbances caused by both medical conditions and intensive treatment procedures. One of the most common problems encountered is sleep disturbance. Several factors contribute to poor sleep quality in ICU patients, including repeated medical procedures, environmental noise from medical equipment and staff activities, discomfort due to body positioning, frequent interactions with health workers, continuous exposure to lighting, pain, and the underlying disease process. Persistent sleep disturbances can delay the healing process, increase blood pressure, and even elevate the risk of stroke. This study aimed to analyze the relationship between anxiety levels and sleep quality in compos mentis patients in the ICU of Sultan Agung Islamic Hospital Semarang. The research design employed a correlational approach with a cross-sectional method. A total of 30 respondents were selected according to the inclusion criteria. Data were collected using the Pittsburgh Sleep Quality Index (PSQI) to measure sleep quality and the Hamilton Anxiety Rating Scale (HARS) to assess anxiety levels. The Chi-Square test was used for statistical analysis. The results showed an equal distribution of male and female respondents (15 each). Ten respondents had a post-laparotomy medical diagnosis, and the majority belonged to the late elderly age group (10 respondents). Most respondents experienced moderate anxiety (18 respondents), while poor sleep quality was reported by 17 respondents. The Chi-Square test revealed a p-value of 0.001, indicating a significant relationship between anxiety levels and sleep quality. In conclusion, higher anxiety levels were associated with poorer sleep quality among compos mentis patients in the ICU. These findings highlight the importance of nursing interventions that address both the physical and psychological aspects of patients to improve sleep quality and support recovery.