{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:39:27Z","timestamp":1790811567437,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2025,3]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Sleep disturbance is one of the clinical manifestations of post\u2010intensive care syndrome (PICS) in ICU. Sleep disorders can cause changes in patients' emotional, cognitive, memory, immune, and motor systems, resulting in delayed wound healing, increased infection rate, readmission rate, mortality rate and complication rate. However, developing prediction models for sleep disorders in post\u2010ICU patients is an understudied problem.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n To explore the risk factors of sleep disorders, establish the prediction model, and verify its prediction efficiency internally and externally, providing a scientific basis for clinical staff to prevent the occurrence of sleep disorder in patients transferred out of ICU in the early stages.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n A total of 405 patients transferred from the intensive care department of the Affiliated Hospital of Nantong University in China from May 2022 to December 2022 were selected as the study subjects by convenience sampling method and were divided into a modelling group of 270 patients and an internal verification group of 135 patients. A total of 67 ICU patients admitted to the same hospital from July 2023 to September 2023 were selected as the external validation group. General data and clinical data questionnaires were used to collect information on the influencing factors. The Pittsburgh Sleep Quality Index (PSQI) was used for follow\u2010up 2\u2009weeks after ICU transfer. According to the follow\u2010up results, the patients were divided into a non\u2010sleep disorder group and a sleep disorder group. Univariate analysis was used to analyse the risk factors of sleep disorders in ICU patients. To avoid multicollinearity, LASSO regression was used to filter variables. Through binary logistic regression, the forward step method and likelihood ratio test were selected to further screen the variables. R language was used to establish a riskprediction model and draw a column graph. Receiver operating characteristic (ROC) and Hosmer\u2010Lemeshow (H\u2010L) tests were used to verify the prediction effect of the model.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The influencing factors for sleep disorders in patients transferred out of ICU were pre\u2010hospital sleep disturbance [Odds Ratio: 4.467, 95% CI (1.191\u201316.749),\n p<\/jats:italic>\n \u2009=\u2009.026], APACHE II score \u226515 [Odds Ratio: 6.452, 95% CI (1.777\u201323.434),\n p<\/jats:italic>\n \u2009=\u2009.005], moderate comorbidities [Odds Ratio: 18.045, 95% CI (1.568\u201366.731),\n p<\/jats:italic>\n \u2009=\u2009.015], severe comorbidities [Odds Ratio:12.083, 95% CI (2.785\u2013116.911),\n p<\/jats:italic>\n \u2009=\u2009.002], remifentanil use [Odds Ratio: 12.083, 95% CI (2.716\u201353.756),\n p<\/jats:italic>\n \u2009=\u2009.001], RCSQ total score <45 [Odds Ratio: 18.037, 95% CI (4.907\u201366.300),\n p<\/jats:italic>\n < .001], moderate depression [Odds Ratio: 70.659, 95% CI (8.195\u2013609.219),\n p<\/jats:italic>\n < .001] and severe depression [Odds Ratio: 8.563, 95% CI (1.165\u201362.936),\n p<\/jats:italic>\n \u2009=\u2009.035]. The prediction model was as follows: Logit (P)\u2009= \u221210.529\u2009+\u20091.497* (pre\u2010hospital sleep disorder) +1.864* (APACHE II score \u226515) +2.325* (moderate complication) +2.893* (severe complication) +2.492* (remifentanil use) +2.892* (RCSQ) Total score <45 +0.574* (mild depression) +4.258* (moderate depression) +2.147* (major depression). The area under the ROC curve of the prediction model was 0.916, the sensitivity was 81.9%, and the specificity was 96.0%. The H\u2010L test showed that\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20094.301,\n p<\/jats:italic>\n \u2009= .829 (\n p<\/jats:italic>\n \u2009>\u2009.05). The area under the internal verified ROC curve (AUC) was 0.896, and the H\u2010L test revealed that\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20093.683 and\n p<\/jats:italic>\n \u2009=\u2009.885 (\n p<\/jats:italic>\n \u2009>\u2009.05). The area under the external verified ROC curve was 0.739, the sensitivity was 72.7%, and the specificity was 64.7%. The H\u2010L test results showed that\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20094.683,\n p<\/jats:italic>\n \u2009=\u2009.699 (\n p<\/jats:italic>\n \u2009>\u2009.05), indicating that the model had a good prediction effect.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The risk histogram of sleep disorders in ICU patients can predict the risk of sleep disorders in ICU patients, and can be used to assess the high risk of sleep disorders in ICU patients, and can help nurses to formulate corresponding intervention measures.<\/jats:p>\n <\/jats:sec>\n \n Relevance to Clinical Practice<\/jats:title>\n The dynamic nomogram can be used to systematically monitor various factors associated with sleep disorders, and the prevention of sleep disorders can improve outcomes and quality of life for patients discharged from the ICU. Furthermore, nurses need to develop and accurately apply nursing interventions, taking into account all relevant variables, thereby reducing the occurrence of sleep disorders.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nicc.13292","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T01:04:56Z","timestamp":1740013496000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prediction model for sleep disorders in patients transferred out of\n ICU<\/scp>\n : Development and validation"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1667-0509","authenticated-orcid":false,"given":"Wenjie","family":"Huang","sequence":"first","affiliation":[{"name":"Medical School of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuxiu","family":"Song","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Xuzhou Medical University Xuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Gao","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linjun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Affiliated Rugao Hospital of Xinglin College Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"Xiao","sequence":"additional","affiliation":[{"name":"Medical School of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Xu","sequence":"additional","affiliation":[{"name":"Medical School of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhao","family":"Deng","sequence":"additional","affiliation":[{"name":"Medical School of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wu","sequence":"additional","affiliation":[{"name":"Affiliated Hospital of Nantong University Nantong China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.12102\/j.issn.1009\u20106493.2022.17.015"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010021\u201003501\u2010z"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1672\u20101756.2020.06.032"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CNQ.0000000000000196"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066614538749"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13613\u2010015\u20100043\u20102"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.2096\u20107950.2021.23.fshlfykfyx202123048"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.7507\/1671\u20106205.201901039"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.3761\/j.issn.0254\u20101769.2022.12.012"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100258(19960229)15:4<361::AID\u2010SIM168>3.0.CO;2\u20104"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0895\u20104356(96)00236\u20103"},{"key":"e_1_2_15_13_1","volume-title":"A Simulation Study on Determining the Required Number of Independent Variable Events with Logistic Regression Sample Size","author":"Yaqing S","year":"2016"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2013.03.019"},{"key":"e_1_2_15_15_1","volume-title":"Machine Learning","author":"Zhihua Z","year":"2016"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(87)90171\u20108"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2017.06.056"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1965.01720310065008"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1891\/1061\u20103749.8.2.131"},{"key":"e_1_2_15_20_1","volume-title":"Study on ICU\u2010Related Memory and Risk Factors of Post\u2010Traumatic Stress Disorder","author":"Li H","year":"2016"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/01612848109140863"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102648.1998.00555.x"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.3761\/j.issn.0254\u20101769.2018.04.027"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100447.1983.tb09716.x"},{"issue":"3","key":"e_1_2_15_25_1","article-title":"Application and evaluation of \"anxiety and depression scale\" in general hospital patients. 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