The impact of ward nighttime noise management under the enhanced recovery after surgery protocol on postoperative sleep quality and mental health in patients with lower extremity fractures: A retrospective, non-randomized, historically controlled study

Abstract

Objective: To explore the impact of ward nighttime noise management under the Enhanced Recovery After Surgery (ERAS) protocol on postoperative sleep quality and mental health in patients with lower extremity fractures.

Methodology: This was a retrospective cohort study conducted at Gutian Campus of our Hospital. It included 65 patients with lower extremity fractures who received ward nighttime noise management under the protocol between April 2024 to April 2025 (observation group); in addition, 65 patients who received conventional nursing management between April 2023 to March 2024 served as the control group. The two cohorts were matched at a 1:1 ratio. Matching criteria included gender, age, body weight, educational level, ASA classification, operation time, and surgical type. The primary outcome was the improvement of sleep quality. Secondary outcomes included mental health scores, material living score, social function score, and nursing satisfaction.

Results: During the perioperative period, the noise level in the observation group was significantly lower than that in the control group (P<0.05). After surgery, the scores of Pittsburgh Sleep Quality Index (PSQI), SDS, SAS, material living, and social function in both groups were significantly improved compared with those before surgery (all P<0.05); moreover, the scores of PSQI, SDS, SAS, and social function in the observation group were superior to those in the control group (all P<0.05). The nursing satisfaction in the observation group was significantly higher than that in the control group (P<0.05).

Conclusions: Ward nighttime noise management under the protocol is beneficial for improving postoperative sleep and mental health of patients with lower limb fractures.