# Nursing Intervention Based on Smart Medical Care on the Sleep Quality of Cardiology Patients

Authors: Guifang Gao; Jingjing Su
Journal: Journal of Healthcare Engineering
 (2021)

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## Abstract

With the rapid development of society and the gradual improvement of people’s living standards, patients with cardiovascular diseases have higher standards and requirements for daily health care and quality of life. The main research of this article is based on the observation of the effect of smart medical nursing intervention on the sleep quality of cardiology patients. The convenience sampling method was used to randomly select 80 cardiology patients from the electronic medical record system of the hospital, and the patients were randomly divided into two groups. One group was the control group. The routine nursing method was adopted, and a dedicated nurse paid attention to the sleep status; the other group was the control group. The research group adopts targeted nursing methods. This paper selects three kinds of sensor data as features. When collecting each scene record, it is first divided into sleeping and awake states, and then the classified time is composed of time segments, and these time segments are finally accumulated into sleep duration. Using sleep time, waking time, and sleep duration as input, the participants were divided into good sleepers and poor sleepers. Through a self-made questionnaire survey, the factors that have an adverse effect on the patient’s sleep are divided into 7 aspects. Using the method of internal continuity measurement, Cronbach’s coefficienta is 0.811, suggesting that the internal consistency is better, and the calculation reliability and validity are 86.1% and 83.4%, respectively, suggesting that the table can be used for sleep in hospitalized patients. The P values of the study group and the control group were 0.420, 0.764, 0.740, 0.881, 0.842, 0.119, and 0.342 P>0.05. The results show that the application of smart medical services has a certain effect on the patient's sleep quality.


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## Body

## 1. Introduction

With the continuous development of medical standards, people have higher and higher requirements for medical and health care. However, with the deteriorating domestic environment, the aging of the population has gradually become a trend. People suffering from diabetes, hypertension, and cardiovascular and cerebrovascular diseases have become more and more demanding. In the health service system, we record the data of doctors and patients. In this public system, we mine and analyze these data and find some valuable things to help us provide better services between doctors and patients. The ultimate goal of treatment is to restore the patient’s social function and improve the quality of life.Smart medical services enable people to enjoy the same monitoring effects of hospitals at low prices in the community or at home, greatly reduce the cost of patients with cardiovascular diseases in hospitals, and improve the quality of life of patients with cardiovascular diseases. For those who are diagnosed with sleep problems, traditional sleep assessment requires the patient to go to a special clinic and requires special monitoring equipment, which are expensive and not suitable for long-term monitoring. Therefore, only the use of cheaper and more convenient sleep monitoring methods can be more conducive to self-management and long-term sleep monitoring.The smart medical system has a certain positive significance for the patient’s sleep quality. Kim believes that due to the rapid spread of the Internet of Things (IoT) as a new communication paradigm, many studies have been conducted on various applications. In particular, interest in smart medical systems is rising. In an intelligent medical system, many medical devices are distributed in popular areas such as stations and medical centers, and such high-density medical device distribution can cause severe communication performance degradation, which is called a coexistence problem. When a coexistence problem occurs in an intelligent medical system, the reliable transmission of the patient’s biological information may not be guaranteed, and the patient’s life may be endangered. Therefore, the coexistence problem in the intelligent medical system should be solved. He proposed an IoT-based distributed coexistence mitigation solution for smart medical systems, which can dynamically avoid interference under coexistence conditions and ensure reliable communication. In order to evaluate the performance of the scheme, he conducted extensive simulations by comparing it with the traditional low-power communication technology IEEE 802.15.4 MAC protocol. Although his research can avoid certain interference, the experimental content is not detailed [1]. Kozak et al. believe that melatonin is a secretion product of the pineal gland and is related to the pathophysiology of migraine. He studied the relationship between melatonin, circadian rhythm, sleep, and emotional state. He compared 55 patients (47 women and 8 men) with 57 gender and age-matched control groups (40 women and 17 men). He conducted a sociodemographic survey on volunteers, Baker Depression Inventory, Baker Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Mood State Profile (POMS), and morning-evening questionnaire. He collected blood samples from all participants at approximately 1 : 00 am in a dark room to prevent the secretion of melatonin and used a quantitative ELISA test to measure the level of melatonin in the blood. Although his research is relatively comprehensive, it is not accurate [2]. Manning et al. believe that sleep disruption is a common but rarely resolved complaint in patients undergoing total joint replacement (TJA). He assessed the quality of sleep before and after primary TJA. A total of 105 patients underwent prospective total hip arthroplasty (THA) or total knee arthroplasty (TKA) before surgery, early postoperatively, and late postoperatively. His survey included the Epworth Sleepiness Scale, current sleep habits, and patients’ perceptions of sleep quality and duration. Although his research is innovative, it lacks specific research content [3]. Astuti et al. believe that sleep is one of the physiological necessities of human life, and postpartum mothers may experience changes in sleep patterns and loss of sleep time at night. Factors of role adaptation and infant characteristics lead to irregular sleep patterns and sleep deprivation. His research aims to determine the correlation between infant temperament and the sleep quality of mothers after childbirth. The inclusion criteria of the sample are the postpartum mother. His samples were collected continuously in the primary health care work areas in Prambanan and Jogunaland, Kradan City, Central Java, Indonesia. Although his experimental samples ensure randomness, there are too many uncontrollable factors [4].This article combines the concept of smart medical care to realize the remote transmission, processing, storage, query, and abnormal alarm of monitoring information. At the same time, patients can interact and communicate with doctors in real time and obtain professional health guidance. Through this research, nurses can understand the status quo of sleep quality, negative emotion, and quality of life of cardiology patients and clarify the relationship between them. They provide a reference for clinical medical staff in the process of treating and nursing patients, improving the patient’s sleep quality, reducing negative emotions, and improving the quality of life.


## 2. Smart Medical Care Intervention

### 2.1. Smart Medical

The overall design framework of the smart medical system is shown in Figure1. It can select the inconsistent text information of preoperative and postoperative diagnosis description from the mid-foot by comparing a large number of texts and then provide an accurate reference result through the algorithm. Moreover, the system is not a fixed and closed system. It can present part of the data that is difficult to distinguish at this stage to hospital experts, and experts with professional knowledge will determine the accuracy of diagnosis. The system learns from the user’s manual judgment, improves the accuracy of future judgments, and gradually reduces the basis for manual judgment in long-term use. The system is mainly responsible for the evaluation and analysis of doctors' diagnosis and treatment capabilities [5–7].Figure 1
The overall design framework of the smart medical system.The cause of electrode contact interference noise can be short-lived, such as electrode looseness and poor contact caused by the movement of the examiner. According to this filter, the coefficients are continuously calibrated through the MATLAB FDATOOL tool and combined with the amplitude-frequency characteristics of the filter, so that the filter has a better 50 Hz attenuation effect. The transfer function of the calibrated filter is as follows [8]:(1)H1Z=−0.25+Z−1−0.5Z−2+Z−3−0.25Z−4.The transfer function of the first-order digital filter is as follows:(2)Hz=z−bz−a=1−bz−11−az−1.Assuming that the current set of previous scenic spots isψf=Z1,Z2,…,Zm, the distribution of the previous scenic spots in the feature space is(3)pX|ψfαγ+1−α1m∑i=1mϕHX−Zi.Traditional medical quality is mainly terminal management. In recent years, with the application of information technology in quality management, some medical quality indicator monitoring has gradually transformed into real-time link management, such as the medical record quality monitoring system, which can control the time limit and structure of medical records. Concerning real-time monitoring and reminding, the rational drug use monitoring system can perform real-time monitoring and reminding when doctors write prescriptions and medical orders. Biological signals have the characteristics of weak intensity, low frequency, large environmental impact, and large individual differences. Medical sensors are required to have high sensitivity and low noise characteristics to ensure that their measurement results are not distorted when they are interfered [9, 10].When performing image forward matching, suppose that the search window of the image featureIk−1xk−1,yk−1 of the previous frame is wk−1xk−1,yk−1, and the expression for calculating the sum of squares of the feature pixel difference between the two frames of the image using Tk−1u,v as the matching template is as follows [11]:(4)Sku,v=∑u,vTk−1u,vIkxk+u,yk+v−Ik−1xk−1+u,yk−1+v2.The target energy equation for fusion registration of the 3D model and the 2D visual image of the real object can be defined as(5)Ecc=1N∑x=0N16∑i=r,IRxi−R¯2+Gxi−G¯2+Bxi−B¯2.Among them,N is the number of visible points of the 3D model in the left and right camera poses [12].In graph optimization, the vertices are the optimization goals, and the edges are the observation equations. An observation data is often observed by multiple vertices, so there is a many-to-many mapping relationship between the observation data and the vertex pose, and then the observation equation is(6)Z^ij=hXi,Xj.The goal of graph optimization is to minimize the observation error of all edges, and the estimated value can be obtained. The objective optimization function is(7)εx=minXk∑Xkeij2.In computer vision, the processing of images is generally based on pixels, and the above camera coordinate system is converted to the screen coordinate system or the length is the unit. Therefore, it is necessary to convert the length unit to the pixel unit to facilitate the subsequent processing of the image [13]. Define C as the centroid coordinate of the corner point in the area, and the expression is as follows:(8)C=Cx,Cy=m10m00,m01m00.In the formula,m00 represents the total density of the area.Define a binary comparison criterion for a smooth image blockP as(9)τp;x,y=1,px<py0,px≥py.Define the two framesJ and I where the target appears. If the two points in the image match, there will be a very small gray squared difference ε. The formula is as follows:(10)ε=∬wJX−IX−d2ωXdX,(11)Z=∬wgXgTXdX,(12)e=∬wIX−JXgXωXdX.ThroughGi,jx and Gi,jy, the gradient amplitude Gi,j and the gradient direction θi,j can be obtained:(13)Gi,j=Gx2i,j+Gy2i,j,(14)θi,j=arcGxi,jGyi,j.In the medical service system, health and medical data usually contain the patient’s private information, and these private data are usually spread through the Internet. If these private data are not properly protected, it will lead to the leakage of the user’s private data. Therefore, data collection privacy protection schemes for medical service systems are becoming more and more important [14, 15].


### 2.2. Nursing Intervention

The nursing intervention in this study covers the intervention of patients’ cognition and behavior. By providing patients with positive psychological suggestion training, patients can pay more attention to the positive side of life; by providing patients with relaxation training, patients can be in the process of learning relaxation training and exert their own strengths and abilities to bring about positive emotions; by giving patients gratitude training, patients can realize the meaning and value of life in work, love, nurturing, friendship, and leisure and thus change the patient’s mentality and lifestyle and reduce the psychological and behavioral risks of major adverse cardiovascular events such as recurrence of acute myocardial infarction [16]. Appropriate exercise can improve the blood circulation of the body, improve the nutritional status of the brain, promote thinking activities, increase the strength of bones and muscles, enhance physical fitness, and avoid the occurrence and development of various related diseases caused by low immunity. Exercise therapy not only plays an important role in perimenopausal syndrome but also prevents the occurrence and development of many diseases and promotes the treatment and rehabilitation of many diseases [17].


### 2.3. Sleep Quality

The human sleep process is not fixed, but a dynamic process in which several relatively stable states overlap and alternately change. In this process, various behaviors and physiological indicators of the body will undergo obvious changes, such as weakening of muscle tone and lowering of blood pressure, heart rate, and metabolic rate, and regular changes in physiological signals such as EEG, EMG, and EOG. If you can collect and analyze this information, you can know the individual's sleep changes and then make a reasonable assessment of their sleep quality [18].Poor sleep quality can easily lead to the decline of the patient’s self-regulatory ability; the physiological function of the body will be destroyed to varying degrees, resulting in lower immunity, etc., and ultimately directly affect the treatment of the patient’s primary disease and the curative effect of Kangxia. Although exercise can increase the vitality of the heart, increase lung capacity, and improve physical function, excessive exercise will increase physical stress, so exercise training must be appropriate, especially for elderly patients with heart failure, especially paying attention to the guidance of professional medical staff to proceed. After treatment, the heart rate, blood pressure, BNP, and other related indicators of heart failure patients with better sleep quality have been significantly improved [19, 20].Therefore, in the process of treating patients with chronic heart failure, we must not only treat the causes and incentives but also pay more attention to the impact of patients’ society, environment, and sleep quality on patients. We should pay more attention to patients’ sleep quality problems. At the same time, the disease should be actively improved, and the sleep disorder problem should be improved to better improve the patient’s prognosis. At the same time, we can see that the number of patients with mild sleep disorders has increased significantly after hospitalization, while the proportion of patients with severe sleep disorders has declined. Although the quality of sleep after hospitalization has deteriorated, patients still have mild sleep disorders [21, 22].Before hospitalization, patients with severe sleep disorders were mainly patients with heart failure. After reasonable treatment, the symptoms improved significantly and the sleep quality improved significantly. This may be the main reason for the decrease in the proportion of patients with severe sleep disorders after hospitalization. Sleep disorders also have a negative impact on the quality of life and daytime physical function of patients [23]. Among all the concepts evaluated by the patient’s quality of life questionnaire, some of the symptoms include sleep and sleep disorders, and anxiety and depression are also closely related to sleep quality. Therefore, it is particularly important to evaluate the mental health and physical function of patients after pacemaker implantation during hospitalization. Early identification and intervention can significantly improve the prognosis of patients [24]. In general medicine, general practitioners can reduce the occurrence of cognitive dysfunction through early identification and treatment of risk factors related to cognitive dysfunction. In addition to organic diseases, sleep dysfunction should also be paid attention to and improved. The quality of sleep in patients with hypertension can reduce the occurrence of cognitive dysfunction and improve the quality of life [25].


## 2.1. Smart Medical

The overall design framework of the smart medical system is shown in Figure1. It can select the inconsistent text information of preoperative and postoperative diagnosis description from the mid-foot by comparing a large number of texts and then provide an accurate reference result through the algorithm. Moreover, the system is not a fixed and closed system. It can present part of the data that is difficult to distinguish at this stage to hospital experts, and experts with professional knowledge will determine the accuracy of diagnosis. The system learns from the user’s manual judgment, improves the accuracy of future judgments, and gradually reduces the basis for manual judgment in long-term use. The system is mainly responsible for the evaluation and analysis of doctors' diagnosis and treatment capabilities [5–7].Figure 1
The overall design framework of the smart medical system.The cause of electrode contact interference noise can be short-lived, such as electrode looseness and poor contact caused by the movement of the examiner. According to this filter, the coefficients are continuously calibrated through the MATLAB FDATOOL tool and combined with the amplitude-frequency characteristics of the filter, so that the filter has a better 50 Hz attenuation effect. The transfer function of the calibrated filter is as follows [8]:(1)H1Z=−0.25+Z−1−0.5Z−2+Z−3−0.25Z−4.The transfer function of the first-order digital filter is as follows:(2)Hz=z−bz−a=1−bz−11−az−1.Assuming that the current set of previous scenic spots isψf=Z1,Z2,…,Zm, the distribution of the previous scenic spots in the feature space is(3)pX|ψfαγ+1−α1m∑i=1mϕHX−Zi.Traditional medical quality is mainly terminal management. In recent years, with the application of information technology in quality management, some medical quality indicator monitoring has gradually transformed into real-time link management, such as the medical record quality monitoring system, which can control the time limit and structure of medical records. Concerning real-time monitoring and reminding, the rational drug use monitoring system can perform real-time monitoring and reminding when doctors write prescriptions and medical orders. Biological signals have the characteristics of weak intensity, low frequency, large environmental impact, and large individual differences. Medical sensors are required to have high sensitivity and low noise characteristics to ensure that their measurement results are not distorted when they are interfered [9, 10].When performing image forward matching, suppose that the search window of the image featureIk−1xk−1,yk−1 of the previous frame is wk−1xk−1,yk−1, and the expression for calculating the sum of squares of the feature pixel difference between the two frames of the image using Tk−1u,v as the matching template is as follows [11]:(4)Sku,v=∑u,vTk−1u,vIkxk+u,yk+v−Ik−1xk−1+u,yk−1+v2.The target energy equation for fusion registration of the 3D model and the 2D visual image of the real object can be defined as(5)Ecc=1N∑x=0N16∑i=r,IRxi−R¯2+Gxi−G¯2+Bxi−B¯2.Among them,N is the number of visible points of the 3D model in the left and right camera poses [12].In graph optimization, the vertices are the optimization goals, and the edges are the observation equations. An observation data is often observed by multiple vertices, so there is a many-to-many mapping relationship between the observation data and the vertex pose, and then the observation equation is(6)Z^ij=hXi,Xj.The goal of graph optimization is to minimize the observation error of all edges, and the estimated value can be obtained. The objective optimization function is(7)εx=minXk∑Xkeij2.In computer vision, the processing of images is generally based on pixels, and the above camera coordinate system is converted to the screen coordinate system or the length is the unit. Therefore, it is necessary to convert the length unit to the pixel unit to facilitate the subsequent processing of the image [13]. Define C as the centroid coordinate of the corner point in the area, and the expression is as follows:(8)C=Cx,Cy=m10m00,m01m00.In the formula,m00 represents the total density of the area.Define a binary comparison criterion for a smooth image blockP as(9)τp;x,y=1,px<py0,px≥py.Define the two framesJ and I where the target appears. If the two points in the image match, there will be a very small gray squared difference ε. The formula is as follows:(10)ε=∬wJX−IX−d2ωXdX,(11)Z=∬wgXgTXdX,(12)e=∬wIX−JXgXωXdX.ThroughGi,jx and Gi,jy, the gradient amplitude Gi,j and the gradient direction θi,j can be obtained:(13)Gi,j=Gx2i,j+Gy2i,j,(14)θi,j=arcGxi,jGyi,j.In the medical service system, health and medical data usually contain the patient’s private information, and these private data are usually spread through the Internet. If these private data are not properly protected, it will lead to the leakage of the user’s private data. Therefore, data collection privacy protection schemes for medical service systems are becoming more and more important [14, 15].


## 2.2. Nursing Intervention

The nursing intervention in this study covers the intervention of patients’ cognition and behavior. By providing patients with positive psychological suggestion training, patients can pay more attention to the positive side of life; by providing patients with relaxation training, patients can be in the process of learning relaxation training and exert their own strengths and abilities to bring about positive emotions; by giving patients gratitude training, patients can realize the meaning and value of life in work, love, nurturing, friendship, and leisure and thus change the patient’s mentality and lifestyle and reduce the psychological and behavioral risks of major adverse cardiovascular events such as recurrence of acute myocardial infarction [16]. Appropriate exercise can improve the blood circulation of the body, improve the nutritional status of the brain, promote thinking activities, increase the strength of bones and muscles, enhance physical fitness, and avoid the occurrence and development of various related diseases caused by low immunity. Exercise therapy not only plays an important role in perimenopausal syndrome but also prevents the occurrence and development of many diseases and promotes the treatment and rehabilitation of many diseases [17].


## 2.3. Sleep Quality

The human sleep process is not fixed, but a dynamic process in which several relatively stable states overlap and alternately change. In this process, various behaviors and physiological indicators of the body will undergo obvious changes, such as weakening of muscle tone and lowering of blood pressure, heart rate, and metabolic rate, and regular changes in physiological signals such as EEG, EMG, and EOG. If you can collect and analyze this information, you can know the individual's sleep changes and then make a reasonable assessment of their sleep quality [18].Poor sleep quality can easily lead to the decline of the patient’s self-regulatory ability; the physiological function of the body will be destroyed to varying degrees, resulting in lower immunity, etc., and ultimately directly affect the treatment of the patient’s primary disease and the curative effect of Kangxia. Although exercise can increase the vitality of the heart, increase lung capacity, and improve physical function, excessive exercise will increase physical stress, so exercise training must be appropriate, especially for elderly patients with heart failure, especially paying attention to the guidance of professional medical staff to proceed. After treatment, the heart rate, blood pressure, BNP, and other related indicators of heart failure patients with better sleep quality have been significantly improved [19, 20].Therefore, in the process of treating patients with chronic heart failure, we must not only treat the causes and incentives but also pay more attention to the impact of patients’ society, environment, and sleep quality on patients. We should pay more attention to patients’ sleep quality problems. At the same time, the disease should be actively improved, and the sleep disorder problem should be improved to better improve the patient’s prognosis. At the same time, we can see that the number of patients with mild sleep disorders has increased significantly after hospitalization, while the proportion of patients with severe sleep disorders has declined. Although the quality of sleep after hospitalization has deteriorated, patients still have mild sleep disorders [21, 22].Before hospitalization, patients with severe sleep disorders were mainly patients with heart failure. After reasonable treatment, the symptoms improved significantly and the sleep quality improved significantly. This may be the main reason for the decrease in the proportion of patients with severe sleep disorders after hospitalization. Sleep disorders also have a negative impact on the quality of life and daytime physical function of patients [23]. Among all the concepts evaluated by the patient’s quality of life questionnaire, some of the symptoms include sleep and sleep disorders, and anxiety and depression are also closely related to sleep quality. Therefore, it is particularly important to evaluate the mental health and physical function of patients after pacemaker implantation during hospitalization. Early identification and intervention can significantly improve the prognosis of patients [24]. In general medicine, general practitioners can reduce the occurrence of cognitive dysfunction through early identification and treatment of risk factors related to cognitive dysfunction. In addition to organic diseases, sleep dysfunction should also be paid attention to and improved. The quality of sleep in patients with hypertension can reduce the occurrence of cognitive dysfunction and improve the quality of life [25].


## 3. Observation Experiment on Sleep Quality of Patients in Cardiology Department

### 3.1. Subjects

80 cases of cardiology patients were randomly selected from the electronic medical record system of the hospital by the convenience sampling method, including 44 male patients, ranging in age from 44.5 to 52.3 years old, with disease age of 2 to 3 years; and 36 cases of female patients, ranging in age from 47.6 to 50.8 years old, with disease age of 1.5 to 2.7 years.


### 3.2. Nursing Methods

The patients were randomly divided into two groups. One group was the control group, with conventional nursing methods, and dedicated nurses paid attention to sleep; the other group was the research group, with targeted nursing methods. The specific operations are as follows:(1)
The nurse is especially responsible for the psychological problems of the patients and provides psychological counseling in a timely manner, takes positive encouragement to ensure the patient’s psychological balance, and carries out thematic activities related to cardiology diseases so that patients have a clear understanding of their own conditions(2)
Adjust the ward environment according to the needs of patients. For patients who have just been admitted to the hospital, we should actively guide them to adapt to the environment more quickly(3)
Nursing staff should actively observe the patient’s condition, and if necessary, they can take sedatives or sleeping pills to ensure sleep. There should be regular review and timely adjustment of drug dosage or treatment plan(4)
Communicate with patients on a regular basis in accordance with the systemic nursing intervention plan, communicate with patients at any time when there is a problem, grasp the patient’s personality characteristics and psychological state, strengthen psychological counseling, correct the wrong psychological state, learn to relax and rest, and reduce the psychological burden. Establish confidence


### 3.3. Sleep Monitoring

This paper selects three kinds of sensor data as features. When collecting each scene record, it is first divided into sleeping and awake states, and then, the classified time is composed of time segments, and these time segments are finally accumulated into sleep duration. Using sleep time, waking time, and sleep duration as input, the participants were divided into good sleepers and poor sleepers.


### 3.4. Sleep Quality Assessment

Through a self-made questionnaire survey on the factors that have adverse effects on patients’ sleep, the influencing factors are divided into 7 aspects, including noise, sleeping environment, discomfort caused by disease, discomfort caused by medical treatment, worry about the condition, economic burden, and lifestyle habits. Change and multiple choices are possible. Using the method of internal continuity measurement, Cronbach’s coefficienta is 0.811, suggesting that the internal consistency is better, and the calculation reliability and validity are 86.1% and 83.4%, respectively, suggesting that the table can be used for sleep in hospitalized patients.


### 3.5. Statistical Processing

We uset-test and analysis of variance to analyze whether there are differences in the effects of different characteristics of patients, such as education level, work nature, medication status, and living habits, on weakness and sleep quality. The influential indicators are screened for multifactor analysis. Both of them were first subjected to single-factor analysis, and factors with p<0.1 were included in the multivariate analysis. Kaplan–Meier curve was used to analyze the relationship between sleep quality and cardiology patients’ readmission. p<0.05 is statistically significant.


## 3.1. Subjects

80 cases of cardiology patients were randomly selected from the electronic medical record system of the hospital by the convenience sampling method, including 44 male patients, ranging in age from 44.5 to 52.3 years old, with disease age of 2 to 3 years; and 36 cases of female patients, ranging in age from 47.6 to 50.8 years old, with disease age of 1.5 to 2.7 years.


## 3.2. Nursing Methods

The patients were randomly divided into two groups. One group was the control group, with conventional nursing methods, and dedicated nurses paid attention to sleep; the other group was the research group, with targeted nursing methods. The specific operations are as follows:(1)
The nurse is especially responsible for the psychological problems of the patients and provides psychological counseling in a timely manner, takes positive encouragement to ensure the patient’s psychological balance, and carries out thematic activities related to cardiology diseases so that patients have a clear understanding of their own conditions(2)
Adjust the ward environment according to the needs of patients. For patients who have just been admitted to the hospital, we should actively guide them to adapt to the environment more quickly(3)
Nursing staff should actively observe the patient’s condition, and if necessary, they can take sedatives or sleeping pills to ensure sleep. There should be regular review and timely adjustment of drug dosage or treatment plan(4)
Communicate with patients on a regular basis in accordance with the systemic nursing intervention plan, communicate with patients at any time when there is a problem, grasp the patient’s personality characteristics and psychological state, strengthen psychological counseling, correct the wrong psychological state, learn to relax and rest, and reduce the psychological burden. Establish confidence


## 3.3. Sleep Monitoring

This paper selects three kinds of sensor data as features. When collecting each scene record, it is first divided into sleeping and awake states, and then, the classified time is composed of time segments, and these time segments are finally accumulated into sleep duration. Using sleep time, waking time, and sleep duration as input, the participants were divided into good sleepers and poor sleepers.


## 3.4. Sleep Quality Assessment

Through a self-made questionnaire survey on the factors that have adverse effects on patients’ sleep, the influencing factors are divided into 7 aspects, including noise, sleeping environment, discomfort caused by disease, discomfort caused by medical treatment, worry about the condition, economic burden, and lifestyle habits. Change and multiple choices are possible. Using the method of internal continuity measurement, Cronbach’s coefficienta is 0.811, suggesting that the internal consistency is better, and the calculation reliability and validity are 86.1% and 83.4%, respectively, suggesting that the table can be used for sleep in hospitalized patients.


## 3.5. Statistical Processing

We uset-test and analysis of variance to analyze whether there are differences in the effects of different characteristics of patients, such as education level, work nature, medication status, and living habits, on weakness and sleep quality. The influential indicators are screened for multifactor analysis. Both of them were first subjected to single-factor analysis, and factors with p<0.1 were included in the multivariate analysis. Kaplan–Meier curve was used to analyze the relationship between sleep quality and cardiology patients’ readmission. p<0.05 is statistically significant.


## 4. Results and Discussion

### 4.1. Analysis of Patients’ Sleep Status

The comparison of the PSQI scores of the two groups of CHD patients before intervention is shown in Table1. The scores of the seven dimensions of the study group and the control group were 1.58 ± 0.70, 1.68 ± 0.57, 1.77 ± 0.50, 1.74 ± 0.52, 1.81 ± 0.85, 1.75 ± 0.91, 2.26 ± 0.85, 2.28 ± 0.80, 1.02 ± 0.15, 1.02 ± 0.13, 0.63 ± 1.18, 0.32 ± 0.81, 1.26 ± 0.44, and 1.37 ± 0.67. Two independent sample t-tests were used to compare the differences between the two groups, and the P values were 0.420, 0.764, 0.740, 0.881, 0.842, 0.119, and 0.342 P>0.05, indicating that there was no statistical difference between the sleep quality factors of the two before the intervention. It is of scientific significance and comparability.Table 1
Comparison of PSQI scores between the two groups of CHD patients before intervention.
ProjectResearch groupControl groupTPPSQI total score10.30 ± 3.1310.12 ± 2.840.3360.738I sleep quality1.58 ± 0.701.68 ± 0.57−0.8090.420II falling asleep time1.77 ± 0.501.74 ± 0.520.3020.764III sleep time1.81 ± 0.851.75 ± 0.910.3330.740IV sleep efficiency2.26 ± 0.852.28 ± 0.80−0.1500.881V sleep disorders1.02 ± 0.151.02 ± 0.130.2000.842VI hypnotic drugs0.63 ± 1.180.32 ± 0.811.5750.119VII daytime dysfunction1.26 ± 0.441.37 ± 0.67−0.9540.342The comparison of sleep indicators between the study group and the control group is shown in Table2. The results suggest that the total sleep assessment of cardiology patients was significantly lower than that of the control group. The time of the first sleep and light sleep was significantly prolonged, the total time of deep sleep was significantly reduced, and the AHI index was higher. It shows that lower sleep time, higher first sleep time, light sleep time, and higher AHI apnea index all affect the sleep quality of cardiology patients.Table 2
Comparison of sleep indicators between the study group and the control group.
Research groupControl groupP valueSleep length (h)7.25 ± 0.968.06 ± 1.750.159Sleep time (min)22.92 ± 21.6430.06 ± 22.890.267Total sound sleep time (h)3.00 ± 0.603.59 ± 1.180.169Total light sleep time (h)2.67 ± 0.491.94 ± 0.690.135Wake up/dreaming time (h)1.58 ± 0.671.94 ± 0.970.346AHI index7.08 ± 4.214.82 ± 4.920.134Sleep score77.17 ± 6.6475.53 ± 6.500.514The comparison of overall nursing satisfaction rate indicators is shown in Figure2. The sleep duration can actually be used to assign tags to clusters. Comparing the two methods of clustering, the K-means clustering effect is much better than that of the Gaussian mixture model. However, compared with the supervised learning sleep quality prediction model, the effect of using clustering to assess sleep quality is not ideal, and there are too many large errors in the assessment of sleep quality, making this method applied to sleep quality assessment in real life. It is impractical, so it is not possible to promote the use of unsupervised learning methods to evaluate sleep quality.Figure 2
Comparison of indicators of overall nursing satisfaction rate. (a) Before intervention. (b) After intervention.
(a)(b)The sleep quality of cardiology patients is shown in Figure3. PSQI was used to evaluate the sleep quality of patients with heart failure. PSQI > 7 points were considered as sleep disorders. The higher the score, the worse the sleep quality. The average score of sleep quality in patients with heart failure was 7.50 ± 2.2, and 43 patients with sleep disorders, accounting for 53.75%, of which PSQI score < 5 and PSQI score > 10 had an average ratio of both ends, and the PSQI score 5–8 interval accounted for 37.5%. Data show that more than half of patients with heart failure have sleep disorders, and 37.5% of patients with heart failure tend to have sleep disorders. The main influencing factors of patients' sleep quality before hospitalization are the discomfort caused by the disease, the worry about the condition, and the economic burden, which accounted for 76.60%, 53.25%, and 34.05% of the total number of cases, respectively. The tolerance of patients to compression is not the same, some patients are hardly affected at all, and some patients will have trouble sleeping all night due to discomfort. In addition, the discomfort of the surgical puncture site will also adversely affect the patient’s sleep quality in the next few days.Figure 3
Sleep quality of cardiology patients.


### 4.2. Results of Sleep Quality Assessment

Table3 shows the comparison of systolic blood pressure on admission and discharge of the two groups of patients. Table 4 shows the comparison of diastolic blood pressure between the two groups of patients on admission and discharge. There was a significant difference in systolic blood pressure between the two groups of patients when they were admitted to the hospital. The systolic blood pressure of the patients in the better sleep quality group was higher than that of the patients in the sleep quality disorder group, which was statistically significant. There was no significant difference in the systolic blood pressure between the two groups of patients at discharge, and the difference was not statistically significant P>0.05, but the systolic blood pressure of the patients in the better sleep quality group was lower at discharge than the systolic blood pressure at admission than in the sleep disorder group. The diastolic blood pressure of the two groups of patients was also significantly different when they were admitted to the hospital. The diastolic blood pressure of the patients in the better sleep quality group was higher than that of the patients in the sleep quality disorder group, which was statistically significant. There was no significant difference in the diastolic blood pressure between the two groups of patients at discharge, and the difference was not statistically significant P>0.05. However, the diastolic blood pressure of patients in the better sleep quality group decreased significantly when they were discharged from the hospital compared with the diastolic blood pressure when they were admitted to the sleep disorder group.Table 3
Comparison of systolic blood pressure at admission and discharge between the two groups.
GroupAdmission to SBPDischarged SBPPSQI ≤ 7 points123.17 ± 12.0899.69 ± 16.23PSQI > 7 points99.22 ± 7.8696.77 ± 8.06P<0.050.114Table 4
Comparison of diastolic blood pressure at admission and discharge between the two groups.
GroupAdmission DBPDischarged DBPPSQI ≤ 7 points80.54 ± 7.3875.06 ± 6.82PSQI > 7 points73.02 ± 7.9370.36 ± 6.93P<0.05<0.05Figure4 shows the comparison of blood pressure compliance rates in different sleep quality groups. It can be seen from the figure that the sleep state recognition model constructed using the deep learning method effectively avoids the error caused by the artificial design of feature parameters. Its deep network structure can automatically extract the deep features hidden in the sleep EEG signal, thereby significantly improving the recognition accuracy. According to the recognition effect of three kinds of recognition models for each sleep state, it can be seen that, compared with other sleep states, the recognition effect of the S1 sleep state is not very satisfactory, and it is often misjudged as a REM sleep state. Through the evaluation of two cognitive scales, compared with the normal sleep group, the detection rate of cognitive dysfunction in the sleep disorder group was higher, and the difference in the detection rate of cognitive dysfunction between the two groups was statistically significant P<0.05.Figure 4
Comparison of blood pressure compliance rate in different sleep quality groups.Figure5 shows the comparison of SF-36 scores between the two groups. After 12 months of intervention in the two groups of patients, the scores involved in the SF-36 questionnaire were tested by t, and the t values were as follows: Physiological Function (PF), 12.442; Physiological Function (RP), 8.211; Physical Pain (BP), 14.099; general health status (GH), 15.751; energy (VT), 9.842; social function (SF), 6.497; emotional function (RE), 5.069; mental health (MH), 16.219; and health change (HT), 10.917; all P values < 0.001 are statistically significant; the intervention group's scores in all aspects of the SF-36 scale were higher than those of the control group. There was no statistically significant difference in the scores of active coping style and negative coping style P>0.05, and they were comparable.Figure 5
Comparison of SF-36 scores between the two groups.


### 4.3. Comparison of Patient Biological Indicators

The PSQI distributions of the patients 7 days before admission and 7 days after admission are shown in Table5. In predicting sleep ability, unmarried patients can evaluate their own situation more reasonably than married patients. This may be due to the fact that most unmarried patients are younger, more educated, and more rational about their sleep ability evaluation. Patients with different education levels have significant differences in the causes of insomnia. Among them, patients with a master’s degree have the highest scores, and patients with a primary school education have the lowest scores. Although patients with a bachelor's degree have a score lower than those with a college degree, the overall trend of the score indicates the level of education. Patients with higher levels of education have more correct perceptions of sleep than those with lower levels of education.Table 5
PSQI distribution of patients 7 days before admission and 7 days after admission.
7 days before admission (composition ratio)7 days after admission (composition ratio)0–7762 (38.10%)113 (5.65%)8–151055 (52.75%)1732 (86.60%)16–21183 (9.15%)155 (7.75%)The comparison of blood pressure of cardiology patients is shown in Figure6. On the basis of taking antihypertensive drugs on time and regularly, the two groups of patients did not take any drugs that affect sleep. After being enrolled in the group for three months, they measured SBP and DBP at 8 points a day and SBP and DBP at 20 points per day. The analysis is performed after the average value. Low-weight elderly patients scored the highest on the frailty index, and the debilitating condition was the most serious. This is because the low weight of the elderly easily causes various physical and mental diseases, resulting in a decline in physical function, and then affects debilitating. In clinical nursing work, elderly patients should be encouraged to strengthen exercise, have a reasonable diet and balanced nutrition, eliminate or reduce risk factors that affect weakness and sleep quality, and control their weight within the normal range. In terms of objective evaluation, patients in the experimental group have longer sleep latency, shorter total sleep time, lower sleep efficiency, higher arousal index, longer awakening time, shorter deep sleep time, and relatively longer light sleep time. The results of subjective assessment and objective assessment of total sleep time in the control group were basically the same.Figure 6
Comparison of blood pressure in cardiology patients.Human brain waves at different stages during sleep are shown in Figure7. The smart medical cloud service platform divides the system according to the service-oriented architecture. Medical service providers can connect the existing medical information system to the medical cloud in the form of medical cloud services. As a public information service system, the smart medical cloud service platform can support users to obtain medical services through various terminal devices without geographical restrictions. At the same time, the decentralized storage of data cannot fully exert its application value. By storing the data scattered in various medical organizations in the cloud, data mining can be performed on such a large amount of medical data to improve the efficiency of data utilization.Figure 7
Human brain waves at different stages during sleep (picture fromhttp://alturl.com/r4tpu).


## 4.1. Analysis of Patients’ Sleep Status

The comparison of the PSQI scores of the two groups of CHD patients before intervention is shown in Table1. The scores of the seven dimensions of the study group and the control group were 1.58 ± 0.70, 1.68 ± 0.57, 1.77 ± 0.50, 1.74 ± 0.52, 1.81 ± 0.85, 1.75 ± 0.91, 2.26 ± 0.85, 2.28 ± 0.80, 1.02 ± 0.15, 1.02 ± 0.13, 0.63 ± 1.18, 0.32 ± 0.81, 1.26 ± 0.44, and 1.37 ± 0.67. Two independent sample t-tests were used to compare the differences between the two groups, and the P values were 0.420, 0.764, 0.740, 0.881, 0.842, 0.119, and 0.342 P>0.05, indicating that there was no statistical difference between the sleep quality factors of the two before the intervention. It is of scientific significance and comparability.Table 1
Comparison of PSQI scores between the two groups of CHD patients before intervention.
ProjectResearch groupControl groupTPPSQI total score10.30 ± 3.1310.12 ± 2.840.3360.738I sleep quality1.58 ± 0.701.68 ± 0.57−0.8090.420II falling asleep time1.77 ± 0.501.74 ± 0.520.3020.764III sleep time1.81 ± 0.851.75 ± 0.910.3330.740IV sleep efficiency2.26 ± 0.852.28 ± 0.80−0.1500.881V sleep disorders1.02 ± 0.151.02 ± 0.130.2000.842VI hypnotic drugs0.63 ± 1.180.32 ± 0.811.5750.119VII daytime dysfunction1.26 ± 0.441.37 ± 0.67−0.9540.342The comparison of sleep indicators between the study group and the control group is shown in Table2. The results suggest that the total sleep assessment of cardiology patients was significantly lower than that of the control group. The time of the first sleep and light sleep was significantly prolonged, the total time of deep sleep was significantly reduced, and the AHI index was higher. It shows that lower sleep time, higher first sleep time, light sleep time, and higher AHI apnea index all affect the sleep quality of cardiology patients.Table 2
Comparison of sleep indicators between the study group and the control group.
Research groupControl groupP valueSleep length (h)7.25 ± 0.968.06 ± 1.750.159Sleep time (min)22.92 ± 21.6430.06 ± 22.890.267Total sound sleep time (h)3.00 ± 0.603.59 ± 1.180.169Total light sleep time (h)2.67 ± 0.491.94 ± 0.690.135Wake up/dreaming time (h)1.58 ± 0.671.94 ± 0.970.346AHI index7.08 ± 4.214.82 ± 4.920.134Sleep score77.17 ± 6.6475.53 ± 6.500.514The comparison of overall nursing satisfaction rate indicators is shown in Figure2. The sleep duration can actually be used to assign tags to clusters. Comparing the two methods of clustering, the K-means clustering effect is much better than that of the Gaussian mixture model. However, compared with the supervised learning sleep quality prediction model, the effect of using clustering to assess sleep quality is not ideal, and there are too many large errors in the assessment of sleep quality, making this method applied to sleep quality assessment in real life. It is impractical, so it is not possible to promote the use of unsupervised learning methods to evaluate sleep quality.Figure 2
Comparison of indicators of overall nursing satisfaction rate. (a) Before intervention. (b) After intervention.
(a)(b)The sleep quality of cardiology patients is shown in Figure3. PSQI was used to evaluate the sleep quality of patients with heart failure. PSQI > 7 points were considered as sleep disorders. The higher the score, the worse the sleep quality. The average score of sleep quality in patients with heart failure was 7.50 ± 2.2, and 43 patients with sleep disorders, accounting for 53.75%, of which PSQI score < 5 and PSQI score > 10 had an average ratio of both ends, and the PSQI score 5–8 interval accounted for 37.5%. Data show that more than half of patients with heart failure have sleep disorders, and 37.5% of patients with heart failure tend to have sleep disorders. The main influencing factors of patients' sleep quality before hospitalization are the discomfort caused by the disease, the worry about the condition, and the economic burden, which accounted for 76.60%, 53.25%, and 34.05% of the total number of cases, respectively. The tolerance of patients to compression is not the same, some patients are hardly affected at all, and some patients will have trouble sleeping all night due to discomfort. In addition, the discomfort of the surgical puncture site will also adversely affect the patient’s sleep quality in the next few days.Figure 3
Sleep quality of cardiology patients.


## 4.2. Results of Sleep Quality Assessment

Table3 shows the comparison of systolic blood pressure on admission and discharge of the two groups of patients. Table 4 shows the comparison of diastolic blood pressure between the two groups of patients on admission and discharge. There was a significant difference in systolic blood pressure between the two groups of patients when they were admitted to the hospital. The systolic blood pressure of the patients in the better sleep quality group was higher than that of the patients in the sleep quality disorder group, which was statistically significant. There was no significant difference in the systolic blood pressure between the two groups of patients at discharge, and the difference was not statistically significant P>0.05, but the systolic blood pressure of the patients in the better sleep quality group was lower at discharge than the systolic blood pressure at admission than in the sleep disorder group. The diastolic blood pressure of the two groups of patients was also significantly different when they were admitted to the hospital. The diastolic blood pressure of the patients in the better sleep quality group was higher than that of the patients in the sleep quality disorder group, which was statistically significant. There was no significant difference in the diastolic blood pressure between the two groups of patients at discharge, and the difference was not statistically significant P>0.05. However, the diastolic blood pressure of patients in the better sleep quality group decreased significantly when they were discharged from the hospital compared with the diastolic blood pressure when they were admitted to the sleep disorder group.Table 3
Comparison of systolic blood pressure at admission and discharge between the two groups.
GroupAdmission to SBPDischarged SBPPSQI ≤ 7 points123.17 ± 12.0899.69 ± 16.23PSQI > 7 points99.22 ± 7.8696.77 ± 8.06P<0.050.114Table 4
Comparison of diastolic blood pressure at admission and discharge between the two groups.
GroupAdmission DBPDischarged DBPPSQI ≤ 7 points80.54 ± 7.3875.06 ± 6.82PSQI > 7 points73.02 ± 7.9370.36 ± 6.93P<0.05<0.05Figure4 shows the comparison of blood pressure compliance rates in different sleep quality groups. It can be seen from the figure that the sleep state recognition model constructed using the deep learning method effectively avoids the error caused by the artificial design of feature parameters. Its deep network structure can automatically extract the deep features hidden in the sleep EEG signal, thereby significantly improving the recognition accuracy. According to the recognition effect of three kinds of recognition models for each sleep state, it can be seen that, compared with other sleep states, the recognition effect of the S1 sleep state is not very satisfactory, and it is often misjudged as a REM sleep state. Through the evaluation of two cognitive scales, compared with the normal sleep group, the detection rate of cognitive dysfunction in the sleep disorder group was higher, and the difference in the detection rate of cognitive dysfunction between the two groups was statistically significant P<0.05.Figure 4
Comparison of blood pressure compliance rate in different sleep quality groups.Figure5 shows the comparison of SF-36 scores between the two groups. After 12 months of intervention in the two groups of patients, the scores involved in the SF-36 questionnaire were tested by t, and the t values were as follows: Physiological Function (PF), 12.442; Physiological Function (RP), 8.211; Physical Pain (BP), 14.099; general health status (GH), 15.751; energy (VT), 9.842; social function (SF), 6.497; emotional function (RE), 5.069; mental health (MH), 16.219; and health change (HT), 10.917; all P values < 0.001 are statistically significant; the intervention group's scores in all aspects of the SF-36 scale were higher than those of the control group. There was no statistically significant difference in the scores of active coping style and negative coping style P>0.05, and they were comparable.Figure 5
Comparison of SF-36 scores between the two groups.


## 4.3. Comparison of Patient Biological Indicators

The PSQI distributions of the patients 7 days before admission and 7 days after admission are shown in Table5. In predicting sleep ability, unmarried patients can evaluate their own situation more reasonably than married patients. This may be due to the fact that most unmarried patients are younger, more educated, and more rational about their sleep ability evaluation. Patients with different education levels have significant differences in the causes of insomnia. Among them, patients with a master’s degree have the highest scores, and patients with a primary school education have the lowest scores. Although patients with a bachelor's degree have a score lower than those with a college degree, the overall trend of the score indicates the level of education. Patients with higher levels of education have more correct perceptions of sleep than those with lower levels of education.Table 5
PSQI distribution of patients 7 days before admission and 7 days after admission.
7 days before admission (composition ratio)7 days after admission (composition ratio)0–7762 (38.10%)113 (5.65%)8–151055 (52.75%)1732 (86.60%)16–21183 (9.15%)155 (7.75%)The comparison of blood pressure of cardiology patients is shown in Figure6. On the basis of taking antihypertensive drugs on time and regularly, the two groups of patients did not take any drugs that affect sleep. After being enrolled in the group for three months, they measured SBP and DBP at 8 points a day and SBP and DBP at 20 points per day. The analysis is performed after the average value. Low-weight elderly patients scored the highest on the frailty index, and the debilitating condition was the most serious. This is because the low weight of the elderly easily causes various physical and mental diseases, resulting in a decline in physical function, and then affects debilitating. In clinical nursing work, elderly patients should be encouraged to strengthen exercise, have a reasonable diet and balanced nutrition, eliminate or reduce risk factors that affect weakness and sleep quality, and control their weight within the normal range. In terms of objective evaluation, patients in the experimental group have longer sleep latency, shorter total sleep time, lower sleep efficiency, higher arousal index, longer awakening time, shorter deep sleep time, and relatively longer light sleep time. The results of subjective assessment and objective assessment of total sleep time in the control group were basically the same.Figure 6
Comparison of blood pressure in cardiology patients.Human brain waves at different stages during sleep are shown in Figure7. The smart medical cloud service platform divides the system according to the service-oriented architecture. Medical service providers can connect the existing medical information system to the medical cloud in the form of medical cloud services. As a public information service system, the smart medical cloud service platform can support users to obtain medical services through various terminal devices without geographical restrictions. At the same time, the decentralized storage of data cannot fully exert its application value. By storing the data scattered in various medical organizations in the cloud, data mining can be performed on such a large amount of medical data to improve the efficiency of data utilization.Figure 7
Human brain waves at different stages during sleep (picture fromhttp://alturl.com/r4tpu).


## 5. Conclusions

This experiment reveals the effect of sleep disorders on the blood pressure reduction effect and blood pressure compliance rate of inpatients in the cardiology department through the analysis of the admission, the day of hospitalization, discharge blood pressure compliance rate, and the range of blood pressure drop during hospitalization, to show that the improvement the quality of patients’ sleep is of great significance to the antihypertensive treatment of inpatients with hypertension. There are differences in the sleep quality of cardiology patients with different family relationships, and the sleep quality of cardiology patients with family relationships is generally worse than that of cardiology patients with harmonious family relationships. The sleep quality of cardiologists living in rural areas is worse than that of cardiologists living in urban areas. It is an effective way to improve the sleep quality of cardiology patients by improving social support. Improving the social support of cardiology patients can reduce their ruminating thinking and enhance their sense of security. The age structure of China’s population has gradually become aging, the elderly have many health problems, and the distribution of resources such as hospitals across the country is uneven. Therefore, these scattered resources can be integrated and classified through the Internet to facilitate people with corresponding needs.



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*Source: 9947438-2021-06-30.xml*