Theory of Inpatient Circadian Care (TICC): A Proposal for a Middle-Range Theory



Andrés Camargo-Sanchez*, 1, Carmen L. Niño1, Leonardo Sánchez1, Sonia Echeverri2, Diana P. Gutiérrez3, Andrés F. Duque4, Oscar Pianeta5, Jenny A. Jaramillo-Gómez6, Martin A. Pilonieta7, Nhora Cataño8, Humberto Arboleda9, Patricia V. Agostino10, Claudia P. Alvarez-Baron11, Rafael Vargas12
1 Nursing School at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
2 Nursing Department at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
3 Division of Internal Medicine at Fundación Santa Fe de Bogotá University Hospital, Bogotá, Colombia
4 Surgical Department at Marly Clinic, Bogotá, Colombia
5 School of Medicine at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A), Bogotá, Colombia
6 Cell Death Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia
7 School of Medicine at the Universidad Nacional de Colombia, Bogotá, Colombia
8 School of Nursing at the Universidad Nacional de Colombia, Bogotá, Colombia
9 Neurosciences Research Group, School of Medicine and Institute of Genetics at the Universidad Nacional de Colombia, Bogotá, Colombia
10 Laboratorio de Cronobiología, Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes/CONICET, Buenos Aires, Argentina
11 Department of Neuroscience, University of Wisconsin - Madison, Wisconsin, USA
12 School of Medicine at the Pontificia Universidad Javeriana, Bogotá, Colombia


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© Camargo-Sanchez et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Universidad de Ciencias Aplicadas y Ambientales (U.D.C.A) at the School of Nursing, Bogotá, Colombia; Tel: +57 1 6684700; Fax: +57 1 6760096;, E-mail: andcamargo@udca.edu.co


Abstract

The circadian system controls the daily rhythms of a variety of physiological processes. Most organisms show physiological, metabolic and behavioral rhythms that are coupled to environmental signals. In humans, the main synchronizer is the light/dark cycle, although non-photic cues such as food availability, noise, and work schedules are also involved. In a continuously operating hospital, the lack of rhythmicity in these elements can alter the patient’s biological rhythms and resilience. This paper presents a Theory of Inpatient Circadian Care (TICC) grounded in circadian principles. We conducted a literature search on biological rhythms, chronobiology, nursing care, and middle-range theories in the databases PubMed, SciELO Public Health, and Google Scholar. The search was performed considering a period of 6 decades from 1950 to 2013. Information was analyzed to look for links between chronobiology concepts and characteristics of inpatient care. TICC aims to integrate multidisciplinary knowledge of biomedical sciences and apply it to clinical practice in a formal way. The conceptual points of this theory are supported by abundant literature related to disease and altered biological rhythms. Our theory will be able to enrich current and future professional practice.

Keywords: : Biological rhythms, chronobiology, circadian rhythms, hospital, middle-range theory, nursing.