Abstract
OBJECTIVE: The study aims to investigate the effect of ward nighttime noise management on sleep quality and negative emotions in postoperative patients with osteonecrosis of the femoral head (ONFH) within an Enhanced Recovery After Surgery (ERAS) framework. METHODS: A single-center retrospective, controlled study was conducted. Clinical data of 140 ONFH patients who underwent total hip arthroplasty (THA) between January 2022 and March 2025 were analyzed. Based on the implementation timeline of ERAS-based ward nighttime noise management at Luoyang Orthopedic-Traumatological Hospital of Henan Province (Henan Provincial Orthopedic Hospital), patients admitted from January 2022 to June 2023 without the noise management protocol (n = 72) were assigned to the conventional group, and those admitted from July 2023 to March 2025 with the protocol (n = 68) were assigned to the noise-reduction group. Sleep quality [using the Richards-Campbell Sleep Questionnaire (RCSQ) and polysomnography (PSG)] and negative emotions [using the short-form Depression, Anxiety, and Stress Scales (DASS-C21) and the Positive and Negative Affect Schedule (PANAS)] were compared between the two groups at admission and 1 week after hospitalization. RESULTS: Compared with baseline at admission, both groups showed improved RCSQ scores, prolonged deep sleep and total sleep time measured by PSG, and reduced frequency of nighttime awakenings after 1 week of hospitalization (all P < 0.05). The noise-reduction group demonstrated significantly better outcomes in all sleep parameters compared with the conventional group (P < 0.05). Similarly, DASS-C21 scores and PANAS negative affect scores decreased, and PANAS positive affect scores increased in both groups after 1 week relative to admission (P < 0.05). The noise-reduction group demonstrated significantly lower ward nighttime noise intensity compared with the conventional group (P < 0.05). CONCLUSION: Incorporating ward nighttime noise management into ERAS protocols improves sleep quality, reduces negative emotions, and effectively lowers noise levels in ONFH patients after THA.