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Open Nurs J. 2015 Feb 27;9:1-9. doi: 10.2174/1874434601509010001. eCollection 2015.

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

The open nursing journal

Andrés Camargo-Sanchez, Carmen L Niño, Leonardo Sánchez, Sonia Echeverri, Diana P Gutiérrez, Andrés F Duque, Oscar Pianeta, Jenny A Jaramillo-Gómez, Martin A Pilonieta, Nhora Cataño, Humberto Arboleda, Patricia V Agostino, Claudia P Alvarez-Baron, Rafael Vargas

Affiliations

  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.

PMID: 25767632 PMCID: PMC4353124 DOI: 10.2174/1874434601509010001

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

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