Exploring Sleep Quality and Pain Experiences Among Patients with Fractures Exploring Sleep Quality and Pain Experiences Among Patients with Fractures

Main Article Content

Rahmad Bagus Saifudin
Ani Syafriati
Ika Rahmawati

Abstract

Fractures can impair physical function, mobility, comfort, independence, and sleep, while pain and hospitalization-related factors may influence patients’ adaptation during recovery. This study aimed to explore sleep quality and pain experiences among hospitalized fracture patients and analyze their adaptive responses using Roy’s Adaptation Model (RAM). A qualitative descriptive design was conducted with 10 fracture patients hospitalized in the RSUD Dr. Soehadi Prijonegoro Sragen. Participants were selected through purposive sampling based on predetermined criteria, and data were collected using in-depth semi-structured interviews and analyzed thematically, followed by mapping the findings onto RAM’s four adaptive modes. Seven interconnected themes emerged: disrupted sleep during hospitalization; pain as a barrier to sleep and mobility; psychological responses to illness and uncertainty; reduced functional independence; family as a source of safety and support; nursing care and the need for comfort-oriented support; and hope for recovery and restoration of normal life. Participants adapted through repositioning, relaxation, limiting painful movements, seeking assistance, communicating with family, and utilizing nursing support. These experiences reflected adaptation across the physiological-physical, self-concept/group identity, role function, and interdependence modes. The findings indicate that pain and sleep disturbances are interconnected and influenced by physical, environmental, psychological, functional, and interpersonal factors. An adaptation-oriented nursing approach integrating pain management, sleep promotion, comfort, functional support, psychological reassurance, and family involvement is important to facilitate patients’ recovery and restoration of daily activities.

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How to Cite
Saifudin, R. B., Syafriati, A., & Rahmawati, I. (2026). Exploring Sleep Quality and Pain Experiences Among Patients with Fractures: Exploring Sleep Quality and Pain Experiences Among Patients with Fractures. Buletin Ilmu Kebidanan Dan Keperawatan, 5(03), 211–224. https://doi.org/10.56741/bikk.v5i03.2625
Section
Articles
Author Biographies

Rahmad Bagus Saifudin, Universitas Muhammadiyah Surakarta

is a nursing graduate with professional interests in holistic, patient-centered, and evidence-based nursing care. His approach emphasizes the integration of clinical competence, ethical responsibility, psychological support, and cultural sensitivity into nursing practice. He is particularly interested in applying critical thinking and technological innovation to improve patient outcomes, dignity, and quality of life. He also values interprofessional collaboration, patient autonomy, and continuous professional development in healthcare settings. (email: rabs2813@gmail.com). 

Ani Syafriati, Universitas Muhammadiyah Surakarta

is a lecturer in the Nursing Science Study Program, Faculty of Health Sciences, Universitas Muhammadiyah Surakarta, Indonesia. She specializes in medical-surgical nursing, particularly cardiovascular care. She obtained her specialist qualification from Universitas Muhammadiyah Jakarta in 2022 and is currently pursuing a PhD in Nursing at Lincoln University College, Malaysia. Her professional activities encompass nursing education, clinical practice, research, and professional nursing organizations. (email: as600@ums.ac.id).

Ika Rahmawati, RSUD Soehadi Prijonegoro

is a professional nurse specializing in adult medical-surgical nursing at RSUD Soehadi Prijonegoro, Sragen, Indonesia. Her clinical responsibilities include preoperative and postoperative nursing care, patient monitoring, pain management, and recovery support. She is committed to providing safe, comprehensive, and patient-centered nursing services. Her professional interests focus on evidence-based clinical practice, improving patient comfort, and enhancing the quality of medical-surgical nursing care. (email: ika133212@gmail.com).

Received 2026-09-03
Accepted 2026-10-05
Published 2026-10-13

Plaudit

References

A. Nur, A. F. Kamal, M. Masfuri, and T. A. Pakasi, “Self-management of lower extremity fracture patients: A concept analysis review,” Multidisciplinary Reviews, vol. 9, Art. no. 2026187, 2025, doi: 10.31893/multirev.2026187.

M. Hassan, I. Barsoum, and M. El-Rich, “Strain-adaptive bone remodeling post-orthopaedic implantation: Current insights and future directions,” Journal of Biomechanics Open, vol. 1, Art. no. 100012, 2026, doi: 10.1016/j.jbmo.2026.100012.

A. Rahmani et al., “Beyond the initial impact: A systematic review of post-traumatic bone loss and its mechanisms,” Osteoporosis International, vol. 37, pp. 15–39, 2026, doi: 10.1007/s00198-025-07716-6.

W. Kang, J. Shi, Y. Long, L. Li, and W. Xu, “Exploring the experience and needs of postoperative rehabilitation management for elderly patients with osteoporotic vertebral compression fractures after percutaneous vertebroplasty: A qualitative study,” BMC Geriatrics, vol. 25, Art. no. 1065, 2025, doi: 10.1186/s12877-025-06667-1.

N. F. Taylor et al., “Hip fracture has profound psychosocial impacts: A systematic review of qualitative studies,” Age and Ageing, vol. 53, Art. no. afae194, 2024, doi: 10.1093/ageing/afae194.

S. A. T. Mitchell, L. A. Majuta, and P. W. Mantyh, “New insights in understanding and treating bone fracture pain,” Current Osteoporosis Reports, vol. 16, pp. 325–332, 2018, doi: 10.1007/s11914-018-0446-8.

A. Nur, Masfuri, Setyowati, A. F. Kamal, and T. A. Pakasi, “Perceptions and experiences of continuity of care (COC) nurses in lower limb fracture patients: Phenomenological approach,” Journal of Nursing Practice, vol. 8, pp. 631–640, 2025, doi: 10.30994/jnp.v8i3.673.

L. Schafthuizen et al., “Hospitalized patients’ sleep quality compared between multioccupancy rooms and single-patient rooms,” HERD: Health Environments Research & Design Journal, vol. 16, pp. 119–133, 2023, doi: 10.1177/19375867231168895.

P. Burger et al., “Sleep in hospitalized pediatric and adult patients: A systematic review and meta-analysis,” Sleep Medicine: X, vol. 4, Art. no. 100059, 2023, doi: 10.1016/j.sleepx.2022.100059.

P. S. Jensen, K. Specht, and H. Mainz, “Orthopaedic patients’ experiences of their sleep during hospitalisation and suggestions for improvements,” International Journal of Orthopaedic and Trauma Nursing, vol. 53, Art. no. 101056, 2024, doi: 10.1016/j.ijotn.2023.101056.

H. Wu, W. Su, S. Huang, Y. Xiao, and L. Lu, “Correlation between pre-operative sleep disturbance and post-operative pain in patients with rotator cuff tear,” Frontiers in Integrative Neuroscience, vol. 16, Art. no. 942513, 2022, doi: 10.3389/fnint.2022.942513.

S. V. Jain, G. D. Panjeton, and Y. C. Martins, “Relationship between sleep disturbances and chronic pain: A narrative review,” Clinical Practice, vol. 14, pp. 2650–2660, 2024, doi: 10.3390/clinpract14060209.

S. H. Onen, F. Onen, P. Courpron, and C. Dubray, “How pain and analgesics disturb sleep,” The Clinical Journal of Pain, vol. 21, pp. 422–431, 2025, doi: 10.1097/01.ajp.0000129757.31856.f7.

X. Wang, Q. Zhang, J. Shao, and Z. Ye, “Conceptualisation and measurement of adaptation within the Roy adaptation model in chronic care: A scoping review protocol,” BMJ Open, vol. 10, Art. no. e036546, 2020, doi: 10.1136/bmjopen-2019-036546.

I. Hasanah, A. S. Sari, and D. A. Ikhwani, “Effectiveness of Roy’s Adaptation Model-based interventions in nursing research: A systematic review,” An Idea Health Journal, vol. 6, pp. 412–427, 2026, doi: 10.53690/ihj.v6i02.682.

C. Roy, The Roy Adaptation Model, 3rd ed. Pearson Prentice Hall, 2008.

A. I. J. Dwi, B. Dedi, and I. Wulaningsih, “Effect of Roy’s Adaptation Theory-based mindfulness therapy on work stress: A quasi-experimental study,” An Idea Health Journal, 2026, doi: 10.53690/ihj.v6i01.630.

K. M. Jennings, “The Roy Adaptation Model,” Advances in Nursing Science, vol. 40, pp. 370–383, 2023, doi: 10.1097/ANS.0000000000000175.

N. Dağcan, D. Özden, and G. Gürol Arslan, “Pain perception of patients in intensive care unit after cardiac surgery: A qualitative study using Roy’s Adaptation Model,” Nursing in Critical Care, vol. 29, pp. 512–520, 2024, doi: 10.1111/nicc.12958.

X. Shi and W. Ma, “Effect of collaborative nursing method based on RAM model on postoperative functional reconstruction, soft tissue pain and living quality in patients with femoral trochanter fracture,” BMC Musculoskeletal Disorders, vol. 25, Art. no. 627, 2024, doi: 10.1186/s12891-024-07746-x.

A. Ramezani, M. Babagoli, A. Ghaseminejad-Raeini, M. Golbakhsh, and S. H. Shafiei, “Factors associated with postoperative quality of life in patients with intertrochanteric fracture,” Annals of Medicine & Surgery, vol. 86, pp. 703–711, 2024, doi: 10.1097/MS9.0000000000001608.

M. Müller, C. Schurr, N. Etter, and N. Komposch, “A guide for preparing and reporting qualitative research,” The Professional Geographer, vol. 77, pp. 569–577, 2025, doi: 10.1080/00330124.2025.2542817.

E. M. Kelleher, A. Wall, B. Seymour, and A. Irani, “Why sleep matters in chronic pain: Evidence across the lifespan,” EBioMedicine, vol. 125, Art. no. 106158, 2026, doi: 10.1016/j.ebiom.2026.106158.

O. M. Alqaisi and S. Al-Ghabeesh, “Quality of postoperative pain management in orthopedic patients and its impact on sleep quality and patient satisfaction: An integrative review,” Cureus, Art. no. e65872, 2024, doi: 10.7759/cureus.65872.

J. Andri, Panzilion, and T. Sutrisno, “Hubungan antara nyeri fraktur dengan kualitas tidur pasien yang di rawat inap,” Jurnal Kesmas Asclepius, vol. 1, pp. 55–64, 2019, doi: 10.31539/jka.v1i1.633.

E. Baker, A. Xyrichis, C. Norton, P. Hopkins, and G. Lee, “The processes of hospital discharge and recovery after blunt thoracic injuries: The patient’s perspective,” Nursing Open, vol. 9, pp. 1832–1843, 2022, doi: 10.1002/nop2.929.

N. Runge et al., “The bidirectional relationship between sleep problems and chronic musculoskeletal pain: A systematic review with meta-analysis,” Pain, vol. 165, pp. 2455–2467, 2024, doi: 10.1097/j.pain.0000000000003279.

C. Bretherton, A. Al-Saadawi, F. Thomson, H. Sandhu, J. Baird, and X. Griffin, “Effectiveness of behavior change in rehabilitation interventions to improve functional recovery after lower limb fracture: A systematic review,” Musculoskeletal Surgery, vol. 108, pp. 417–429, 2024, doi: 10.1007/s12306-024-00845-x.

D. Karimi et al., “Exploring patient experiences after treatment of humeral shaft fractures: A qualitative study,” International Journal of Orthopaedic and Trauma Nursing, vol. 46, Art. no. 100957, 2022, doi: 10.1016/j.ijotn.2022.100957.

A. Audilla, Farida, Nurhidayati, Surtini, and Suharyoto, “The role of family in pain management among patients with chronic illness,” Jurnal Kesehatan Komunitas Indonesia, vol. 6, pp. 52–62, 2026, doi: 10.58545/jkki.v6i1.695.

T. O. Smith, S. Arnold, and M. Baxter, “Health professional support for friends and family members of older people discharged from hospital after a fracture: A survey study,” Geriatrics, vol. 10, Art. no. 36, 2025, doi: 10.3390/geriatrics10020036.

D. Ring, “Recovery after musculoskeletal injury: Mental and social health,” Journal of Orthopaedic Trauma, vol. 36, pp. S1–S5, 2022, doi: 10.1097/BOT.0000000000002447.

C. P. Orlas et al., “Perceived social support is strongly associated with recovery after injury,” Journal of Trauma and Acute Care Surgery, vol. 91, pp. 552–558, 2021, doi: 10.1097/TA.0000000000003230.

A. M. Y. Chu et al., “Nurses’ knowledge, attitudes, and role perception in medication administration: Do hospital context and nurses’ level of professional experience make a difference?” BMC Nursing, vol. 25, Art. no. 37, 2025, doi: 10.1186/s12912-025-04110-9.

J. R. Chang et al., “Comparative effectiveness of non-pharmacological interventions on sleep in individuals with chronic musculoskeletal pain: A systematic review with network meta-analysis,” Sleep Medicine Reviews, vol. 73, Art. no. 101867, 2024, doi: 10.1016/j.smrv.2023.101867.

P. Rocha, C. L. Baixinho, and M. A. Henriques, “A qualitative study of older adults: The difficulties and needs of returning home after hip fractures,” International Journal of Orthopaedic and Trauma Nursing, vol. 55, Art. no. 101141, 2024, doi: 10.1016/j.ijotn.2024.101141.

R. Patel et al., “Patients’ recovery of mobility and return to original residence after hip fracture are associated with multiple modifiable components of hospital service organisation: The REDUCE record-linkage cohort study in England and Wales,” BMC Geriatrics, vol. 23, Art. no. 459, 2023, doi: 10.1186/s12877-023-04038-2.

M. I. Martinsen, M. E. B. de Lima, and A. M. Rudolph, “Discharge and post-hospital care,” pp. 253–269, 2024, doi: 10.1007/978-3-031-33484-9_16.

N. Beer, A. Riffat, B. Volkmer, D. Wyatt, K. Lambe, and K. J. Sheehan, “Patient perspectives of recovery after hip fracture: A systematic review and qualitative synthesis,” Disability and Rehabilitation, vol. 44, pp. 6194–6209, 2022, doi: 10.1080/09638288.2021.1965228.

R. McKeown, R. S. Kearney, Z. H. Liew, and D. R. Ellard, “Patient experiences of an ankle fracture and the most important factors in their recovery: A qualitative interview study,” BMJ Open, vol. 10, Art. no. e033539, 2020, doi: 10.1136/bmjopen-2019-033539.