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Introduction: Nature sounds as non-pharmacological care can reduce environmental sounds to improve patients’ sleep quality. Therefore, the present study aimed at investigating the effect of listening to nature sounds on sleep quality in patients hospitalized in cardiac care unit.
Methods: In this randomized clinical trial, 93 patients, admitted to the Cardiac Care Units (CCUs) of three teaching hospitals in an urban area of Iran, were randomly selected in 2016. They were randomly assigned to three groups, including nature sounds, silence, and control groups. The patients in the intervention group listened to nature sounds for 30 minutes via headphones. The patients in the silence group wore headphones without any sound for 30 minutes. The patients in the control group were only provided with routine care. The sleep quality was assessed on the night before the intervention and two nights of the intervention using Pittsburgh Sleep Quality Index (PSQI). The data were analyzed by SPSS 21.0, using chi-square tests, fisher exact test, paired t-test and ANOVA.   
Results: Statistically significant differences were reported among the groups in terms of sleep quality (P<0.001), indicating an improved quality of sleep in both nature sounds (7.68 ± 4.24) and silence (7.41 ± 4.00) groups compared with the control group (9.41 ± 4.40).
Conclusion: It seems that listening to nature sounds or wearing headphones to prevent environmental noises help to improve sleep quality in patients. Therefore, nurses are recommended to provide the patients with nature sounds or silence (as they prefer) to improve their quality of sleep during hospitalization.

Keywords: patient, critical care, complementary medicine

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