지역사회간호학회지 (Research in Community and Public Health Nursing)

  • 제33권3호
  • /
  • Pages.340-355
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  • 2022
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  • 1225-9594(pISSN)
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  • 2288-4203(eISSN)
한국지역사회간호학회 (Korean Academy of Community Health Nursing)
권호 표지
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The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis

  • 투고 : 2022.04.28
  • 심사 : 2022.09.01
  • 발행 : 2022.09.30
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초록

Purpose: This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities. Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the meta-analysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library. Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective. Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.

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참고문헌

  1. Patel D, Steinberg J, Patel P. Insomnia in the elderly: A review. Journal of Clinical Sleep Medicine. 2018;14(6):1017-1024. https://doi.org/10.5664/jcsm.7172
  2. Li J, Chang YP, Porock D, Chang YP. Factors associated with daytime sleep in nursing home residents. Research on Aging. 2015;37(1):103-117. https://doi.org/10.1177/0164027514537081
  3. Kim DE, Yoon JY. Factors that influence sleep among residents in long-term care facilities. International Journal of Environmental Research and Public Health. 2020;17(6):1889. https://doi.org/10.3390/ijerph17061889
  4. Jeon SN, Song HJ. The relationship between EQ-5D and optimal sleep duration among community dwelling elderly. Korean Public Health Research. 2017;43(1):13-22. https://doi.org/10.22900/kphr.2017.43.1.002
  5. Brenes GA, Miller ME, Stanley MA, Williamson JD, Knudson M, McCall WV. Insomnia in older adults with generalized anxiety disorder. The American Journal of Geriatric Psychiatry. 2009;17(6):465-472. https://doi.org/10.1097/JGP.0b013e3181987747
  6. Ellmers T, Arber S, Luff R, Eyers I, Young E. Factors affecting residents' sleep in care homes. Nursing Older People. 2013;25(8):29-32. https://doi.org/10.7748/nop2013.10.25.8.29.e466
  7. Barreto PDS, Morley JE, Chodzko-Zajko W, Pitkala KH, Weening-Djiksterhuis E, Rodriguez-Manas L, et al. Recommendations on physical activity and exercise for older adults living in long-term care facilities: A taskforce report. Journal of the American Medical Directors Association. 2016;17(5):381-392. https://doi.org/10.1016/j.jamda.2016.01.021
  8. Chun SY, Kim HS. Current status and factors related to physical activity of older nursing home residents with and without dementia: effects of individual and institutional characteristics. Health Policy and Management. 2018;28(4):392-401. https://doi.org/10.4332/KJHPA.2018.28.4.392
  9. Kume Y, Kodama A, Sato K, Kurosawa S, Ishikawa T, Ishikawa S. Sleep/awake status throughout the night and circadian motor activity patterns in older nursing-home residents with or without dementia, and older community-dwelling people without dementia. International Psychogeriatrics. 2016;28(12):2001- 2008. https://doi.org/10.1017/S1041610216000910
  10. Garms-Homolova V, Flick U, Rohnsch G. Sleep disorders and activities in long term care facilities -a vicious cycle? Journal of Health Psychology. 2010;15(5):744-754. https://doi.org/10.1177/1359105310368185
  11. Valenza MC, Cabrera-Martos I, Martin-Martin L, Perez-Garzon VM, Velarde C, Valenza-Demet G. Nursing homes: impact of sleep disturbances on functionality. Archives of Gerontology and Geriatrics. 2013;56(3):432-436. https://doi.org/10.1016/j.archger.2012.11.011
  12. Lee SA, Choi SW. The effect of sleep on depression among older adults. Korean Journal of Clinical Psychology. 2019;38(2):171-181. https://doi.org/10.15842/kjcp.2019.38.2.004
  13. Kim MS, Kim JI. Relationship among the health state, daily living activities (ADL, IADL), sleep state, and depression among old people at elderly care facilities. Journal of the Korea Academia-Industrial cooperation Society. 2015;16(4):2609-2619. https://doi.org/10.5762/KAIS.2015.16.4.2609
  14. Diem SJ, Blackwell TL, Stone KL, Yaffe K, Tranah G, Cauley JA, et al. Measures of sleep-wake patterns and risk of mild cognitive impairment or dementia in older women. The American Journal of Geriatric Psychiatry. 2016;24(3):248-258. https://doi.org/10.1016/j.jagp.2015.12.002
  15. Tempesta D, De Gennaro LD, Natale V, Ferrara M. Emotional memory processing is influenced by sleep quality. Sleep Medicine. 2015;16(7):862-870. https://doi.org/10.1016/j.sleep.2015.01.024
  16. Gaugler JE, Duval S, Anderson KA, Kane RL. Predicting nursing home admission in the US: A meta-analysis. BMC Geriatrics. 2007;7(13):13. https://doi.org/10.1186/1471-2318-7-13
  17. Hahn EA, Wang HX, Andel R, Fratiglioni L. A change in sleep pattern may predict Alzheimer disease. The American Journal of Geriatric Psychiatry. 2014;22(11):1262-1271. https://doi.org/10.1016/j.jagp.2013.04.015
  18. Ye L, Richards KC. Sleep and long-term care. Sleep Medicine Clinics. 2018;13(1):117-125. https://doi.org/10.1016/j.jsmc.2017.09.011
  19. Hwang EH, Kim KH. The sleep experiences of elderly living in the long-term care facilities in Korea. Journal of Qualitative Research. 2015;16(1):12-20. https://doi.org/10.22284/qr.2015.16.1.12
  20. Neubauer DN, Pandi-Perumal SR, Spence DW, Buttoo K, Monti JM. Pharmacotherapy of insomnia. Journal of Central Nervous System Disease. 2018;10:1-7. https://doi.org/10.1177/1179573518770672
  21. Menza M, Dobkin RD, Marin H, Gara M, Bienfait K, Dicke A, et al. Treatment of insomnia in Parkinson's disease: a controlled trial of eszopiclone and placebo. Movement Disorders: Official Journal of the Movement Disorder Society. 2010;25(11):1708-1714. https://doi.org/10.1002/mds.23168
  22. Shash D, Kurth T, Bertrand M, Dufouil C, Barberger-Gateau P, Berr C, et al. Benzodiazepine, psychotropic medication, and dementia: a population-based cohort study. Alzheimer's & Dementia: The Journal of the Alzheimer's Association. 2016;12(5):604-613. https://doi.org/10.1016/j.jalz.2015.10.006
  23. Tago M, Katsuki NE, Oda Y, Nakatani E, Sugioka T, Yamashita SI. New predictive models for falls among inpatients using public ADL scale in Japan: A retrospective observational study of 7,858 patients in acute care setting. PloS One. 2020;15(7):e0236130. https://doi.org/10.1371/journal.pone.0236130
  24. Samara MT, Huhn M, Chiocchia V, Schneider-Thoma J, Wiegand M, Salanti G, et al. Efficacy, acceptability, and tolerability of all available treatments for insomnia in the elderly: a systematic review and network meta-analysis. Acta Psychiatrica Scandinavica. 2020;142(1):6-17. https://doi.org/10.1111/acps.13201
  25. Capezuti E, Zadeh RS, Pain K, Basara A, Jiang NZ, Krieger AC. A systematic review of non-pharmacological interventions to improve nighttime sleep among residents of long-term care settings. BMC Geriatrics. 2018;18(1):143. https://doi.org/10.1186/s12877-018-0794-3
  26. Shang B, Yin H, Jia Y, Zhao J, Meng X, Chen L, et al. Nonpharmacological interventions to improve sleep in nursing home residents: a systematic review. Geriatric Nursing. 2019;40(4):405-416. https://doi.org/10.1016/j.gerinurse.2019.01.001
  27. Kim JH, Oh PJ. Effects of non-pharmacological interventions on primary insomnia in adults aged 55 and above: A metaanalysis. Korean Journal of Adult Nursing. 2016;28(1):13-29. https://doi.org/10.7475/kjan.2016.28.1.13
  28. Kim AR, Chae MO, Jeon HO. Effects of physical activity programs on sleep among community-dwelling elders in Korea: A systematic review and meta-analysis. Journal of the Korea Academia-Industrial cooperation Society. 2018;19(3):186-197. https://doi.org/10.5762/KAIS.2018.19.3.186
  29. Kwon CY, Lee B, Cheong MJ, Kim TH, Jang BH, Chung SY, et al. Non-pharmacological treatment for elderly individuals with insomnia: a systematic review and network meta-analysis. Frontiers in Psychiatry. 2021;11:608896. https://doi.org/10.3389/fpsyt.2020.608896
  30. Kim SY, Park JE, Seo HJ, Lee YJ, Jang BH, Son HJ. Neca's guidance for undertaking systematic reviews and meta-analyses for intervention [Internet]. Seoul: National Evidence-Based Healthcare Collaborating Agency; 2011 [cited 2021 March 20]. Available from: https://www.neca.re.kr/lay1/bbs/S1T11C102/F/39/view.do?article_seq=5329&cpage=1&rows=10&condition=A.TITLE&keyword=%EC%B2%B4%EA%B3%84%EC%A0%81&show=&cat=0.
  31. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. British Medical Journal. 2003; 327(7414):557-560. https://doi.org/10.1136/bmj.327.7414.557
  32. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates; 1988.567 p.
  33. Egger M, Smith GD, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. British Medical Journal. 1997;315(7109):629-634. https://doi.org/10.1136/bmj.315.7109.629
  34. Kim JH, Oh PJ. Effects of non-pharmacological interventions on primary insomnia in adults aged 55 and above: A metaanalysis. Korean Journal of Adult Nursing. 2016;28(1):13-29. https://doi.org/10.7475/kjan.2016.28.1.13
  35. Ko YJ. Effects of lavender fragrance inhalation method on sleep, depression and stress of institutionalized elderly. Journal of East-West Nursing Research. 2012;18(2):74-80. https://doi.org/10.14370/jewnr.2012.18.2.074
  36. Oh JJ, Song MS, Kim SM. Development and validation of Korea sleep scale A. Journal of Korean Academy of Nursing. 1998;28(3):563-572. https://doi.org/10.4040/jkan.1998.28.3.563
  37. Jeon HJ. Effects of Korean dance therapy program on the life stress and sleep quality of elderly dementia patients. The Korean Journal of Physical Education. 2017;56(6):447-457. https://doi.org/10.23949/kjpe.2017.11.56.6.31
  38. Lee HJ, Cha SM. The effects of Occupation-Based Sleep Intervention Program (OBSP) for inpatients in elderly: a single case study. Korean Aging Friendly Industry Association. 2020;12(2):177-187. https://doi.org/10.34264/jkafa.2020.12.2.177
  39. Hong SJ, Kim EH. Effects of aroma head and neck massage on sleep disturbance and problematic behaviors, depression, blood serotonin, blood cortisol, and the vital signs on elders with dementia. Crisisonomy. 2014;10(9):75-92.
  40. Kim AR, Chae MO, Jeon HO. Effects of physical activity programs on sleep among community-dwelling elders in Korea: A systematic review and meta-analysis. Journal of the Korea Academia-Industrial Cooperation Society. 2018;19(3):186-197. https://doi.org/10.5762/KAIS.2018.19.3.186
  41. Kim ME, Jun JH, Hur MH. Effects of aromatherapy on sleep quality: a systematic review and meta-analysis. Journal of Korean Academy of Nursing. 2019;49(6):655-676. https://doi.org/10.4040/jkan.2019.49.6.655
  42. Li H, Lin L, Li Y, Xiong M, Tang P. Efficacy of aromatherapy in improving elderly's sleep quality. Journal of Chengdu Medical College. 2016;11(1):112-115. https://doi.org/10.3969/j.issn.1674-2257.2016.01.027
  43. Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: A meta-analytic review. Journal of Behavioral Medicine. 2015;38(3):427-449. https://doi.org/10.1007/s10865-015-9617-6
  44. Choi HY, Lim WJ. Current clinical practice of insomnia. The Ewha Medical Journal. 2013;36(2):84-92. https://doi.org/10.12771/emj.2013.36.2.84
  45. Chae JH, Kim YS, Han MY. Effects of non-pharmacological interventions on cancer patients with sleep disorder: A metaanalysis. Asian Oncology Nursing. 2021;21(1):1-14. https://doi.org/10.5388/aon.2021.21.1.1
  46. Chung BY, Park HS. Effects of non-pharmacological interventions for adults with insomnia in Korea: a meta-analysis. Journal of the Korea Academia-Industrial cooperation Society. 2017;18(1):95-106. https://doi.org/10.5762/KAIS.2017.18.1.95
  47. Santos MAD, Conceicao APD, Ferretti-Rebustini REDL, Ciol MA, Heithkemper MM, Cruz DALMD. Non-pharmacological interventions for sleep and quality of life: a randomized pilot study. Revista Latino-Americana de Enfermagem. 2018;26. https://doi.org/10.1590/1518-8345.2598.3079
  48. Lin PC, Lee PH, Tseng SJ, Lin YM, Chen SR, Hou WH. Effects of aromatherapy on sleep quality: a systematic review and metaanalysis. Complementary Therapies in Medicine. 2019;45:156-166. https://doi.org/10.1016/j.ctim.2019.06.006
  49. Herrmann WJ, Flick U. Nursing home residents' psychological barriers to sleeping well: A qualitative study. Family Practice. 2012;29(4):482-487. https://doi.org/10.1093/fampra/cmr125
  50. Morone NE, Greco CM. Mind-body interventions for chronic pain in older adults: a structured review. Pain Medicine. 2007; 8(4):359-375. https://doi.org/10.1111/j.1526-4637.2007.00312.x
  51. Oh ES, Park KM, An SK, Nam KK, Shim DH, Lee E. The effects of a brief intervention for insomnia on community dwelling older adults. Sleep Medicine and Psychophysiology. 2018;25 (2):74-81. https://doi.org/10.14401/KASMED.2018.25.2.74
  52. Edinger JD, Sampson WS. A primary care "friendly" cognitive behavioral insomnia therapy. Sleep. 2003;26(2):177-182. https://doi.org/10.1093/sleep/26.2.177