• Journal of Korean Academy of Nursing
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• v.44 no.3
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• pp.270-279
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• 2014

Purpose: The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed. Methods: For this study, 11 older patients with depression were purposively chosen. Data were collected through indepth individual interviews from July 2013 to January 2014 and analyzed in terms of by Giorgi's phenomenological methodology. Results: The study results showed that sleep disorder experience in older patients with depression consisted of sixteen themes and five themes-clusters: 1) exposure of the causes of sleep disorders; 2) life is painful; 3) harassing themselves and their family; 4) difficulty in controlling themselves; 5) trying to deal with the sleep disorder to overcome the situation. Conclusion: It is necessary to develop educational guidelines for patients with sleep disorders or nursing interventions that anyone can easily provide for elders in the communities. The first priority should be given to efforts to apply diverse methods to improve sleep hygiene and minimize the period of exposure to medication before starting medication for patients with sleep disorders.

• Journal of Korean Biological Nursing Science
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• v.11 no.1
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• pp.23-31
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• 2009

Purpose: The purpose of the present study was to investigate the prevalence and related factors of sleep-wake disturbance (SWD) in Korean post-stroke patients. This study was the first to address post-stroke SWD in Korea using a structured questionnaire. Method: We investigated the prevalence of SWD and related factors including lesion location, stroke severity, presence of depression and fatigue. We assessed sleep-wake pattern including quality of sleep, sleep latency, wake episodes, wake time after sleep onset, daytime sleep episode and sleep time at daytime. Ninety stroke patients admitted to a university affiliated hospital in Seoul between the period September 2008 and January 2009 were included in the study. Result: Thirty five patients (38.9%) complained insomnia and 32 (35.6%) complained excessive daytime sleepiness (EDS). Quality of sleep (p=.000), sleep latency (p=.000) and total sleep time (p=.001) were significantly poorer in 16 patients with both insomnia and EDS than in the others. The related factors to insomnia were level of education (p=.030), depression (p=.007) and fatigue (p=.034), though related factors to EDS were stroke onset time (p=.049), stroke severity (p=.005), motor dysfunction (p=.035), dysphasia (p=.018), fatigue (p=.001) and lesion location (p=.019). Conclusion: Sleep-wake disturbance is a common problem in Korean stroke patients. Strategies to improve quality of sleep are urgently needed in the post-stroke patients.

• Women's Health Nursing
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• v.16 no.3
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• pp.276-287
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• 2010

Purpose: This study was to identity the relationships between the side effects of depression and quality of sleep among gynecological cancer patients undergoing chemotherapy. Methods: The data was collected from 113 patients at two general hospitals within B metropolitan city. The instruments used to collect the data for the study was the 'Side Effect Scale' developed by Kwon, Young-eun; 'Depression scale' developed by Oh, Se-man, and the 'Quality of Sleep Scale' developed by Oh, Song & Kim. Results: Results showed that the mean of side effects was $39.75{\pm}9.99$, mean of depression was $9.63{\pm}3.93$ and mean of 'quality of sleep' was $36.99{\pm}6.66$. The quality of sleep variable showed statistically significant differences for the variables: age (F=3.203, p=.026), cancer insurance (t=-2.278, p=.025), and perceived physical condition (F=3.152, p=.047) respectively. The relationship between side effects and quality of sleep showed a low negative, but significant correlation (r=-.327, p<.001). The relationship between depression and quality of sleep also showed a low negative correlation (r=-.365, p<.001). Conclusion: This study shows that it is necessary to develop nursing intervention programs because it can successfully improve the quality of sleep of gynecological cancer patients undergoing chemotherapy.

• The Journal of the Convergence on Culture Technology
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• v.5 no.2
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• pp.287-297
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• 2019

The purpose of this study was to investigate the factors influencing suicidal ideation among the elderly over 60 years old living in the community centered on sleep and depression. A total of 210 elderly people living in a metropolitan city were surveyed about suicidal ideation, sleep pattern (sleep time, quality of sleep) and depression. Data analysis showed that 14.3% of the subjects were seniors with a high suicidal ideation, 23.3% were sleeping less than 5 hours, 17.6% were poor sleep quality, and 33.3% were depressed. According to multiple logistic regression analysis, the factors influencing suicidal ideation were identified as depression (OR=6.889, 95% CI=2.679-17.712), sleep quality (OR=3.770, 95% CI=1.469-9.679), and gender (OR=3.080, 95% CI=1.266-7.491). These three factors accounted for 31.6% of suicidal ideation variables. Based on the results of this study, it is suggested that reducing the depression and improving the quality of sleep in consideration of gender should be an essential strategy for the elderly in the community to reduce the suicidal ideation.

• Journal of Korean Public Health Nursing
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• v.32 no.2
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• pp.263-274
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• 2018

Purpose: This study examined the correlation of insomnia, sleep quality, depression, and circadian rhythm in nursing students. Methods: A total of 213 subjects completed a questionnaire consisting of their general characteristics, Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), Center for Epidemiologic Studies Depression (CES-D), and Composite Scale of Morningness (CSM). The collected data were analyzed by descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient using the SPSS 23.0 program. Results: The subjects' mean scores were ISI 7.18; PSQI 11.18; CES-D 16.00; and CSM 30.18. In insomnia, there were significant differences according to caffeine, perceived health status and major satisfaction. In sleep quality, there were significant differences according to perceived health status and major satisfaction. Significant differences in depression were observed according to gender, caffeine, subjective health status, major satisfaction, and circadian rhythm by drinking and exercise. A significant positive correlation was observed among ISI, PSQI, and CES-D. ISI and CES-D were negatively correlated. Conclusion: Tailored health care programs should be developed and applied to prevent and manage sleep-related and emotion-related problems in nursing students by considering the health status, major satisfaction, and gender.

• Women's Health Nursing
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• v.15 no.2
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• pp.108-120
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• 2009

Purpose: This study aimed to explore the subjective sleep quality of depressed and non-depressed mothers in the late postpartum period and to determine the relationship with their health promoting behaviors, family functioning, parenting stress. Method: A non-probability sample of 128 mothers completed a self-administered questionnaires at 4-6weeks postpartum. The Edinburgh postnatal Depression Scale (EPDS) and Pittsburgh Sleep Quality Index were used to measure mother's experiences of depression symptoms and sleep. Related factors of sleep quality were measured by the Korean Family Functioning Scale, Health Promoting Lifestyle Profile, and Parenting Stress Index. The data was analysed using t-test, one-way ANOVA, and the Pearson's correlation coefficients. Result: The results indicated that the depressed mothers (EPDS$\geq$ 10) had poorer sleep quality than the non-depressed mothers(EPDS < 10), reported shortened sleep duration, and experienced more daytime dysfunctions. Depressed mothers who had no job, did not drink coffee, and were primipara tended to report poorer sleep quality. There were significant correlation between poorer sleep quality and lower health promoting behaviors, higher family intimacy and lower family communication, and higher parenting stress among depressed mothers. Conclusion: Our findings support the view that depressed mothers' experiences of poor sleep are much higher than non-depressed mothers and multi-faced. Nurse professionals should screen for sleep problems in the depressed mothers with a different biopsychosocial and behavioral aspect from the non-depressed mothers in the late postpartum period.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2609-2619
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• 2015

The purpose of this study was to investigate relationship among the depression, physical condition, daily living activities, and sleep state among old people at elderly care facilities. The subjects include old people aged 65 or older residing at an elderly care facility. At elderly care facilities, the depression of old people was related with the state of vision, mastication ability, quality of sleep, and sleep state. The degree of relation was high in the group with a poor vision, the one with a bad condition of teeth, the one that considered their quality of sleep to be poor, and the one with somnipathy. Their depression had negative correlations with age and positive ones with mastication ability and assessment of quality of sleep. At elderly care facilities, the depression of old people was highly connected with the state of vision, mastication ability, sleep state, and hearing ability. In short, the depression of old people at elderly care facilities is highly connected to the health state perceived individually. The findings point to the importance of close interest in individual health state and management of old people in poor vision, mastication ability in healthcare and nursing intervention.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.285-297
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• 2013

Purpose: This study was conducted to investigate the differences in sleep disturbance, stress, self-efficacy and depression by fatigue level and to identify the factors influencing fatigue in hemodialysis patients. Methods: This study used a cross-sectional design and the subjects were 195 patients undergoing hemodialysis in a local unit. Data were collected using a structured questionnaire and medical records from June to August 2012. The data were analyzed using descriptive statistics, independent t-test, one way ANOVA, $Scheff{\grave{e}}$ test, and Pearson's correlation coefficients. Also a multiple regression analysis was used to assess the independent association between fatigue status and indices of sleep disturbance, stress, self-efficacy and depression. Results: A total of 99 (50.8%) subjects experienced a high level of fatigue and 96 (49.2%) experienced a low level of fatigue. There were significant differences in the levels of sleep disturbance, stress, self-efficacy and depression between the two groups. Fatigue was significantly correlated to sleep disturbance, stress, self-efficacy and depression. The most important factor related to fatigue was stress, followed by sleep disturbance. These factors explained about 37% of fatigue of the respondents. Conclusion: The results of this study showed that sleep disturbance and stress were significant predictors of fatigue in hemodialysis patients. Possible interventions for minimizing fatigue in patients undergoing long-term hemodialysis should be aimed to manage the known contributing factors.

• Journal of muscle and joint health
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• v.8 no.1
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• pp.27-50
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• 2001

Rheumatoid arthritis is a chronic systemic autoimmune disease. Although the joints are the major loci of the disease activity, fatigue is a common extraarticular symptom that exists in all gradations of rheumatoid arthritis. Fatigue is defined as a subjective sense of generalized tiredness or exhaustion and has multiple dimensions. Therefore fatigue is a common and frequent problem for those with rheumatoid arthritis. In fact, 88-100% of individuals with rheumatoid arthritis experience fatigue. Especially the degree of fatigue is higher in women than men with rheumatoid arthritis. Despite the importance of fatigue among the patients with rheumatoid arthritis, the mechanism that leads to fatigue in rheumatoid arthritis is not completely understood. This study was intended to test and validate a model to predict fatigue in women with rheumatoid arthritis. Especially it was intended to identify the direct and indirect effects of the variables of pain, disability, depression, sleep disturbance, morning stiffness, and symptom duration to fatigue. Data were collected by questionnaires including Multidimensional Assesment of Fatigue(Tack, 1991), numeric scale of pain, graphic scale of joints, Ritchie Articular Index, Korean Health Assessment Questionnaire(Bae, et al., 1998), Inventory of Function Status(Tulman, et al., 1991), Center for Epidemiologic Studies-Depression, and Korean Sleep Scale(Oh, et al 1998). The sample consisted of 345 women with a mean duration of rheumatoid arthritis for 10.06 years and a mean age of 49.64 years. SPSS win and Win LISREL were used for the data analysis. Structural equation modeling revealed the overall fit of the model. Pain predicted fatigue directly and indirectly through disability, depression, and sleep disturbance. Disability, sleep disturbance predicted fatigue only directly, while depression only indirectly through disability and sleep disturbance. Also morning stiffness and symptom duration predicted fatigue through disability and depression. All predictors accounted for 65% of the variance of fatigue. Depression, pain, and disability predicted sleep disturbance. Depression had reciprocal relationship with disability and they both were predicted by pain directly and indirectly. In summary, pain, depression, disability, sleep disturbance, morning stiffness, and symptom duration contributed to the fatigue of patients with rheumatoid arthritis. The best predictor of fatigue was pain. This finding indicates that the modification of pain, depression, disability, sleep disturbance, morning stiffness could be nursing intervention for relief or prevention of fatigue.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.24 no.3
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• pp.209-218
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• 2017

Purpose: The purpose of this research was to identify factors that influence health-related quality of life of patients who have had knee or hip arthroplasty. Factors included sleep disorders, pain, activities of daily living, and depression. Methods: The participants in this research were 97 patients within one year after receiving knee or hip arthroplasty surgery and who regularly visited a hospital outpatient department. Data were analyzed using descriptive statistics, t-test, ANOVA, and stepwise regression analysis with the SPSS program. Results: Sleep disorders, pain, activities of daily living, and depression had significant correlations with health related quality of life. Factors influencing health-related quality of life among arthroplasty patients were the length of time since surgery, sleep disorders, activities of daily living, and depression. These factors explained 58% of the participants' health-related quality of life. Conclusion: The results show that various factors can affect patients' health-related quality of life following joint replacement surgery. The findings indicate that sleep disorders and depression should receive continued attention after the arthroplasty. It is also necessary to develop appropriate nursing intervention programs to lower depression and increase patient participation in daily living activities.