Sleep is a necessity for survival. Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of n and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparision between before and after admission of their sleep pattern, “sleep onset” tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics ; 37.5%), physiological factor (snoring ; 59.4%) environmental factor (pillow ; 78.1%), emotional factor(anxiety related to disease ; 37.5%), and illness factor(fatigue ; 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop Intervention strategies to promote sleep and to prevent sleep problems.
To provide the physician with adequate information to diagnose and treat sleepwalking and sleep terrors, the author reviewed clinical features, epidemiology, causative and precipitating factors, polysomnography, diagnosis, differential diagnosis, and treatment for these disorders. Sleepwalking and sleep terrors have been defined as disorders of arousal that occur early in the night and have their onset during stage 3 or 4 sleep. In both disorders, patients are difficult to arouse, and complete amnesia or minimal recall of the episode is frequent. Genetic, developmental, and psychological factors have been identified as causes of both sleepwalking and sleep terrors. Sleepwalking and sleep terrors typically begin in childhood or early adolescence and are usually outgrown by the end of adolescence. When sleepwalking or sleep terrors have a post-pubertal onset or continue to adulthood, psychopathology is a more significant causative factors. The behavior that occur from deep slow-wave sleep can be painful or dangerous to the individual and/or disturbing to those close to that individual. The assessment of patients suspected of having these conditions requires a thorough medical and sleep history. The most important consideration in managing patients with sleepwalking or sleep terrors episodes is protection from injury.
Sleep is an essential component for health and the quality of life of individuals, and is affected by multiple factors. Thereby, sleep impairment is known to be frequent even in healthy subjects. The purpose of the study is to compare sleep patterns and related factors between healthy young and old adults and to identify aging effects upon sleep in a cross-sectional way. The survey questionnaire was developed by translation and modification of two well-known sleep questionnaires which were originally developed by Monroe(1967) and Ellis, et al. (1982). Discussion with experts and pilot study were completed to finalize the contents of the questionnaire that was used in this study. Results are as follows : 1. Sleep complaints were lower in older adults. 2. The most frequent variables that explain sleep satisfaction were feeling rested in the morning in the older adults and feeling rested and failing asleep within five minutes in the young adults. 3. Regarding sleep-disturbing factors, physical factors were more frequently reported in the older adults and environmental factors are reported more frequently in the young adults, and there was no difference related to the emotional factors between the two groups. 4. Young adults were practiced strategies for better sleep more often than the older adults, and they were mainly in-home activities just before sleep. 5. Sleep patterns which change with aging were as follows : going to bed and waking up earlier : not staying in the bed long after waking up ; getting harder to fall asleep ; frequent arousal after sleep onset ; getting harder to go back to sleep after arousal during night sleep. From the results of this study, it can be concluded that sleep and related factors of the young and the older adults are different. Also, sleep patterns change with aging and those changes seem to be negative for sleep in the elderly. Repeated studies are needed to establish more concrete information regarding sleep patterns. In addition, further research is needed to develop more reliable, valid, and feasible sleep measure tools, and to develop and evaluate nursing interventions.
This study was attempted to show basic data for search of nursing intervention about sleep improving in home and institute elderly peoples. Research design was cross-sectional survey method for comparison of sleep patterns and another variables between home and institute elderly peoples. Subjects were sampled by purpose as home and institute elderly peoples at age of 65 or older in Seoul or nearly. The survey questionnaire was used by modification of sleep questionnaire which Kim, O, Song & Bak(1997) developed. Data were collected between December, 1999 and April, 2000. And data were analyzed by SPSS PC+ for purpose of research. Results are as follows: 1. Home and institute elderly peoples, all were change of sleep patterns and sleep pattern was showed early sleeping down. But institute elderly peoples slept earlier than home elderly peoples. 2. As rest of morning, difficulty of falling asleep and disturbance of re-asleep, subjective thinking and feeling were showed more negative thing home elderly peoples than institute elderly peoples. As frequency of falling asleep within 5 min in 1 week, frequency of falling asleep over 30 min in 1 week and frequency of awakening in a day, objective frequency were showed more insomnia institute elderly peoples than home elderly peoples. Home elderly peoples didn't nap most and institute elderly peoples napped on very short time. 3. Regarding sleep-disturbing factors, physical factor was popularly joint-disturbance in all, home and institute elderly peoples. Environmental factor was popularly noise, particularly institute elderly peoples. Emotional factor wasn't all. 4. Practiced strategies for better sleep was popularly TV/Radio in home elderly peoples and were popularly regular sleep and religious action in institute elderly peoples. From the results of this study, home elderly peoples need nursing intervention of improving self-satisfaction on sleep and institute elderly peoples need nursing intervention of decreasing falling asleep-disturbing and decreasing frequency of awakening in sleep.
Journal of Korean Academy of Fundamentals of Nursing
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v.14
no.1
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pp.62-71
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2007
Purpose: This study was done to compare sleep patterns, factors of sleep disturbance and sleep enhancement behaviors between sleep disturbance and non-sleep disturbance elderly patients. Method: The participants were 117 patients over 65 years old who were hospitalized at 5 general hospitals in Seoul. There were 83 patients in the good sleeper group and 34 in the poor sleeper group. The survey questionnaires included questions on general characteristics, sleep patterns, sleep disturbing factors, and sleep enhancement behaviors of the patients. Results: For sleep patterns and environmental factors of sleep disturbance, the poor sleepers was significantly higher than that of the good sleepers. Significant differences between good sleepers and poor sleepers were also found on the following variables: Environmental factors of sleep disturbance -'Sound of other patient's or care-giver's', 'Discomfort of bed, linen, pillow and patient's gown', 'Light in the room', 'Emergency situations', 'Temperature of patients rooms too hot or too cold'. The significant physical factor of sleep disturbance was 'Hard to breath even without moving' and for sleep enhancement behaviors: 'Use of ear plugs or eye covers' Conclusion: Consequently it is necessary to develop positive and differentiated programs for sleep enhancement for the inactive and poor sleeper among the elderly patients.
Background: Sleep-related disturbances and sleep disorders are common in Parkinson's disease (PD) and have a great impact on daily life of PD patients. This study was done to find the sleep characteristics and sleep disturbing factors in PD patients according to disease severity through clinical interview and polysomnographic (PSG) study. Methods: Fifty patients with PD (22 males, age $60.6{\pm}6.4$, Hoehn and Yahr (HY) stage $2.7{\pm}1.0$) were recruited and thoroughly interviewed about their sleep. PSG was performed on the patients taking routine antiparkinsonian medications. Patients were grouped into mild and moderate/severe group according to HY stage, and the results were compared between each group. Results: Ninety-four percent of total patients had one or more sleep-related disturbances based on the interview or PSG. On interview, the moderate/severe group complained more insomnia and REM sleep behavior disorder (RBD) than mild group. In PSG findings, the moderate/severe group showed lower sleep efficiency, longer sleep latency, REM sleep latency, waking time after sleep onset, and higher prevalence of RBD. Conclusions: In this study, most patients with PD had sleep disturbances. Clinical interview and PSG findings revealed deterioration of sleep quality along the disease severity. Our results suggest that sleep disturbances in PD patients are prevalent and warrant clinical attention, especially to the patients with advanced disease.
Objectives : Periodic limb movements during sleep (PLMS) may cause arousals that may lead to non-restorative sleep. PLMS is characterized by long sleep latency, sleep fragmentation, frequent stage shifts, and rarity of stages 3/4 NREM sleep on polysomnography. However, controversies have existed and it still remains to be elaborated whether PLMS actually causes insomnia, since normal persons happen to have PLMS. Clinically, it would be crucial to know factors which might disturb sleep in PLMS. We became interested in Coleman's theory(1980) that invariant periodic movements disturb patients' sleep less. Though, Coleman's study seems to have been confounded by including PLMS patients with various co-morbid sleep disorders. Therefore, we attempted to study in patients only with PLMS the effects of movement patterns on sleep architecture. Methods : In 27 patients diagnosed as having PLMS only with clinical interview and nocturnal polysomnography, we studied the relationship between the movement patterns such as mean duration and variability of periodic limb movement's interval and the sleep architecture variables. Results : The shorter and the more regular the limb movement intervals were, the fewer arousals followed. The movement intervals of the older patients were shorter and more regular than the younger patients. The probability of the accompanying arousal with each limb movement increased as the duration and variance of the movement intervals increased. It decreased as the age and the frequency of limb movements increased. Among these factors the most significant one was the mean duration of the movement intervals. In other words, the shorter the movement intervals were, the less disturbed sleep was. Conclusion : PLMS frequency increases with aging but the probability of the accompanying arousal with each movement decreases with aging. Sleep-disturbing effects of PLMS depends more on the duration and variability of movement intervals than the PLMS frequency.
Journal of Society of Occupational Therapy for the Aged and Dementia
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v.12
no.2
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pp.47-55
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2018
Objective : The purpose of this study is to consider the change of hand function according to the quality of sleep and to find out a correlation among the quality of sleep and hand function, and sleep disturbing factors. Method : 23 patients who were hospitalized more than 6 months from Nov. 2017 to Jan. 2018 were tested for the quality of sleep used by sleep quality scale, for the grip strength used by a dynamometer, and for the coordination used by BBT and 9-Hole Peg test. The collected data were analyzed to implement the paired t-test and Pearson correlation coefficient. Result : In the high grade group of sleep score, the quality of sleep & BBT, and the grip strength & BBT have correlated each other; and in the medium group, only the latter has shown a correlation. In both groups, the quality of sleep and the sleep pattern have showed significant high correlation. Conclusion : When the elderly in geriatric hospitals show qualitative differences, BBT and the combination of treatment for the improvement of grip strength can improve the quality of sleep. And the sleep pattern intervention is considered to be effective to improve the quality of sleep.
Purpose: The purpose of this study was to identify relationships between quality of sleep, symptom cluster, depression, environmental disorder, and quality of life among hospitalized cancer patients. Methods: The subjects were 114 patients who underwent chemotherapy for colon cancer, gastric cancer, gynecologic cancer and breast cancer. They were recruited from the cancer center of a university hospital. Data were collected from August 4th to 30th, 2011. The questionnaires included the Korean sleep scale A (quality of sleep), MDASI-K (symptom cluster), the environmental sleep disturbing scale, Zung's depression scale, and the Korean version of EORTC QLQ-C30. The collected data was analyzed by t-test, ANOVA, multiple regression analysis using the SPSS 19.0 program. Results: Functional QOL was negatively associated with symptom QOL (r=-.798, p<.001). Symptom cluster, depression, & spouse (46.3%) were the most powerful predictors for functional QOL (46.3%) and symptom QOL (53.4%). Conclusion: It is evident that oncology nurses need to evaluate two dimensions of quality of life for cancer patients, for example, functional and symptom QOL. We recommend nurses develop specific protocols for relieving physical symptoms and alleviating depression, and furthermore test the effectiveness of them.
Journal of Korean Academy of Fundamentals of Nursing
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v.1
no.2
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pp.173-191
/
1994
This descriptive-correlational study was conducted to exam if there were relation between noise level and reaction to noise of inpatient. The purpose of this study was to provide a basic data for comfort of patient hospitalized. The hypotheses of the study are : 1. The higher perceived noise level of inpatient, the higher reaction level to noise. 2. The higher perceived noise level of inpatient, physiological reaction level to noise. 3. The higher perceived noise level of inpatient, the higher emotional reaction level to noise. The participant were 153 patients hospitalized in one general hospital. The research instruments used for this study were noise scale and reaction of patient scale developed by the author. Data was collected over a period of 10 days from the 9th of July to the 18th of July, 1994. Statistical analysis of the data included percentage, t-test, ANOVA and Scheffe test. Examination of the hypotheses was done by use of pearson correlation coefficient. The results are summarized as follows ; 1. The mean score of noise level was 2.24. Among noise factors reported by the subjects, that which ranked highest was 'Conversation of Visitors'(2.82). Next were 'noise of handling receptacle'(2.73), 'the others noise from outside'(2.73) and 'Conversation of supporter'(2.71). 2. The mean score of reaction level to noise was 2.19, physiological reaction level 2.04 and emotional reaction level 2.37. Among Physiological reaction to noise reported by the subjects, that which ranked highest was 'tired'(2.39). Next were 'sweating'(2.22) and 'headache'(2.20). Among emotional reaction to noise reported by the subjects, that which ranked highest was 'to irritate nerve'(2.53). Next were 'disturbing rest'(2.51) and 'to disturb sleep'(2.46). 3. The relationship between perceived noise level of inpatient and reaction to noise was statically significant (r=0.599, p=.0001). The relationship between perceived noise level of inpatient and physiological reaction to noise was statically significant (r=0.554, p=.0001). The relationship between perceived noise level of inpatient and emotional reaction to noise was statically significant(r=0.535, p=.0001). Thus hypothese 1, 2, 3 were supported. 4. There were significant differences between noise level of inpatient, admission periods, mobility of physical condition and exposure level to noise. 5. There were significant differences between physiological reaction level to noise, admission periods, mobility of physical condition and operation Yes or No. 6. There were significant difference between emotional reaction level to noise, admission periods, mobility of physical condition and exposure level to noise.
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