Journal of Korean Gerontological Nursing 2000;2(1):35-47.

입원 노인 환자의 수면 장애 요인과 그 상대적 중요도에 관한 연구

백윤아, 송미순

Abstract

Sleep is an essential component in health and the quality of life of individuals, and is affected by multiple factors. Sleep disturbance leads to numerous adverse physiological and psychological consequences. The purpose of this study is to explore sleep patterns and disturbing factors and to investigate relative significance of sleep disturbing factors-environmental, physiological and psychological factors-among hospitalized older patients. The ultimate goal is to develop nursing interventions for sleep disturbance by delineating most influencing factor of elderly sleep. The subject of this study were 108 elderly over 65-year-old who were hospitalized at a general hospital in Seoul, Data collection was done from August, 16 to September, 22, 1999 using a self-report questionnaires and chart review. At the beginning of the interview, subjects were screened for dementia who were scored lower than 8 by Mental Status Questionnaire and were eliminated from the study subjects. Korean sleep scale, Spielberger's state anxiety inventory. Short form geriatric depression scale. Environmental and Physiological disturbing factors scale developed by the researcher with the consultation of expert and literature review were include in the survey questionnaires. The results were as follows: 1) The subjects' mean age was 70.7, and 63% of subjects were male. 2) The subjects' mean score of Korean sleep scale was 37.09±5.15(maximum 60). Subjects sleep patterns were as followed: difficulty in falling asleep(64.3%), frequent awakening (83.3%). getting harder to go back to sleep after arousal during sleep(73.1%). lack of deep sleep(63.9%), insufficience nocturnal sleep time(62.0%). 3) The most frequently reported sleep-disturbing factors were nocturnal urinary frequency (81.4%) in physiological aspect, noise from very ill patients(47.2%) and verbal sound from other patients or visitor (47.2%) in environmental aspect. 4) Factors negatively correlated with level of sleep were, age(r=-.221, p=.022), environmental factors(r=-.207, p=.032), anxiety (r=-.391, p=.000), depression(r=-.451, p=.000), and physical symptoms(r=-.291, p=.002). 5) Three significant predictive factors of sleep were identified, depression accounted for 20.4% of sleep, nocturnal urinary frequency, 5.7%, pruritus, 2.9%. Therefore, these three factors accounted for 28.9% of sleep. In conclusion, the most frequent variables that explain sleep in hospitalized elderly were depression, nocturnal urinary frequency and pruritus. Therefore, it is suggested to alleviate depression and physical comfort in nursing strategy of sleep promotion for the hospitalized elderly.

Key words: 입원 노인환자, 수면 양상, 수면 장애 요인