School of Nursing & Midwifery, University of Dundee, Dundee, United Kingdom.
J Pain Symptom Manage. 2013 Mar;45(3):579-94. doi: 10.1016/j.jpainsymman.2012.03.013. Epub 2012 Aug 25.
Alterations in sleep-wake patterns of care recipients and their informal caregivers are common in the context of a chronic illness. Given the current notion that sleep may be regulated within and affected by close human relationships, concurrent and interrelated sleep problems may be present in care recipient-caregiver dyads.
To critically analyze evidence regarding concurrent sleep patterns or changes in care recipient-caregiver dyads in the context of a chronic illness and address methodological and research gaps.
Using a wide range of key terms and synonyms, three electronic databases (Medline, CINAHL, and Embase) were systematically searched for the period between January 1990 and July 2011.
Ten studies met prespecified selection criteria and were included for analysis. Study quality was fair to good on average. Seven studies were conducted in the context of dementia or Parkinson's disease, two in the context of cancer, and one study included a group of community elders with mixed related comorbidities and their informal caregivers. Bidirectional associations in the sleep of care recipient-caregiver dyads seem to exist. Concurrent and comparable nocturnal sleep disruptions also may be evident. Yet, inconsistencies in the methods implemented, and the samples included, as well as uncertainty regarding factors coaffecting sleep, still preclude safe conclusions to be drawn on.
The dyadic investigation of sleep is a promising approach to the development of truly effective interventions to improve sleep quality of care recipients and their caregivers. Nevertheless, more systematic, longitudinal dyadic research is warranted to augment our understanding of co-occurrence and over time changes of sleep problems in care recipient-caregiver dyads, as well as to clarify covariates/factors that appear to contribute to these problems within the dyad and across time and context of illness.
在慢性病的背景下，护理对象及其非专业照护者的睡眠-觉醒模式的改变是常见的。鉴于目前睡眠可能在密切的人际关系内得到调节并受到其影响的观点，护理对象-照护者对可能同时存在相关的睡眠问题。
批判性分析关于慢性病背景下护理对象-照护者对睡眠模式同时出现或改变的证据，并解决方法学和研究方面的差距。
使用广泛的关键词和同义词，系统地检索了三个电子数据库（Medline、CINAHL 和 Embase），检索时间范围为 1990 年 1 月至 2011 年 7 月。
符合预先指定的选择标准的 10 项研究被纳入分析。研究质量平均为良好到中等。其中 7 项研究是在痴呆症或帕金森病的背景下进行的，2 项研究是在癌症的背景下进行的，1 项研究包括一组患有多种相关合并症的社区老年人及其非专业照护者。护理对象-照护者对睡眠存在双向关联。同时，夜间睡眠中断也可能是明显的。然而，由于实施方法和纳入样本的不一致，以及影响睡眠的因素不确定，目前还不能得出安全的结论。
对睡眠的对偶性研究是一种很有前途的方法，可以开发出真正有效的干预措施，以改善护理对象及其照护者的睡眠质量。然而，需要进行更系统、更长期的对偶研究，以增加我们对护理对象-照护者对睡眠问题同时出现和随时间变化的理解，以及澄清似乎在对和跨时间和疾病背景下对这些问题有贡献的协变量/因素。
