Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand.
Preventative and Social Medicine, Dunedin School of Medicine, University of Otago, New Zealand.
Age Ageing. 2021 May 5;50(3):955-962. doi: 10.1093/ageing/afaa292.
Hospital inpatients experience substantial sleep problems that have been linked with worse health outcomes, poor quality of life and the post-hospital syndrome. However, little is known about assessing sleep issues in older hospitalised patients.
To conduct an in-depth investigation on hospitalised older adults' sleep challenges and methods of sleep assessment.
Cross-sectional observational study.
Public hospital inpatient unit.
Long-stay hospitalised older adults.
Data were collected using validated sleep questionnaires, actigraphy devices and qualitative interviews. Quantitative data were analysed with descriptive statistics, multiple logistic regression and Cohen's Kappa. Qualitative data were analysed with qualitative content analysis; findings compared to the quantitative assessments.
We collected data on 33 older long-stay hospital inpatients, who were mean (SD) 80.2(7.4) years old, 57.6% female and were hospitalised following stroke, medical illness and orthopaedic fracture. Mean (SD) total sleep time and actigraphic sleep efficiency were 480.6(73.6) minutes and 81.5(11.2)%, respectively. About, 57.6% were poor sleepers (Pittsburgh Sleep Quality Index [PSQI]) and 30.8% had indicators of clinical depression/low quality of life (WHO-5 well-being index). Three main themes were identified: "sleep assessment"; "factors that affect sleep"; "expectations of sleep". Bad sleepers were more likely to feel a lack of control over their sleep, while good sleepers spoke about the ability to adjust and accept their circumstances.
We found high levels of sleep problems and identified substantial discrepancies between the validated sleep questionnaire and qualitative response data. Our findings indicate that standard assessment tools, such as PSQI, may not be suitable to assess sleep in hospitalised older adults and call for further investigations to build more appropriate methods. Further exploring psychological factors and expectations could potentially lead to novel interventions to improve sleep in this setting.
医院住院患者经历了大量的睡眠问题，这些问题与更差的健康结果、较差的生活质量和住院后综合征有关。然而，对于评估老年住院患者的睡眠问题知之甚少。
深入调查住院老年患者的睡眠挑战和睡眠评估方法。
横断面观察性研究。
公立医院住院病房。
长期住院的老年患者。
使用经过验证的睡眠问卷、活动记录仪设备和定性访谈收集数据。使用描述性统计、多元逻辑回归和 Cohen's Kappa 分析定量数据。使用定性内容分析分析定性数据；将发现与定量评估进行比较。
我们收集了 33 名长期住院的老年住院患者的数据，他们的平均（标准差）年龄为 80.2（7.4）岁，57.6%为女性，因中风、内科疾病和骨科骨折住院。平均（标准差）总睡眠时间和活动记录仪睡眠效率分别为 480.6（73.6）分钟和 81.5（11.2）%。约 57.6%的患者睡眠质量差（匹兹堡睡眠质量指数[PSQI]），30.8%的患者有临床抑郁/生活质量低的指标（世界卫生组织-5 幸福感指数）。确定了三个主要主题：“睡眠评估”；“影响睡眠的因素”；“对睡眠的期望”。睡眠质量差的患者更有可能感到对睡眠缺乏控制，而睡眠质量好的患者则谈到了调整和接受自己处境的能力。
我们发现睡眠问题水平较高，并确定了经过验证的睡眠问卷和定性反应数据之间存在显著差异。我们的研究结果表明，标准评估工具（如 PSQI）可能不适合评估住院老年患者的睡眠情况，并呼吁进一步研究以开发更合适的方法。进一步探讨心理因素和期望可能会为改善该环境中的睡眠带来新的干预措施。
