신규간호사의 수면장애 영향 요인: 수면위생과 신체적 활동을 중심으로 - 2차자료 종단적 연구

유민정,최스미,기지선,김경숙 간호행정학회 2023 간호행정학회지 Vol.29 No.3

Purpose: The aim of this study was to longitudinally compare novice nurses’ sleep disturbance, sleep hygiene, and physical activity and analyze factors affecting sleep disturbance. Methods: Data were obtained from three follow-up surveys of 178 novice nurses. The data were analyzed using SPSS 25.0 to calculate descriptive statistics. A repeated measures ANOVA and Cochran’s Q test were performed, and a logistic regression analysis was conducted using generalized estimation equations. Results: The sleep disturbance rate increased significantly over time in the following order: before the start of shift work, after six months of shift work, and after 18 months of shift work (T=98.67, p<.001). Sleep hygiene significantly deteriorated over time after the start of shift work (F=127.95, p<.001). Arousal behavior (OR=10.34, p<.001) and the sleep environment (OR=1.54, p=.005) in sleep hygiene, significantly influenced sleep disturbance. Stretching exercises were an influencing factor in sleep disturbance (OR=1.71, p=.039). Conclusion: Sleep disturbance among novice nurses increased after the start of shift work. Sleep hygiene and stretching were influencing factors. Therefore, to prevent and reduce sleep disturbance in novice nurses, efforts are needed to improve sleep hygiene and promote stretching exercises. 연구목적: 본 연구는 신규간호사의 수면장애 및 수면위생, 신체적 활동에 대해 종단적으로 비교하고, 수면장애 영향 요인을 분석하는 2차자료 조사연구이다. 연구방법: 본 연구는 수도권 소재 대학병원에 근무하는 신규간호사 178명을 대상으로 1년 6개월간 추적 조사한 자료를 활용하였다. 수집된 자료는 SPSS 25.0을 활용하여 기술통계, 반복측정 분산분석, Cochran’s Q test, 일반화추정방정식을 통한 이분형 로지스틱 회귀분석으로 분석하였다. 연구결과: 신규간호사의 수면장애 비율은 교대근무 시작 전, 교대근무 6개월, 18개월 순으로 시간에 따라 유의하게 증가하였다(T=98.67, p<.001). 신규간호사의 수면위생은 교대근무 시작 전, 교대근무 6개월, 18개월 순으로 시간에 따라 유의하게 악화되었으며(F=127.95, p<.001), 각성관련 행동(OR=10.34, p<.001) 및 수면환경(OR=1.54, p=.005) 수면위생이 수면장애의 유의한 영향 요인으로 나타났다. 또 다른 수면장애 영향요인으로는 유연성 운동이 확인되었다(OR=1.71, p=.039). 결론: 본 연구에서 신규간호사의 수면장애 비율 및 정도가 교대근무 시작 후 크게 증가하였으며, 그 이후 완화되지 않는 것으로 나타났다. 신규간호사의 수면장애의 유의한 영향요인은 수면위생과 유연성 운동으로 나타났다. 따라서 신규간호사의 수면장애를 예방하고 감소시키기 위해 수면위생 개선 및 유연성 운동의 실천을 위한 노력이 필요하다.

노인병원 거주 치매 환자의 수면 장애

김용원,김근호,윤성환,김찬석,이승현,이지만,이호원 대한수면연구학회 2009 Journal of sleep medicine Vol.6 No.1

Background : Sleep disturbance is commonly accompanied by patient with dementia. The aim of this study is to investigate the prevalence of sleep disturbance in dementia patients of geriatric hospital and relationship of between sleep disturbance and neuropsychiatric symptoms. Method : The one hundred forty-fourpatients with dementia were included in this study. Seventy-nine patients had sleep disturbances. Patients with dementia met National Institute of Neurological and Communicative Disorders and Stroke-the Alzheimer’s disease and Related Disorders Association (NINCDS-ADRDA) criteria or National Institute of Neurological Disorders and Stroke and the Association International pour la recherche et l’Enseignement en Neuroscience (NINDS-AIREN) criteria. Sleep disturbance was assessed by subscale of Neuropsychological Inventory (NPI). The participants were assessed by Korean Version of Mini-Mental State Exam, Clinical Dementia Rating, Short Form of Samsung Dementia Questionnaires, Burden interview, NPI. Results: There was no significant differences in the demographic factors and cognitive function between two groups. The patients with sleep disturbance had more neuropsychiatric symptoms. Apathy and irritability was significantly correlated with sleep disturbance. Sleep disturbance was mediated by apathy and irritability. Conclusion : Apathy and irritability played a role as a mediator of sleep disturbance in dementia.

입원환자의 수면 방해 요인이 수면의 질에 미치는 영향

이미련,남문희,Lee, Mi-Ryon,Nam, Mun-Hee 한국임상보건과학회 2014 한국임상보건과학회지 Vol.2 No.3

Purpose. The purpose of this study was to identify the factors affecting quality of sleep and sleep disturbance among inpatient. Methods. A descriptive correlational study was conducted Participants were 200 inpatient in a hospital located in B city. A structured questionnaire was used for data collection. Collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression. Result. Hospitalized patient's score of sleeping quality was 38.26 on an overall scale of 60, indicating it to be higher than 'Medium (30 points). Almost hospitalized patient in this study suffer from sleep disturbances. As results of univariate analyses, Educational level, Departments, Why hospitalized, Insomnia / depression, Chronic Disease, Scale of pain, physical symptoms, environmental factors, emotional factors, and sleep promoting behavior, disturbed sleep among hospitalized. However, the result of stepwise multiple regression analysis identified that physical symptoms, environmental factors, emotional factors, sleep promoting behavior, and Why hospitalized disturbed sleep and were significant score of sleeping quality for hospitalized and these sleep disturbance factors accounted 46.8% of variance of sleeping quality among hospitalized. Conclusion. These findings suggest that hospitalized patients with poor sleep quality should have their health carefully screened for physical symptoms, environmental factors, emotional factors, sleep promoting behavior, and why hospitalized. In addition, we recommend the development of a nursing program for improving sleep quality.

교대근무 간호사의 수면위생 지식과 수행이 수면장애에 미치는 영향

정빛나(Jung Bit Na),한기혜(Han Kihye),유해영(Yoo Hae Young),정지혜(Chung Sophia Jihey) 한국기초간호학회 2020 Journal of korean biological nursing science Vol.22 No.4

Purpose: This study aimed to explore the knowledge and performance of sleep hygiene among nurses with shift work schedules and examine the influence on sleep disturbance. Methods: A total of 199 shift-work nurses from a tertiary hospital were included in the study. To examine the knowledge and performance of sleep hygiene, the participants were asked to respond to a self-reported survey. To assess sleep disturbance, the General Sleep Disturbance Scale was used. Descriptive statistics and multiple linear regression were applied using the SPSS/WIN 21.0 program to analyze the data. Results: Both the knowledge and performance of sleep hygiene among nurses with shift work schedules were measured at a moderate level. Nurses’ knowledge and the performance of sleep hygiene was not significantly associated with sleep disturbance, whereas age, experience with shift-working, and perceived health status were significantly associated. Conclusion: Strategies for providing more accurate information and motivating better sleep hygiene would help to enhance sleep hygiene in nurses with shift work schedules. Further studies examining the association of knowledge and the performance of sleep hygiene with sleep disturbances in nurses with shift work schedules are needed.

노인의 수면 문제와 주관적 인지 저하의 관계에서 정서적 문제의 매개효과

권희진,박수현 한국건강심리학회 2021 한국심리학회지 건강 Vol.26 No.1

The relationship between sleep disturbance and subjective cognitive decline has recently come into the spotlight, as researchers continue to look at the effects of sleep disturbance on the early detection of Alzheimer’s disease and the overall well-being of older individuals. Nevertheless, the results of the studies have shown mixed results in tracing the relationship between the process of sleep disturbance and objective indices of decline in cognitive functioning as well as symptoms of depression and anxiety. This present study therefore aimed to examine this process and the effects of affective disturbance. A total of 101 community dwelling older adults in Korea participated in the study, and had their sleep disturbance level, affective disturbance, subjective cognitive decline, and objective cognitive functioning assessed. The results indicated that affective disturbance fully mediated the relationship between sleep disturbance and subjective cognitive decline, even when controlling for objective cognitive functioning. Such results suggests the possibility that subjective cognitive decline, concurrent with sleep problems in the elderly, may be associated with affective disturbance, and affecting depression and anxiety in particular, therefore emphasizing the importance of utilizing a biopsychosocial approach when addressing the health-related complaints of older adults. 수면 문제는 노년기에 흔히 경험하는 문제들 중 하나로 인지기능의 저하와의 관련성이 확인되어왔다. 최근에는 특히 치매의 조기 진단과 노년기 심리적 웰빙에 영향을 주는 주관적 인지 저하와의 관련성이 주목받고 있다. 한편, 수면문제가 주관적인지 저하에 영향을 미치는 과정에서 객관적인지 기능의 저하 여부와 우울, 불안 등의 영향에 대한 연구 결과가 혼재되어 있는 실정이다. 이에 본 연구에서는 노인의 수면 문제가 주관적 인지 저하에 영향을 미치는 기제를 구체적으로 살펴보고자 하였다. 특히 정서장애의 대표적 증상인 우울과 불안, 걱정 등 세 가지 요인으로 구성된 정서적 문제가 수면 문제와 주관적 인지 저하의 관계에 미치는 영향을 알아보고자 하였다. 이를 위해 국내 지역사회 만 60세 이상 성인 101명을 대상으로 수면 문제와 정서적 문제, 주관적 인지 저하, 객관적 인지기능을 측정하였다. 상관분석 결과, 수면 문제와 정서적 문제, 주관적 인지 저하가 모두 서로 유의한 정적 상관을 보인 반면, 객관적 인지기능은 이들 세 변인과 유의한 상관을 보이지 않았다. 객관적 인지기능을 통제한 후, 수면 문제와 주관적 인지 저하의 관계에서 정서적 문제의 매개효과를 검증한 결과, 정서적 문제가 수면 문제와 주관적 인지 저하의 관계를 완전매개하는 것으로 나타났다. 이는 노인들이 수면 문제를 경험하면서 나타나는 주관적 인지 저하가 실제 인지 수행의 저하로 인한 것이기보다는 정서적 문제와 더 큰 관련이 있을 가능성을 제기하며, 노인들의 건강 및 기능 관련 문제 호소에 대한 생물심리사회적 접근의 중요성을 시사한다.

Efficacy of Yokukansankachimpihange on sleep disturbance in Parkinson's disease : A study protocol of a randomized, double blind, placebo-controlled pilot trial

Jang, Jung-Hee,Lee, JuAh,Jung, Inchul,Yoo, Horyong Wolters Kluwer Health 2018 Medicine Vol.97 No.26

<P><B>Abstract</B></P><P><B>Introduction:</B></P><P>Parkinson's disease (PD) is a progressive neurodegenerative disorder that includes motor and nonmotor symptoms. Sleep disturbance is known to decrease the quality of life in patients with PD, and there are limitations to the pharmacotherapy currently in use. Therefore, complementary treatment therapies are required to address these limitations. The traditional herbal medicines Yokukansan (YKS) and Yokukansankachimpihange (YKSCH) have been used to treat insomnia and night crying in children, suggesting their effectiveness against sleep disturbance in patients with PD. We will evaluate whether YKSCH improves sleep disturbance in PD and will identify YKS-related changes in hemodynamic parameters, and neurotransmitter and hormone levels in patients with PD experiencing sleep disturbance.</P><P><B>Methods:</B></P><P>We will conduct a randomized, double-blinded, placebo-controlled parallel trial in 34 patients with PD and sleep disturbance, randomly allocating the patients to either placebo-control (n = 17) or treatment groups (n = 17). The total study period will be 16 weeks; administration of YKSCH or placebo, as intervention, will be performed for a 12-week period, and follow-up will be performed over a 4-week period. All subjects will undergo conventional treatment, and be required to maintain a regular medication schedule throughout the study period. The primary outcome measure will be the Scales for Outcomes in PD-Sleep Scale score, and the secondary outcome measures will be polysomnography results, findings from instruments related to sleep disorders, neurotransmitter and hormone levels, and hemodynamic changes in the brain cortex.</P><P><B>Discussion and conclusions:</B></P><P>This trial will evaluate the effectiveness and safety of YKSCH for sleep improvement in PD with sleep disturbance, and investigate the underlying mechanism of action. We expect improvement in the scores for subjective and objective sleep scales, hemodynamic changes in prefrontal cortical activity, and changes in neurotransmitter and hormone levels. The findings will provide insight into the mechanism underlying the therapeutic effect of YKSCH in PD, and lay the foundation for further studies on whether YKSCH improves sleep disturbance in PD.</P><P><B>Trial registration number:</B></P><P>Clinical Research Information Service (KCT0002869).</P>

Combined effect of emotional labor and job insecurity on sleep disturbance among customer service workers

Sunguk Choi,Kwon Ko,Jae Bum Park,Kyung-Jong Lee,Seungho Lee,Inchul Jeong 대한직업환경의학회 2020 대한직업환경의학회지 Vol.32 No.-

Background: Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance. Methods: This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects. Results: Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22–1.69], 1.18 [0.99–1.40], 1.52 [1.30–1.79] for emotional labor; and 2.00 [1.75–2.29], 2.20 [1.91–2.53], 1.67 [1.45–1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42–3.86), 2.89 (2.26–3.69), and 2.60 (2.06–3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions. Conclusions: Customer service workers suffered from severe sleep disturbances according tothe existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.

Gender Differences in Sleep Disturbance among Elderly Koreans: Hallym Aging Study

Shan-Ai Quan,이용춘,Wen-Jie Li,정진영,김동현 대한의학회 2016 Journal of Korean medical science Vol.31 No.11

Sleep is an important component in our lives as it is necessary throughout one’s entire life span. This study was conducted to elucidate whether there are gender differences in sleep quality and what factors can affect sleep quality in community-dwelling elderly Koreans. A total of 382 subjects (175 males and 207 females) were recruited among elderly aged 45 or over who participated in the 2010 Hallym Aging Study (HAS). They were invited to a general hospital and were evaluated for socioeconomic status, smoking history, and various clinical measures. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A higher score indicates poorer subjective sleep quality, (PSQI global score > 5 suggests sleep disturbance). After adjusting for potential covariates, our results show that alcohol increases the odds for poor sleep (odds ratio [OR] = 3.35, 95% confidence interval [CI] = 1.11–10.10) in males. In females, lack of exercise was the major risk factor of poor sleep as they are 4.46 times more likely to suffer from low sleep quality than those who exercise regularly (95% CI=1.56–13.75). Stress was also a risk factor for poor sleep. It was 5.60 times higher in the “always have stress” group than the “do not have stress” group (95% CI = 1.54–20.34). Thus, alcohol consumption is associated with men’s sleep quality, while exercise and stress level affect women’s.

Effect of Pink Noise on Sleep Quality of College Students

Gyungsik Jeon,Eunbi No,Woojae Han 한국청각언어재활학회 2024 Audiology and Speech Research Vol.20 No.1

Purpose: Sleep is very important to modern people. Recently, various noises that help with sleep have been introduced. The present study attempted to analyze a positive effect of pink noise and sleep quality on college students with high stress regarding career and future employment. Methods: A total of 120 students with normal hearing were participated and randomly divided into three different pink noise types, which were sound of rain, sound of waves, and heart sound. They were asked to listen to the pink noise for an hour before going to sleep for 3 days. Korean version of Pittsburgh Sleep Quality Index (PSQI-K) was measured twice, before and after the experiment, to compare the subjects’ sleep quality after exposure to pink noise with their sleep quality in the everyday sleep environment. Results: With pink noise exposure, the PSQI-K scores were decreased from 5.94 to 2.85. In addition, there were significant differences in three sub-categories of the PSQI-K, i.e., subjective sleep quality, sleep disturbances, and daytime dysfunction with and without sleep-inducing noise. However, there was no statistically significant difference in PSQI-K scores between groups according to the three types of pink noise. Conclusion: Based on the current results, pink noise helped them sleep better although they are being exposed for a very short period. Since the current study collected data only from healthy college students, following research should be conducted to determine the effects of pink noise on sleep disorders.

입원 노인 환자의 수면 장애 요인과 그 상대적 중요도에 관한 연구

백윤아,송미순 노인간호학회 2000 노인간호학회지 Vol.2 No.1

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.