Paper
Thursday, July 12, 2007
Psychosocial Factors Associated with Sleep Quality in Older Adults living in the Community: A Path Analysis
Wen-Chun Liao, PhD, RN1, Yn-Jen Tzeng, BS, RN1, Yueh-Hsia Tzeng, PhD2, Hsin-Tien Hsu, RN, PhD3, and Shiow-Li Huang, PhD, RN4. (1) Nursing, Chun Shan Medical University, Taichung, Taiwan, (2) Nursing, National Taichung Institute of Technology, Taichung, Taiwan, (3) Nursing Department, Chang Gung Institute of Technology, Tao-Yuan, Taiwan, (4) School of Nursing, Chang Gung University, Tao-Yuan, Taiwan
| Learning Objective #1: learn what psychosocial factors predict sleep quality in community dwelling elderly. |
| Learning Objective #2: learn how psychosocial management improves sleep quality in elders living in community. |
Insomnia is a common complaint in the elderly, but little effort has been made to evaluate how physical-psychosocial dimensions are related to the overall sleep quality. Secondary analyses of data obtained from a cross-sectional survey of 259 community dwelling elders (mean age 76.0±6.4 years) was conducted to examine how physical-psychosocial factors impact sleep quality. The Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) were used to evaluate sleep quality, anxiety and depression state, respectively. Higher scores in these scales indicate poor sleep or more anxiety and depression. A conceptual framework and bivariate correlations guided a series of multiple regressions to identify the best predictors for sleep quality. Demographic variables of age and gender were originally controlled in all analyses but discard due to no effect on sleep quality. Results showed that anxiety (B=.431), depression (B=.209), and disease number (B=.224) had direct effects on sleep quality and predicted poorer sleep quality (R2=.412). Leisure activies (B=-.527, -.916) and exercise (B=.-.691, -1.432) had direct effects on anxiety (R2=.136) and depression (R2=.157), but no direct effects on sleep quality. The main effects of leisure activies and exercise on better sleep quality were indirect through lowering anxiety and depression. This study partially explains the relationships between psychosocial factors and sleep quality. Anxiety and depression are the leading causes of poor sleep in older adults living in community. Elders who exercise and participate in more leisure activities in any kind are less anxious and depressed. Findings in this study provide evidence-based practice for health providers in developing exercise program and leisure activities for community dwelling elderly.