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The Effects of Non-pharmacological Interventions on Sleep among Older Adults in Korean Long-term Care Facilities: A Systematic Review and Meta-analysis
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Sun Ok Jung, Hye Young Kim, Eun Ju Choi
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J Korean Acad Community Health Nurs. 2022;33(3):340-355. Published online September 30, 2022
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DOI: https://doi.org/10.12799/jkachn.2022.33.3.340
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 Abstract
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- Purpose
This study aimed to examine the effects of non-pharmacological sleep intervention programs in improving sleep quality among older adults in long-term care facilities.
Methods: A literature search and selection was performed on nine different databases using the guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Overall, 14 studies met the inclusion criteria and were systematically reviewed. For the metaanalysis, the effect size was estimated using the random-effects model in Review Manager (RevMan) desktop version 5.4 of the Cochrane Library.
Results: The meta-analysis of overall non-pharmacological interventions obtained a total effect size of 1.0 (standardized mean difference [SMD]=1.0, 95% confidence interval [CI]: 0.64~1.35), which was statistically significant (Z=5.55, p<.001). The most frequently studied non-pharmacological intervention was aroma therapy, with an effect size of 0.61 (SMD=0.61, 95% CI: 0.14~1.08), which was statistically significant (Z=2.55, p=.010). In the subgroup analysis, group-based interventions, interventions for >4 weeks, and untreated control studies were more effective.
Conclusion: This study confirms that non-pharmacological interventions are effective in improving sleep quality among older adults in long-term care facilities. However, the sample size was small and the risk of bias in assessing the interventions of individual studies was unclear or high, thereby limiting the generalizability of the results. Further reviews that evaluate randomized control trials, evidence-based interventions that consider older adult participants' physical activity levels, different intervention methods and durations, and different control group intervention types are needed to obtain more conclusive evidence.
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Relationships among Perceived Life Stress, Self-esteem and Depression in Middle-Aged Women
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Geum Ja Park, Ji Hyun Lee, Mi Ok Kim, Boo Kyeong Bang, Su Jung Youn, Eun Ju Choi
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J Korean Acad Community Health Nurs. 2002;13(2):354-362. Published online June 30, 2002
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Abstract
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- OBJECTIVES
This study was conducted to examine the relationships among perceived life stress, self-esteem, and depression in middleaged women.
METHODS
Data were collected from March 30 to May 25, 2000. The study subjects were 123 middle-aged women living in Pusan. The instruments used for this study were the Perceived Life Stress scale developed by Lee (1984), based on the original scale designed by Yu, et al. (1994), Self-esteem scale developed by Rho, et al. (1997), and the Depression scale developed by Ahn (1988). For data analysis, the SPSS PC+ was utilized, by which frequency and percentage, mean and standard deviation, t-test, ANOVA, Sheffe's test and Pearson's correlation coefficients were examined. The reliability of the instruments were tested by Cronbach's alpha, showing the internal consistency of 0.7328 for the self-esteem scale, and 0.8987 for the depression scale.
RESULTS
1) The results showed a relatively low perceived life stress score in the middle-aged women with a mean and standard deviation of 363.18 and 72.92 (range: .00 - 1877.38).
2) The results showed a relatively high self-esteem score in the middle-aged women with a mean and standard deviation of 29.77 and 5.06 (range: 10 - 40).
3) The results showed a relatively high depression score in the middle-aged women with a mean and standard deviation of 39.46 and 9.38 (range: 0 - 61).
4) There were no statistically significant differences in perceived life stress by demographic related factors.
5) There were statistically significant differences in self-esteem by health status (F= 8.930, p= .000) and economic status (t=4.792, p= .010).
6) There were statistically significant differences in depression by age (F=3.770, p= .0261), education (F=4.850, p= .003) and regularity of menstrual cycle (F=13.180, p= .000).
7) There was no statistically significant correlation between perceived life stress, and self-esteem in the middle-aged women (r=-.077, p= .399).
8) There was no significant correlation between perceived life stress, and depression in the middle-aged women (r= .010, p= .916).
9) There was a significant negative correlation between self-esteem, and depression in the middle-aged women (r=- .359, p= .000).
CONCLUSION
Higher self-esteem was related to a lower depression status. Therefore, it is necessary to elevate the level of self-esteem in order to reduce the level of depression in middle-aged Korean women.
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KACHN
