INTRODUCTION:

Sleep and rest are basic human needs essential to all individual’s physical and psychological wellbeing. About one third of our lives are spent in sleeping. The purpose of sleep is a mystery; however it is necessary for good health and a sense of wellbeing.

¹Sleep is a state of decreased awareness of environmental stimuli that is distinguished from states such as coma or hibernation by its relatively rapid reversibility. Sleeping individuals move little and tend to adopt stereotypic postures, generally recognizes when he or she feels sleepy and is aware that he or she has been asleep at the termination of an episode.

Ruth M. Benca M.D., Ph.D. (2006) stated that in addition to cognitive impairment, sleep deprivation in humans may also affect various physiological systems with impacts on overall health². It has been suggested that sleep loss can affect host defense systems.

³The frequency of sleep/wake complaints rises progressively with age. Complaints of difficulty initiating sleep and early morning awakening become relatively more prevalent in older.

Sleep disturbances are the most common mental disorders reported among the older people in various countries. Thus, investigator felt the present study provide the information about the Quality of Sleep among elderly residents at old age homes, Salem.

OBJECTIVES:

1. To assess the level of quality of sleep among the elders residing at selected old age homes.

2. To associate the quality of sleep among the elders with their selected socio-demographic variables.

NULL HYPOTHESIS:

Ho: There will not be any significant association between the quality of sleep among the elders and their selected demographic variables at 0.05 level of significance.

MATERIALS AND METHODS:

Research Approach

⁴Quantitative Research Approach was adopted for this study.

Research Design

The research design chosen for this study was descriptive research design

Population

Population refers to the elders with the age group of more than 50 years who are residing in selected old age homes, Salem.

Sampling

Sample:

Elderly people who were fulfill the sampling criteria included for the study.

Sample size:

The sample size of this study was 60.

Sampling technique:

The technique adopted for this study was Non-probability, Convenient sampling technique.

Criteria for sample selection

Inclusion Criteria:

· Those who are in the age group of 50-85 years.

· Both Male and female participants.

· Those who are willing to participate in the study

Exclusion Criteria:

· Those who have hearing impairment.

· Those who are seriously ill during the period of data collection.

Data Collection Procedure

The data was collected between 13.07.2011 to 7.08.2011. Two old age homes were selected for this study. They were Henry old age home, Salem and Saradha old age home, Salem. In Henry old age home, the investigator selected a list of 37 elders who fulfilled the sampling criteria from a total of 57 elders. Similarly in Saradha old age home the investigator selected a list of 23 elders who are fulfilled the sampling criteria from a total of 52 elders. The investigator conducted the interview to assess the quality of sleep with the help of a structured interview schedule (Modified Pittsburgh sleep Quality index) was used to assess the quality of sleep among the elders. It consists of 4 point rating scale and the score ranges between 0 – 3.

Method of data collection

Self report

Tool used for the study:

Structured interview schedule

Descriptions of the Tool

Section I: Demographic variables

This section deals with demographic data in relation to age, sex, religion, marital status, education, present medical illness, duration of stay in old age home, frequency of visit and mode of entry into the old age home.

Section II: Modified Pittsburgh Sleep Quality Index to assess the quality of sleep among the elders

⁵Modified Pittsburgh Sleep Quality Index, (reliability was established by split half technique {0.76} ) was used to assess the quality of sleep among elders. It is a 4 point rating scale and the score ranges between 0 – 3.

DATA ANALYSIS AND INTERPRETATION:

Part – I

Table: 1 FREQUENCY AND PERCENTAGE DISTRIBUTION OF THE ELDERS ACCORDING TO THEIR SOCIO- DEMOGRAPHIC VARIABLES N = 60

S. No	Personal Variables	Frequency	Percentage
S. No	Personal Variables	Frequency	Percentage
1	Age in years
	50 – 60 61-70 71-80 81and above	8 25 25 2	13.35 41.67 41.67 3.33
2.	Sex
	a. Male b. Female	26 34	43.33 56.67
3.	Religion	40 - 20 -	66.67 - 33.33 -
	a. Hindu Muslim Christian
	Others
4.	Marital status a. Married b. Single c. Widow/widower d. Separated or divorced	37 14 7 2	61.67 23.33 11.67 3.33
5.	Educational status Illiterate Primary education Secondary education Graduate Post graduate	21 31 8 - -	35 51.67 13.33 - -
6.	Any present medical illness a. Diabetes mellitus b. Hypertension c. Cardiac problem d. Ortho problem Other problem	18 18 9 2 13	30 30 15 3.33 21.67

Table -1 shows that the distribution of elders according to their selected socio – demographic variables. Maximum no of participants (41.67 %) were belongs to age group of 50-60 yrs and 61- 70 yrs, 56.67 %of the elders were females, 66.67 % of them were Hindu, 61.67 % of them were married, 51.67 % of them were primary educated and 30 % of them had diabetes and hypertension respectively

TABLE: 2 Frequency and percentage distribution of the elders according to their habitual variables

S. No	Habitual variables	Frequency	Percentage
1.	Duration of stay in old age home
1.	0-1 years 2-3 years 4-5 years above 5 years Never	2 33 18 7	3.33 55 30 11.67
2.	Mode of entry into old age home
	Voluntary by Force brought by police other organisation	41 18 1 -	68.33 30 1.67 -
3.	Frequency of visits by family members
	daily Frequently Occasionally Never	13 37 10 -	21.67 61.67 16.66 -

Table -2 show that the distribution of the elders according to their habitual variables. It shows the higher percentage

(55%) of elders stayed for 2-3 years, 61.67% of them had visitors frequently and 68.33% of them joined voluntarily in old age home.

Part - II level of quality of life among elders according to modified Pittsburgh Sleep Quality Index Scale

FIGURE: 1 Level of Quality of sleep Among Elders

The above Fig- 1 shows that 5% of them had good quality of sleep, 48.33% of them had fair quality of sleep and 46.67% of them had poor quality of sleep.

Part-III Association between the quality of sleep among elders and their selected socio – demographic variables

Table -3: Association between the quality of sleep among elderly and their selected personal variables

S. No	Personal Variables	Chi Square λ		Level of significant
S. No	Personal Variables	Calculated Value	Table value	Level of significant
1	Age in years ⁶			Non Significant
	50 – 60 61-70 71-80 81and above	5.45	12.59	Non Significant
2.	Sex
	Male Female	2.41	5.69	Non Significant
3.	Religion	2.41	12.59	Non Significant
	Hindu
	Christian
4.	Marital status Married Single Widow/widower Separated or divorced	13.56 *	12.59	Significant
5.	Education Illiterate Primary education Secondary education	21.38 *	12.59	Significant
6.	Any present medical illness Diabetes mellitus Hypertension Cardiac problem Ortho problem Other problem	6.63	15.5	Non Significant

The above Table-3 show that there is significant association between the quality of sleep among the elders and their Socio - demographic variables like marital status, and educational status. Hence the Null hypothesis is rejected.

It also shows that there is no significant association between the quality of sleep among the elders and their demographic variables like age, sex, religion and medical illness. Hence null hypothesis is accepted.

Table -4: Association between the quality of sleep among the elders and their selected Habitat variables

Sl. no	Habitat variables	Chi Square λ		Level of significant
Sl. no	Habitat variables	Calculated Value	Table value	Level of significant
1.	Duration of stay in old age home 0-1 years 2-3 years 4-5 years Above 5 years	14.39*	12.59	Significant
2.	Frequency of visit by family members. Daily Frequently. Occasionally	9.07	12.59	Non-Significant
3.	Mode of entry into old age home Voluntary By force Brought by police	2.486	12.59	Non-Significant

The above Table-4 shows that there is significant association between the quality of sleep among elderly and their duration of stay in old age home. It shows that there is no association between the quality of sleep among elderly and their demographic variables like mode of entry and frequency visit by family members. Hence the null hypothesis is rejected.

DISCUSSION:

This study was done to assess the quality of sleep among the elders residing at selected old age homes, Salem.

Out of 60 elders 3(5%) of them had good quality of sleep, 29(48.33%) of them had fair quality of sleep and 28(46.67%) of them had poor quality of sleep. Findings of the study were supported by the other study which was a case control study on quality of sleep and factors disturbing sleep among elderly at selected hospital erode. The researcher concluded that 56.5% have severe sleep disturbance, 12.5% had moderate sleep disturbance, 26.5 had mild sleep disturbance and 4.55% had no sleep disturbance.

RECOMMENDATION:

1. A study can be conducted with large sample size to generalize the results of the study

2. The study can be carried out for a longer period of time

3. The study can be carried to assess the quality of life among the elderly residents of old age home

4. A similar study can be conducted using experimental and control group

5. Research can be conducted to find out the various innovative methods to improve the sleep of the elders

6. Researchers should focus on non-pharmacological interventions to promote sleep

CONCLUSION:

The study was done to assess the quality of sleep among elders at selected old age homes in Salem. The result of this study showed that most of the elders had fair and poor quality of sleep. As the elderly population increase in number in the world, nurses are in position to care of those elderly. Nurse administrator can make arrangements for non-pharmacological intervention to reduce their sleep related problem.

REFERENCES:

1. Kaplan H.P. and Sadok. B.J,. Modern Synopsis of Comprehensive Text Book of Psychiatry. Williams and Williams. Baltimore. 1982; 3^rd ed.

2. Henry Kellerman,. Text book of sleep disorder. New York, Mazel Publishers, 1986.

3. Bhatia. M.S. Text Book of Psychiatry. C.B.S Publishers and Distributors, New Delhi, 2007; 3^rded.

4. Burns, Nancy and Susan, K. Grove, (2004).The Practice of Nursing Research. Conduct. Crialle and Utilization, (5^thedition), W. B Sunders Company, Philadelphia.

5. Daniel. J, Buysse. Review of sleep and psychiatry. (1^st edition), American Psychiatry Publications, Washington, 2005; 1^st ed

6. Pressman and Auther Mark. Sleep duration from ages 20 to 50 years, 2009. A review. available from: URL: http://from www.medicinenet.com/sleep/article.htm/augest 2011

Received on 28.08.2013 Modified on 11.12.2013

Asian J. Nur. Edu. & Research 4(2): April- June 2014; Page 161-164