Dataset Information

Nursing Home Eligible, Community-Dwelling Older Adults' Perceptions and Beliefs About Sleep: A Mixed-Methods Study.

ABSTRACT: Sleep disturbances are highly prevalent in older adults; little is known about sleep in those who remain living in the community despite qualifying for nursing home placement. We conducted a concurrent, nested, mixed-methods study to describe sleep characteristics and sleep disturbances in this population. Our final sample (n = 40) was Black (100%), female (85%) older adults with a mean (±SD) age of 72 ± 9.5 years. Of these, 35 had objectively measured short or long sleep duration, and 30 had subjectively reported poor sleep quality. Our evidence suggests that sleep disturbances are common in this group, and these older adults had adjusted their expectations and adapted to their sleep disturbances. Given that at-risk older adults may not perceive their sleep disturbances as problematic, clinicians must proactively assess sleep and educate about the importance of sleep. These results reveal modifiable factors with potential to improve health outcomes in this vulnerable population.

SUBMITTER: McPhillips MV

PROVIDER: S-EPMC6859197 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Nursing Home Eligible, Community-Dwelling Older Adults' Perceptions and Beliefs About Sleep: A Mixed-Methods Study.

McPhillips Miranda V MV Dickson Victoria V VV Cacchione Pamela Z PZ Li Junxin J Gooneratne Nalaka N Riegel Barbara B

Clinical nursing research 20190518 3

Sleep disturbances are highly prevalent in older adults; little is known about sleep in those who remain living in the community despite qualifying for nursing home placement. We conducted a concurrent, nested, mixed-methods study to describe sleep characteristics and sleep disturbances in this population. Our final sample (<i>n</i> = 40) was Black (100%), female (85%) older adults with a mean (±<i>SD</i>) age of 72 ± 9.5 years. Of these, 35 had objectively measured short or long sleep duration, ...[more]

PMID: 31104492

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Project description:IntroductionOptimal medication management is one of the basic conditions necessary for home-dwelling older adults living with multiple chronic conditions (OAMCC) to be able to remain at home and preserve their quality of life. Currently, the reasons for such high numbers of emergency department visits and the very significant rate of hospitalisations for OAMCC, due to medication-related problems (MRPs), is poorly explored. This study aims to reveal the current state of the medication management practices of polymedicated, home-dwelling OAMCC and to make proposals for improving clinical and medication pathways through an innovative and integrated model for supporting medication management and preventing adverse health outcomes.Methods and analysisA mixed-methods study will address the medication management of polymedicated, home-dwelling OAMCC. Its explanatory sequential design will involve two major phases conducted sequentially over time. The quantitative phase will consist of retrospectively exploiting the last 5 years of electronic patient records from a local hospital (N ≈ 50 000) in order to identify the different profiles-made up of patient-related, medication-related and environment-related factors-of the polymedicated, home-dwelling OAMCC at risk of hospitalisation, emergency department visits, hospital readmission (notably for MRPs), institutionalisation or early death. The qualitative study will involve: (a) obtaining and understanding the medication management practices and experiences of the identified profiles extracted from the hospital data of OAMCC who will be interviewed at home (N ≈ 30); (b) collecting and analysing the perspectives of the formal and informal caregivers involved in medication management at home in order to cross-reference perspectives about this important dimension of care at home. Finally, the mixed-methods findings will enable the development of an innovative, integrated model of medication management based on the Agency for Clinical Innovation framework and Bodenheimer and Sinsky's quadruple aim.Ethics and disseminationEthical approval has been obtained from the Human Research Ethics Committee of the Canton Vaud (2018-02196). Findings will be disseminated in peer-reviewed journals, professional conferences and other knowledge transfer activities with primary healthcare providers, hospital care units, informal caregivers' and patients' associations.

Project description:BackgroundGhana is experiencing an epidemiological shift in public health issues toward non-communicable diseases that are underpinned by modifiable health behaviors. Physical activity rates have decreased, especially among older adults, coinciding with urbanization and an increase in sedentary work. Community-based physical activity programs are a recommended method of increasing physical activity levels; however, none currently exist in Ghana. The aim of this exploratory study was to determine older Ghanaian adults' perceptions of physical activity and asses fit and feasibility of adapting and delivering a physical activity program for this population.MethodsThrough a concurrent exploratory mixed-methods design, data were gathered from Ghanaian older adults (N = 123) during focus groups (N = 10) conducted at one diabetes clinic and nine churches across three urban areas. Qualitative data were collected using a semi-structured script that prompted for responses related to physical activity perceptions and the fit and feasibility of physical activity program characteristics. Quantitative data were collected through a questionnaire assessing participant demographics, physical activity levels, and health rating as well as physical activity knowledge and self-efficacy.ResultsFindings indicate that older adults in Ghana have a need for and an interest in physical activity promotion. Participants had positive perceptions of being physically active, but were unaware of physical activity guidelines and how to meet them. Peer influence and health care providers' recommendations were motivating factors for physical activity participation. As for desired physical activity program characteristics, participants expressed interest in group-based activities and becoming peer leaders and preference for a church-based program.ConclusionsThe results suggest that a group-based physical activity program encouraged by health care providers and delivered at churches through a train-the-trainer model would be well received by aging adults from three urban areas of Ghana. In addition, education on physical activity types is needed, along with better dissemination and education on Ministry of Health physical activity guidelines. This exploratory work highlights preliminary support for a group- and community-based physical activity program for the aging population in Ghana. Beginning with the end in mind, these program characteristics should be considered when adopting, adapting, and implementing an intervention with this population.

Dataset Information

Nursing Home Eligible, Community-Dwelling Older Adults' Perceptions and Beliefs About Sleep: A Mixed-Methods Study.

Publications

Nursing Home Eligible, Community-Dwelling Older Adults' Perceptions and Beliefs About Sleep: A Mixed-Methods Study.

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