Development of a self-evaluation scale of nursing practices for improving sleep quality among dementia patients taking sleeping pills
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Abstract
Background & Aim: Many patients with dementia experience sleep-related issues. However, the nursing practices that address those issues are unclear. Therefore, to develop a self-assessment scale of nursing practices to improve sleep quality in patients with dementia taking sleep medication and confirm its validity and reliability.
Methods & Materials: In this mixed-methods study, qualitative research was conducted by interviewing six expert-level nurses with a wealth of experience in caring for patients with dementia; then, quantitative survey questions were administered. The preliminary scale was created and evaluated its face validity. This quantitative study was conducted using questionnaire surveys among nurses with psychiatric ward experience employed at dementia treatment centers across Japan. Data from 525 nurses were used to verify the validity and reliability of the scale.
Results: Exploratory factor analysis resulted in a three-factor, 16-item scale. Criterion validity was confirmed by calculating correlation coefficients with existing scales (the self-evaluation scale of oriented problem-solving behavior in nursing practice) as external criteria (r= 0.574, p< .05). The sum of scale scores and Cronbach’s α coefficients for the three factors all exceeded 0.7.
Conclusion: The development of this scale will improve the quality of nursing practice for patients with dementia who take sleeping pills. Additionally, it provides foundational research on nursing practice for the appropriate use of medications, as it offers evidence that nurses participate in drug treatment.
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19. Yang YY, Hsiao CH, Chang YJ, Ma SC, Wang JJ. Exploring dementia care competence of nurses working in acute care settings. Journal of Clinical Nursing. 2022 Jul;31(13-14):1972-82. https://doi.org/10.1111/jocn.15190.
20. Melina E, Andreas C, Nicos M, Evridiki P. Nurses’ knowledge and attitudes about dementia care: Systematic literature review. Perspectives in psychiatric care. 2019 Jan;55(1):48-60. https://doi.org/10.1111/ppc.12291.
21. Benner P. From novice to expert. Excellence and power in clinical nursing practice, commemorative edition. Hoboken: Prentice Hall; 2001.
22. Hair JF, Black WC, Babin BJ, & Anderson RE. Confirmatory Factor Analysis. Multivariate data analysis. 2014;599-638.
23. Zwakhalen SM, Hamers JP, Peijnenburg RH, Berger MP. Nursing staff knowledge and beliefs about pain in elderly nursing home residents with dementia. Pain Research and Management. 2007 Jan;12(3):177-84. https://doi.org/10.1155/2007/518484.
24. El-Gilany AH, Saleh NMH, Mohamed H, Elsayed EBM. Prevalence of insomnia and its associated factors among rural elderly: A community based study. International Journal of Advanced Nursing Studies. 2017;6(1):56. http://doi.org/10.14419/ijans.v6i1.7415.
25. Tanaka H, Taira K, Arakawa M, Urasaki C, Yamamoto Y, Okuma H, et al. Short naps and exercise improve sleep quality and mental health in the elderly. Psychiatry and Clinical Neurosciences. 2002 Jun;56(3):233-4. https://doi.org/10.1046/j.1440-1819.2002.00995.x.
26. Sella E, Toffalini E, Canini L, Borella E. Non-pharmacological interventions targeting sleep quality in older adults: A systematic review and meta-analysis. Aging and Mental Health. 2022:1-15. https://doi.org/10.1080/13607863.2022.2056879.
27. Legere LE, McNeill S, Schindel Martin L, Acorn M, An D. Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews. Journal of Clinical Nursing. 2018 Apr;27(7-8):e1360-76. https://doi.org/10.1111/jocn.14007.
2. Kabir ZN, Leung AYM, Grundberg Å, Boström AM, Lämås K, Kallström AP, et al. Care of family caregivers of persons with dementia (CaFCa) through a tailor-made mobile app: Study protocol of a complex intervention study. BMC Geriatrics. 2020 Dec;20(1):305.
https://doi.org/10.1186/s12877-020-01712-7.
3. Velandia PP, Miller-Petrie MK, Chen C, Chakrabarti S, Chapin A, Hay S, Tsakalos G, Wimo A, Dieleman JL. Global and regional spending on dementia care from 2000–2019 and expected future health spending scenarios from 2020–2050: An economic modelling exercise. EClinicalMedicine. 2022 Mar 1;45:101337. https://doi.org/10.1016/j.eclinm.2022.101337.
4. McDonald EM, Caslangen J. Benzodiazepine use and falls in older adults: Is it worth the risk? Research in Gerontological Nursing. 2019 Sep;12(5):214-6.
https://doi.org/10.3928/19404921-20190813-01.
5. Woods DL, Phillips LR, Martin JL. Biological basis for sleep disturbance and behavioral symptoms in dementia: A biobehavioral model. Research in Gerontological Nursing. 2011 Oct;4(4):281-93.
https://doi.org/10.3928/19404921-20110302-01.
6. McCurry SM, Reynolds III CF, Ancoli-Israel S, Teri L, Vitiello MV. Treatment of sleep disturbance in Alzheimer's disease. Sleep Medicine Reviews. 2000 Dec;4(6):603-28.
7. Moran M, Lynch CA, Walsh C, Coen R, Coakley D, Lawlor BA. Sleep disturbance in mild to moderate Alzheimer's disease. Sleep Medicine. 2005 July;6(4):347-52.
8. Donnelly K, Bracchi R, Hewitt J, Routledge AR, Carter B. Benzodiazepines, Z-drugs and the risk of hip fracture: A systematic review and meta-analysis. PloS one. 2017 Apr;12(4):e0174730. https://doi.org/10.1371/journal.pone.0174730.
9. O’Mahony D, O’Sullivan D, Byrne S, O’Connor MN, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: Version 2. Age and Ageing. 2015 Oct;44(2):213-8. https://doi.org/10.1093/ageing/afu145.
10. Pottie K, Thompson W, Davies S, Grenier J, Sadowski CA, Welch V, et al. Deprescribing benzodiazepine receptor agonists: Evidence-based clinical practice guideline. Canadian Family Physician. 2018 May;64(5):339-51.
11. American Geriatrics Society 2015 Beers Criteria Update Expert Panel, Fick DM, Semla TP, Beizer J, Brandt N, Dombrowski R, DuBeau CE, Eisenberg W, Epplin JJ, Flanagan N, Giovannetti E. American Geriatrics Society 2015 updated beers criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society. 2015 Nov;63(11):2227-46. https://doi.org/10.1111/jgs.13702.
12. Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: The process of deprescribing. JAMA Internal Medicine. 2015 May;175(5):827-34. https://doi.org/10.1001/jamainternmed.2015.0324.
13. Tannenbaum C, Martin P, Tamblyn R, Benedetti A, Ahmed S. Reduction of inappropriate benzodiazepine prescriptions among older adults through direct patient education: The EMPOWER cluster randomized trial. JAMA Internal Medicine. 2014 Jun;174(6):890-8. https://doi.org/10.1001/jamainternmed.2014.949.
14. Clinical medication review—A practice guide. Available at: https://www.coursehero.com/file/119342024/345759510-MedicationReview-PracticeGuide2011pdf/. Accessed August 26, 2022.
15. Bosch-Lenders D, van den Akker M, Stoffers HE, van der Kuy H, Schols JM, Knottnerus JA. How much do patients and health professionals (really) know? The surplus value of a home visit to the patient with polypharmacy by the practice nurse, to support medication reviews in primary care Tijdschr Gerontol Geriatr. 2013 Apr;44(2):72-80. https://doi.org/10.1007/s12439-013-0015-7.
16. Lader M. Benzodiazepine harm: How can it be reduced? British Journal of Clinical Pharmacology. 2014 Feb;77(2):295-301. https://doi.org/10.1111/j.1365-2125.2012.04418.x.
17. Frazier SC. Health outcomes and polypharmacy in elderly individuals: An integrated literature review. Journal of Gerontological Nursing. 2005 Sep; 31(9):4-9. https://doi.org/10.3928/0098-9134-20050901-04.
18. Merve AA, Seher GŞ, Burcu AS, Özlem K. Assessment of Dementia Knowledge Scale for the nursing profession and the general population: Cross-cultural adaptation and psychometric validation. Dementia and Geriatric Cognitive Disorders. 2021;50(2):170-7.
19. Yang YY, Hsiao CH, Chang YJ, Ma SC, Wang JJ. Exploring dementia care competence of nurses working in acute care settings. Journal of Clinical Nursing. 2022 Jul;31(13-14):1972-82. https://doi.org/10.1111/jocn.15190.
20. Melina E, Andreas C, Nicos M, Evridiki P. Nurses’ knowledge and attitudes about dementia care: Systematic literature review. Perspectives in psychiatric care. 2019 Jan;55(1):48-60. https://doi.org/10.1111/ppc.12291.
21. Benner P. From novice to expert. Excellence and power in clinical nursing practice, commemorative edition. Hoboken: Prentice Hall; 2001.
22. Hair JF, Black WC, Babin BJ, & Anderson RE. Confirmatory Factor Analysis. Multivariate data analysis. 2014;599-638.
23. Zwakhalen SM, Hamers JP, Peijnenburg RH, Berger MP. Nursing staff knowledge and beliefs about pain in elderly nursing home residents with dementia. Pain Research and Management. 2007 Jan;12(3):177-84. https://doi.org/10.1155/2007/518484.
24. El-Gilany AH, Saleh NMH, Mohamed H, Elsayed EBM. Prevalence of insomnia and its associated factors among rural elderly: A community based study. International Journal of Advanced Nursing Studies. 2017;6(1):56. http://doi.org/10.14419/ijans.v6i1.7415.
25. Tanaka H, Taira K, Arakawa M, Urasaki C, Yamamoto Y, Okuma H, et al. Short naps and exercise improve sleep quality and mental health in the elderly. Psychiatry and Clinical Neurosciences. 2002 Jun;56(3):233-4. https://doi.org/10.1046/j.1440-1819.2002.00995.x.
26. Sella E, Toffalini E, Canini L, Borella E. Non-pharmacological interventions targeting sleep quality in older adults: A systematic review and meta-analysis. Aging and Mental Health. 2022:1-15. https://doi.org/10.1080/13607863.2022.2056879.
27. Legere LE, McNeill S, Schindel Martin L, Acorn M, An D. Nonpharmacological approaches for behavioural and psychological symptoms of dementia in older adults: A systematic review of reviews. Journal of Clinical Nursing. 2018 Apr;27(7-8):e1360-76. https://doi.org/10.1111/jocn.14007.
| Files | ||
| Issue | Vol 10 No 1 (2023): Winter | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/npt.v10i1.12255 | |
| Keywords | ||
| dementia; sleep aids; nursing evaluation research | ||
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How to Cite
1.
Iwamoto Y, Fujino N, Furuno T, Fujimoto Y. Development of a self-evaluation scale of nursing practices for improving sleep quality among dementia patients taking sleeping pills. NPT. 2023;10(1):32-43.
