Sleep disturbance is a typical health problem of the elderly. The purpose of this study was to explore the extent of sleep disturbance of Korean elderly, and to identify the influencing and predicting factors. A total of 15216 subjects were interviewed. To measure the quality of sleep, "The Korean Sleep" Scale was used, and as influencing factors on sleep, physical health, emotional and social activity variables were included. In this study, the percentage of a change of sleep pattern was 59.2%, and it was higher in elderly women and in above 80 yrs. But only 10.4% of subjects regarded a change of sleep pattern as a problem, and it was higher in elderly women. Total sleeping time was shorter in female and it was shortest in 65-69yrs. The higher age, the presence of Ds, the longer sickdays, the lower level of ADL and IADL, the more depressive, the more tedious during the daytime, and the less frequent engagement in exercise, the lower quality of sleep measured by KSS. Predicting variables of quality of sleep included depression, boredness during the daytime, sex, the presence of Ds, IADL, the frequency of exercise during a week, and age. These seven variables explained 13% of total quality of sleep. The extent of change of sleep pattern in the elderly is very high. Continuous efforts to increase quality of sleep of the elderly by intervening in factors influencing quality of sleep are needed.

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• Importance of Hypertension and Social Isolation in Causing Sleep Disruption in Dementia
  Sima Ataollahi Eshkoor, Tengku Aizan Hamid, Siti Sa’adiah Hassan Nudin, Chan Yoke Mun
  American Journal of Alzheimer's Disease & Other Dementias®.2014; 29(1): 61.     CrossRef
• The Effects of Social Support and Having a Partner on Sleep Quality in Dementia
  Sima Ataollahi Eshkoor, Tengku Aizan Hamid, Siti Sa’adiah Hassan Nudin, Chan Yoke Mun
  American Journal of Alzheimer's Disease & Other Dementias®.2013; 28(3): 253.     CrossRef

The agitation of dementia patient is a factor which aggravates the care-givers' burdon, and it is needed to develop intervention methods. Hall and Buckwalter hypothesized that an increase in agitation behavior occur when persons experience high levels of stress. This study was conducted to explore the efficacy of hand massage in producing relaxation and decreasing agitation behaviors in persons with dementia. Hand massage was administered once a day in afternoon for 8days to 24 patients and 4days to 23 patients. There was no difference in result between the two groups. Significant differences were found in systolic blood pressure, pulse rate, emotional state from pre to post -intervention with the use of hand massage. The change of systolic blood pressure was 26% explained by ADL, MMSE-K and institutionalized period. The most significant variable was institutionalized period. The change of diastolic blood pressure was 11% explained by ADL, and it was significant. But no decrease in agitation behavior was observed and no increase in functional capacity.

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• Effects of Hand Massage with Nail Art on Depression, Self-esteem, and Vital signs of Elderly Women living in a Nursing Home
  Joo Hyun Kim, Hye Jin Hyun, So Yean Kang, Hye Ri Nam, Mi Jin Shin, Hyun Jung Lee, Young Ran Chae
  Journal of Korean Biological Nursing Science.2016; 18(3): 169.     CrossRef
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Providing care to the dementia elderly with behavioral problem is a major issue in nursing homes today. This study was aimed to explore the nursing staffs' response to aggressive dementia patients, and the effect that the aggressive behavior had on Nsgstaff. The interviews used a semi-structured questionnaire are were carried out from May to July, 1999. The subjects were 23 nursing personnel working in the nursing homes for dementia elderly. The result are as follows; 1. The types of aggressive behavior cited by the subjects was "physical", "linguistic", and "sexual". 2. The factors that caused the behavior were "symptoms of disease", "under- conditioning", "context of nursing care", "unsatisfied need", "relationship to other patients", "change of outer environment", and "invasion of one's own privacy". 3. The response of the subjects were "unhappiness", "stress", "anger", "exaggeration", "anxiety", and "fear". 4. The management strategies listed by nursing personnel used to alleviate aggressive behavior were "ignorance" "patience" "leaving the area" "soothing sounds" "verbal punishment" "restriction and isolation" and "various management skill appliance" "adaptation". 5. The effect that aggressive behavior and were "disturbance of relationship to elderly" "decline in the amount and quality of nursing care" "interruption of task performance" "job exhaustion" "desire to leave the job" "physical impact" "stress on the cognition of others" "anxiety about health and one own future" "interference to family life'. The findings of this study will be useful in understanding the difficulties of nursing personnel when confronting the aggressive behavior of dementia partients. It also is useful as basic data in preparing efficient intervention program for these difficulties.

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• Factors Influencing Job Satisfaction of Nurses Working in Long-term Care Hospitals: Focused on Burnout and Burden for Caring Problematic Behaviors in Dementia
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• Agitation in Home-dwelling Persons with Dementia and Coping Behaviors in Primary Care-givers to the Agitation
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The purpose of study was to develop and validate Korean Sleep Scale A which can be easily administrated by nurse for a wide range of adult subjects. Dimensions of adult concept were derived by literature review. Previously developed sleep scales were also analyzed in order to develop scales items. The Korean sleep scale A was structured as a 15 item, 4 point like type scale. The Scale was tested an 298 female and male adult subjects after pilottest and content validation. The results showed reliability by internal consistency of Cronbach's alpha=75 Construct validity was tested by factor analysis and known group technique. Factor analysis showed 4 factor-sleep pattern, sleep evaluation, sleep result, and cause of sleep disturbance. Theses four factors explained 55.9% of total variance. Correlations between factors ranged from .15-.32. There was correlation among Korean Sleep Scale A score, Verran and Snyder-Halpern(VSH) Sleep Scale scale, and sleep satisfaction scale score, r= .71(p=.00), r=.51(p=.03), respectively. These study results partially support reliability, construct validity, and criterion related validity of Korean Sleep Scale A. Further validation study is required with other subjects and other settings.

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Sleep is an essential component for health and the quality of life individuals, and is affected by multiple factors. Thereby, sleep impairment is know to be frequent even in health subjects. The purpose of the study is to compare sleep patterns and related factors between healthy young and old adults and to identify aging effects upon sleep in a cross-sectional way. The survey questionnaire was developed by translation and modification of two well-know sleep questionnaires which were originally developed by Monroe(1967) and Ellis, et al.(1982). Discussion with experts and pilot study were completed to finalize the contents of the questionnaire that was used in this study. Results are as follows : 1. Sleep complaints were lower in older adults. 2. The most frequent variables that explain sleep satisfaction were feeling rested in the morning in the older adults and feeling rested and falling asleep within five minutes in the young adults. 3. Regarding sleep-disturbing factors, physical factors were more frequently reported in the older adults and environmental factors are reported more frequently in the young adults. and there was no difference related to the emotional factors between the two groups. 4. Young adults were practiced strategies for better sleep more often than the older adults, and they were mainly in-home activities just before sleep. 5. Sleep patterns which change with aging were as follows : going to bed and waking up earlier ; not staying in the bed long after waking up ; getting harder to fall asleep ; frequent arousal after sleep onset ; getting harder to go back to sleep after arousal during night sleep. From the results of this study, it can be concluded that sleep and related factors of the young and the older adults are different. Also, sleep patterns change with aging and those changes seem to be negative for sleep in the elderly. Repeated studies are needed to establish more concrete information regarding sleep patterns. In addition, further research is needed to develop more reliable, valid, and feasible sleep measure tools, and to develop and evaluate nursing interventions.

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