As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means and SD, and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role and economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were 'the prognosis of disease', 'the communication trouble with the medical team and interpersonal relationships'. 'The change of daily life' was not a perceived factor by nurses, but ranked third by patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship, the patient group reported that the worst disturbance was due to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors, the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded 'physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or in favorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information, the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.
Sleep is a necessity for survival, Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of 60 and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparison between before and after admission of their sleep pattern, "sleep onset" tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics : 37.5%), physiological factor(snoring : 59.4%) environmental factor(pillow : 78.1%), emotional factor(anxiety related to disease : 37.5%), and illness factor(fatigue : 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop intervention strategies to promote sleep and to prevent sleep problems.