The purpose of this study was to investigate the effects of aromatherapy on sleep quality.

This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese.

The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (Q_B=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant.

A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

This study aimed to develop and test a structural model for sleep quality in female shift work nurses. The hypothetical model was constructed on the basis of Spielman's 3P model of insomnia and previous research related to the sleep quality of shift nurses.

This cross-sectional study used structural equation modeling and recruited 285 female shift work nurses from four general and university hospitals with over 300 beds located in C and J cities in Gyeongsangnamdo. Data were collected from September 27 to October 20, 2016, and then analyzed using descriptive statistics, Pearson's correlation, and structural equation modeling. The study used SPSS/Win 18.0 and AMOS 18.0 in processing the data.

The final model showed good fit to the empirical data: χ²/df=2.19, SRMR=.07, RMSEA=.07, AGFI=.85, TLI=.91, GFI=.93, GFI=.89, NFI=.87. The factors that influenced sleep quality were sleep hygiene (β=.32), perceived shift work status (β=−.16), stress response (β=.16), shift work experience (β=.15), perceived health status (β=−.14), and circadian rhythm (β=−.13) explaining 36.0% of the variance.

The model of sleep quality of the shift work nurses constructed in this study is recommended as a model to understand and predict the sleep quality of shift work nurses. The results suggest that strategies for improving the sleep quality of shift work nurses should focus on sleep hygiene, perceived health status, stress response, circadian rhythm, perceived shift work status, and shift work experience.

This study aimed to examine the effects of cognitive behavior therapy for insomnia (CBT-I) based on the mobile social networking service (SNS) on dysfunctional beliefs and attitudes about sleep, sleep quality, daytime sleepiness, depression, and quality of life among rotating-shift nurses in a hospital in Korea.

A nonequivalent control group pre-post test design was used. The participants included 55 nurses with rotating three-shift work (25 in the experimental group and 30 in the control group). For the experimental group, CBT-I using mobile SNS was provided once a week for 60 minutes over six weeks. Data were analyzed using descriptive statistics, χ²-test, independent samples t-test, and Mann-whitney U test with the SPSS 21.0 program.

In the homogeneity test of the general characteristics and study variables, there were no significant differences between the two groups. Nurses in the experimental group had significantly lower scores on dysfunctional beliefs and attitudes regarding sleep and sleepiness than nurses in the control group. Nurses in the experimental group had significantly higher scores on sleep quality and quality of life than nurses in the control group.

These findings indicate that using the mobile SNS-based CBT-I is feasible and has significant and positive treatment-related effects on rotating-shift nurses' irrational thoughts and beliefs in association with sleep, sleep quality, daytime sleepiness, and quality of life. These contribute to expanding our knowledge of rotating-shift nurses' sleep issues and their preferences for intervention.

The purpose of this study was to analyze the effects of a pruritus intervention program on pruritus and sleep satisfaction in patients undergoing hemodialysis.

This study was designed for a nonequivalent control group repeated measures quasi-experimental study. Hemodialysis patients were recruited from a kidney center at a university hospital located in G city, Korea. The subjects consisted of 43 patients 21 for the experimental group and 22 for the control group. The 2-week pruritus intervention program was given to the experimental group only.. An analytical survey was done before and after the pruritus intervention program.

There was a significant decrease in pruritus and increase in sleep satisfaction in the experimental group compared to the control group. There was significant improvement in clinical symptoms and sleep satisfaction after completing the pruritus intervention program in the experimental group.

Pruritus intervention program in hemodialysis patients decreased pruritus severity and increased sleep satisfaction, which can be used as an efficient nursing intervention for hemodialysis patients.

The purpose of the study was to investigate fatigue, depression and sleep in young adult and middle-aged.

The convenient sample consisted of 415 subjects from 20 to 59 years old. Data were collected using a self-report questionnaire from July to October, 2001. The VAS-F and CES-D were utilized to measure the level of fatigue and depression. Sleep duration and sleep satisfaction were measured based on the subject's self-report.

The result of the study revealed that the level of fatigue and depression was higher among young adult than middle-aged. Considering age and gender, the level of fatigue and depression was higher among young adult women and middle-aged men. Depression and sleep satisfaction influenced on the fatigue.

Health care providers need to concern about fatigue and depression in young adult women and middle-aged men. Especially, more concern and intervention programs are needed for young adult women and middle-aged men.

The purpose of this study was to evaluate the effectiveness of a sleep improvement program combined with an aroma-necklace on sleep, depression, anxiety, and blood pressure in elderly women living at home.

A program consisting of a four-week (one hour per week) sleep improvement intervention plus use of an aroma-necklace, was developed based on Cox's Interaction Model of Client Health Behavior. 70 elderly women were assigned to the experimental (n=35) or control group with no intervention (n=35). Data from 62 participants (32 in the experimental and 30 in the control) were analyzed using the SPSS 21.0 program. Women in the experimental group were instructed to constantly wear the aroma necklace filled with marjoram and orange oil until the program was completed. Sleep quality, sleep duration, sleep satisfaction, depression, anxiety, and blood pressure were measured to identify the effectiveness of the program.

Significant group differences were found in sleep quality (t=-5.10, p<.001), sleep duration (z=-3.10, p=.002), sleep satisfaction (z=-4.13, p=<.001), depression (t=2.53, p=.015), and anxiety (z=-2.47, p=.014). No differences were found in the systolic or diastolic blood pressure.

The results indicate that a sleep improvement program combined with an aroma-necklace was effective in improving sleep disturbances in elderly women living at home. Nurses may contribute to improving sleep among elderly women by applying this program to aged women living in various environments.

This study was an experimental study to compare the inhalation effects of aroma essential oil on the quality of sleep (QOS) for shift nurses after working nights.

The participants were 60 healthy adults who didn't have any disease. As an experimental treatment, the participants in the experimental group were asked to inhale essential oil for 3 minutes at a distance of approximately 10 cm fromt heir nose and then they were asked to sleep with the aroma stone beside their head (within a 30 cm distance). QOS were measured four times on Pretest, Day 1, Day 2, and Day 3 after they slept. To measure QOS, Perceived QOS (Numeric Rating Scale), the Verran & Synder-Halpern (VSH) Sleep Scale were used, and number of awakenings (NoA) was measured by Actigraph.

There were no significant differences in the homogeneity tests for general characteristics and dependent variables prior to the experiments, except for VSH of subjective sleep quality. Also, there was no significant interaction between group and time. The VSH of the experimental group was higher than the control group (F=6.39, p=.002). The NoA between the experimental group and the control group was significantly different after experimental treatment 3rd day (F=13.35, p=.001).

The findings show that the inhalation of aroma essential oil had effects to increase the quality of sleep. Therefore, the inhalation of aroma essential oil could be applied to general nursing interventions to improve the quality of sleep.

Purpose was to explore associations between sleep duration and metabolic syndrome (MS) risks, and to determine factors associated with self-rated health (SRH) of adults with MS compared to other adults.

This is a secondary data analysis based on the Fifth Korea National Health and Nutrition Examination Survey KNHANES V (N=12662). Study instruments included sleep duration, MS risk factors, SRH and health-related quality of life (HRQoL).

Mean age of participants was 43.68±12.26 years. Fifty-eight percent were women, and 18.3% were identified as having MS. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and SRH were significantly different according to sleep duration (p<.05) among all participants. In the non MS group, male gender, younger age (19~30 and 41~50 age brackets) upper income level, sufficient sleep duration, and high density lipoprotein (HDL) were positively associated with SRH, whereas, lower education levels (≤ middle school), glucose level, and waist circumference were negatively associated with SRH (p<.05). In the MS group, lower income, lower education levels (≤ middle school), glucose level, and waist circumference were negatively associated with SRH, whereas, having an occupation was positively associated with SRH (p<.05).

Results suggest that tailored approaches are required for prevention and control of MS and sleep duration of each individual should be considered rather than applying standardized guidelines. However, as sleep quality was not included in the analysis, further investigations regarding influence of sleep quality on MS and SRH and controlling for other lifestyle and health behavior factors are required.

The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed.

For this study, 11 older patients with depression were purposively chosen. Data were collected through in-depth individual interviews from July 2013 to January 2014 and analyzed in terms of by Giorgi's phenomenological methodology.

The study results showed that sleep disorder experience in older patients with depression consisted of sixteen themes and five themes-clusters: 1) exposure of the causes of sleep disorders; 2) life is painful; 3) harassing themselves and their family; 4) difficulty in controlling themselves; 5) trying to deal with the sleep disorder to overcome the situation.

It is necessary to develop educational guidelines for patients with sleep disorders or nursing interventions that anyone can easily provide for elders in the communities. The first priority should be given to efforts to apply diverse methods to improve sleep hygiene and minimize the period of exposure to medication before starting medication for patients with sleep disorders.

This study was done to construct and test a structural model to explain health risk behavior of late adolescents.

Data for this study were secondary data from the 2010 Korea Adolescent Health Survey based and 3,675 high school students who participated. Data were analyzed using SPSS 18.0 and AMOS 19.0 programs.

After 7 lines were removed, fitness statistics for the hypothetical model were appropriate (χ²=559.13, p<.001, GFI=.98, SRMR=.03, RMSEA=.04, NFI=.88, IFI=.90, CFI=.90, TLI=.86, AIC=671.13). The result showed that drinking-smoking is directly affected by 5 variables (32.5%), obesity is directly affected by 2 variables (0.7%), lack of physical activity is directly affected by 5 variables (22.2%), skipping of breakfast is directly affected by 3 variables (11.9%), improper sleep is directly affected by 3 variables (7.5%), and psychological adaptation is directly affected by 4 variables (26.8%).

The results of this study, indicate that late adolescents' health risk behavior is affected by many factors with complicate correlations suggesting further study compare youth health risk behaviors in a variety of environments.

The purpose of this study was to examine the effects of aroma massage on pruritus, skin pH, skin hydration and sleep in elders in long-term care hospitals.

The participants were elders over 65 years old admitted to long-term care. They were assigned to the experimental group (26) or control group (28). Data were collected from May to August, 2012. Visual Analogue Scale and Verran and Snyder-Halpern Sleep scale were used to identify levels of pruritus and sleep. A skin-pH meter and moisture checker were used to measure skin pH and skin hydration. Aroma massage was performed three times a week for 4 weeks for elders in the experimental group. The data were analyzed using the SPSS Win 17.0 program.

There were significant differences in pruritus, skin pH and skin hydration between the two groups. However there was no significant difference in sleep.

The results indicate that aroma massage is effective in reducing pruritus, skin pH and increasing skin hydration in elders. Therefore, this intervention can be utilized in clinical practice as an effective nursing intervention to reduce pruritus in elders in long-term care hospitals.

This study was done to test structural equation modeling of health-related quality of life (QOL) of men with obstructive sleep apnea in order to identify parameters affecting QOL and provide guidelines for interventions and strategies to improve QOL in these patients.

Model construction was based on 'The conceptual model of patient outcome in health-related QOL' by Wilson and Cleary, using the variables; age, physiological factors, social support, cognitive appraisal, symptoms and QOL. Participants were 201 adult male patients recruited at a tertiary university hospital in Seoul. Data were collected via questionnaires, polysomnography, and clinical records.

Age and symptoms directly influenced QOL. Social support and cognitive appraisal about sleep did not have a direct influence on QOL, but indirectly affected it via symptoms. QOL was lower in patients who were younger and had more severe symptoms. Symptoms were more severe for patients with lower social support and more dysfunctional cognitive appraisal. When social support was lower, cognitive appraisal was more dysfunctional.

These results suggest it is necessary to not only manage symptoms, but also apply interventions to increase social support and cognitive appraisal about sleep in order to increase QOL in patients with obstructive sleep apnea.

The purposes of this study were to develop a Minimal Insomnia Screening Scale for Korean adults (KMISS) and to evaluate psychometric properties and discriminant ability of the developed scale.

Data from a cross-sectional survey of 959 Korean adults were analyzed to develop the summated insomnia scale, which was evaluated in terms of reliability, validity, and discriminant ability by receiver operating characteristics (ROC) curve analysis.

Item-total correlations ranged between .71-.79 and Cronbach's α was .87. Adequate validity was also evident. ROC-curve analysis showed area under ROC was .87 (95% CI: .84-.90) and identified the optimal cut-off score as ≤ 20 (sensitivity, .83; specificity, .75; positive/negative predictive values, .40/.95). Using this cut-off score, the prevalence of insomnia in the study sample was 26.3% and most frequent among women and the oldest group.

Data supports the psychometric properties of KMISS as a possible insomnia screening instrument. KMISS also shows promise as a convenient ultra-short screening measure of insomnia for adults and epidemiological studies in community health care settings.

The purpose of this study was to evaluate the effectiveness of foot reflexology on fatigue, sleep and pain.

A systematic review and meta-analysis were conducted. Electronic database and manual searches were conducted on all published studies reporting the effects of foot reflexology on fatigue, sleep, and pain. Forty four studies were eligible including 15 studies associated with fatigue, 18 with sleep, and 11 with pain. The effects of foot reflexology were analyzed using Comprehensive Meta-Analysis Version 2.0. The homogeneity and the fail-safe N were calculated. Moreover, a funnel plot was used to assess publication bias.

The effects on fatigue, sleep, and pain were not homogeneous and ranged from 0.63 to 5.29, 0.01 to 3.22, and 0.43 to 2.67, respectively. The weighted averages for fatigue, sleep, and pain were 1.43, 1.19, and 1.35, respectively. No publication bias was detected as evaluated by fail-safe N. Foot reflexology had a larger effect on fatigue and sleep and a smaller effect on pain.

This meta-analysis indicates that foot reflexology is a useful nursing intervention to relieve fatigue and to promote sleep. Further studies are needed to evaluate the effects of foot reflexology on outcome variables other than fatigue, sleep and pain.

The aim of this study was to develop and test an explanatory model for sleep disorders in people with cancer. A hypothetical model was constructed on the basis of a review of previous studies, literature, and sleep models, and 10 latent variables were used to construct a hypothetical model.

Data were collected from April 19 to June 25, 2010, using self-report questionnaires. The sample was 291 outpatients with cancer who visited the oncology cancer center at a university hospital. Collected data were analyzed using SPSS Win 15.0 program for descriptive statistics and correlation analysis and AMOS 7.0 program for covariance structural analysis.

It appeared that overall fit index was good as χ²/df=1.162, GFI=.969, AGFI=.944, SRMR=.052, NFI=.881, NNFI=.969, CFI=.980, RMSEA=.024, CN=337 in the modified model. The explanatory power of this model for sleep disorders in people with cancer was 62%. Further, sleep disorders were influenced directly by cancer symptom experience, dysfunctional beliefs and attitudes about sleep, and past sleep pattern.

Findings suggest that nurses should assess past sleep pattern and consider the development of a comprehensive nursing intervention program to minimize the cancer symptom experience, dysfunctional beliefs and attitudes about sleep, and thus, reduce sleep disorders in people with cancer.

The purpose of this study was to compare the quality of sleep with the serum lipid profile in patients who have restless legs syndrome (RLS).

The data were obtained from 116 patients with RLS through questionnaires and blood sampling.

The results of this study showed correlations between lower quality of sleep and serum lipid profile (LDL Cholesterol) in patients with RLS (r=.19, p=.040). There were correlations for scores of quality of sleep from the, Pittsburgh Sleep Quality Index (PSQI) sub-region between lower subjective sleep quality and serum lipid profile (LDL Cholesterol) (r=.20, p=.026), between fewer hours of sleep duration and serum lipid profile (Total Cholesterol) (r=-.21, p=.024), and, between higher daytime dysfunction and serum lipid profile (LDL Cholesterol) (r=.42, p<.001) of patients with RLS.

Patients with RLS have sleep disorders with lower quality of sleep and changes in the serum lipid profile for total cholesterol and LDL cholesterol. That is, patients with RLS have lower quality of sleep and dyslipidemia compared to persons without RLS. Further research is needed to monitor serum the lipid profile in early stage symptoms of midlife adult patients with RLS and especially older women.

The purpose of this study was to investigate sleep habits, sleep disturbance, and circadian types, and to identify factors influencing sleep disturbance in nursing students.

Participants were 140 senior nursing students. The data were collected from May 19 to 27, 2008 using self-report questionnaires.

1) Evening type delayed sleep-wake schedules were more frequent than for morning type, especially during weekend and evening shift duty. 2) In total sleep time, there were no significant statistical differences between morning type and evening type during weekdays, weekend, day or evening shift duty. 3) On weekdays and day shift duty, the mean score for sleep disturbance was significantly higher in the evening type compared to the morning type. 4) Sleep disturbance in weekday and day shift duty was influenced by circadian types, eating habits, and gender.

The circadian types are a very important factor for determining the sleep quantity and quality in nursing students.

The study was done to identify factors influencing the sleep of elderly women.

Data were collected by questionnaires from 203 elderly women in Seoul and Gyeong-gi province. Measures were physical health state, family support, life satisfaction, sleep, depression, and quality of life. Data were analyzed using Pearson correlation coefficients, t-test, ANOVA, and stepwise multiple regression with SPSS/WIN 13.0 version.

The mean score for sleep for elderly women was 39.04. Sleep for elderly women according to religion, education level, spouses, and monthly income showed significant differences. Sleep for elderly women showed significantly positive correlations to physical health state, family support, life satisfaction, and quality of life. The significant factors influencing sleep of elderly women were physical health state, family support, depression, and quality of life, which explained about 70.4% of the variance. The strongest factors influencing the sleep was physical health state.

The results suggest that in developing nursing interventions and practice for sleep pattern of elderly women spouses and family support should be considered.

In this study rest-activity rhythm, sleep pattern and quality of life of patients with restless legs syndrome were compared with those of a normal group.

The participants in this study were 36 patients with restless legs syndrome diagnosed by a neurologist and 36 participants in the normal group. An actigraph, sleep diary, Pittsburgh Sleep Quality Index and Insomnia Severity Index scale were used as measurement tools for the study. Chi-square test, Lamda test, t-test and Kendall's correlation with SPSS 12.0 program were used to analyze the data.

Patients with restless legs syndrome had a higher rest-activity rhythm curve of Least 5 hr's activity (L5) and Most 10 hr's activity (M10) than those of normal group and sleep problems included decreased sleep efficiency and increased sleep latency, wake time and number of awakenings. The scores for the subscales of quality of life in patients with restless legs syndrome were lower than the normal group for general health, physical functioning, role limitations due to emotional problems, role limitation due to physical problems, social functioning, bodily pain, vitality and mental health.

The results suggest that further studies are needed to identify rest-activity rhythm according to symptom severity and to develop nursing interventions which consider rest-activity rhythm.