노인요양기관 입소노인의 수면증진을 위한 비약물적 중재의 효과: 체계적 문헌고찰 및 메타분석
Effects of Nonpharmacological Interventions to Improve Sleep in Elderly Residents in Care Facilities: A Systematic Review and Meta-analysis
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Purpose: This systematic review and meta-analysis aimed to assess the types and effectiveness of nonpharmacological interventions for improving sleep among elderly nursing home residents. Methods: A literature search was performed using electronic databases (PubMed, CINAHL, Medline, Embase, RISS, and KISS) and PRISMA guidelines. Population characteristics, program content, and outcomes were systematically reviewed. Quality assessment was performed using the RoB 2.0 (revised Cochrane risk of bias for randomized trials) and ROBINS-I (risk of bias in non-randomized intervention studies) tools. For the meta-analyses, the effect sizes of the interventions were calculated as standardized mean differences. Results: Of the 3058 publications, 23 met the inclusion criteria, of which 14 were randomized controlled trials and nine had a quasi-experimental design with nonequivalent controls. The 23 intervention studies for improving sleep included exercise therapy, acupressure therapy, light therapy, massage, aromatherapy, footbaths, cognitive behavioral therapy, and reminiscence therapy. Meta-analysis was conducted in 12 studies to estimate the effect sizes of nonpharmacological interventions for improving sleep. The results showed that exercise (95% CI; -2.17 ~ -0.91, p<.001), acupressure (95% CI; -2.27 ~ -0.10, p=.03), and light (95% CI; -2.29 ~ -1.34, p<.001) therapies improved sleep. Conclusion: These results suggest that easily implementable and cost-effective nonpharmacological interventions are needed to improve sleep among elderly nursing home residents. Further research is required to confirm the consistency of the effects of sleep interventions.
Abstract
Purpose: This systematic review and meta-analysis aimed to assess the types and effectiveness of nonpharmacological interventions for improving sleep among elderly nursing home residents. Methods: A literature search was performed using electronic databases (PubMed, CINAHL, Medline, Embase, RISS, and KISS) and PRISMA guidelines. Population characteristics, program content, and outcomes were systematically reviewed. Quality assessment was performed using the RoB 2.0 (revised Cochrane risk of bias for randomized trials) and ROBINS-I (risk of bias in non-randomized intervention studies) tools. For the meta-analyses, the effect sizes of the interventions were calculated as standardized mean differences. Results: Of the 3058 publications, 23 met the inclusion criteria, of which 14 were randomized controlled trials and nine had a quasi-experimental design with nonequivalent controls. The 23 intervention studies for improving sleep included exercise therapy, acupressure therapy, light therapy, massage, aromatherapy, footbaths, cognitive behavioral therapy, and reminiscence therapy. Meta-analysis was conducted in 12 studies to estimate the effect sizes of nonpharmacological interventions for improving sleep. The results showed that exercise (95% CI; -2.17 ~ -0.91, p<.001), acupressure (95% CI; -2.27 ~ -0.10, p=.03), and light (95% CI; -2.29 ~ -1.34, p<.001) therapies improved sleep. Conclusion: These results suggest that easily implementable and cost-effective nonpharmacological interventions are needed to improve sleep among elderly nursing home residents. Further research is required to confirm the consistency of the effects of sleep interventions.
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