Study On Self-management Model For Elderly Persons With Insomnia

Objective To change the erroneous cognition of elderly with insomnia and decrease medication abuse through investigate the model of elderly self-management for insomnia ,in order to provide a guide for improve the sleep quality of elderly.Methods 94 community elderly with insomnia of Kaifeng were included and randomly allocated to an experiment group(n=47) and a control group(n=47) by means of random number table. Both groups were evaluated with Pittsburgh sleep quality index (PSQI). The experiment group carried on progressive intervention including cognitive behavioral therapy, self-acupoint massage and self-medicine management, while the control group maintained their daily life and original therapy without any intervention. The raw data was input database after being collected, checked and sorted out. SPSS11.5 statistical software packet was used to analyze the data. The measurement data was described by x±s and analyzed with t test, analysis of variance (ANOVA) and rank-sum test while the count data was analyzed with chi-square test.Results(1) In the experiment group significant differences could be found in all the factors and the total scores of PSQI before and after the intervention(P<0.05), and after the intervention there wrer significant differences between the two groups except sleeping latent period (P<0.01).(2) After the intervention , among the experiment group,10 cases (22.2%) were excellent improved, 31 cases (68.9%) were improve and 4 cases (8.9%) were inefficient, the total effective rate was 91.1%, while among the control group, 2 cases (4.4%) were improved,43 cases (95.6%) were inefficient, the total effective rate was 4.4%. There was a significant difference between the two groups(P<0.01).(3) 26(96.2%)patients of the esperiment group reduced the dose of medicine in different degrees after non-pharmacological self-management with 13(48.1%)patients being drug withdrawal. (4) Clinical effects of the intervention was influented by course of disease and age. Clinical effects of patients with disease course of less than 2 years and 2~10 years were both better than that of disease course of more than 10 years(P<0.01). Clinical effects of patients in age of less than 70 years were better than that of age of both 70~80 years and over 80 years(P<0.05,P<0.01). There was no significant difference between the age of 70~80 years and over 80 years(P<0.01).(5) In 3 month follow-up, there were 18 (40%)cases got to relapse, 14 (29%)cases to maintain effective, 14 (31%)cases to improve effects in the experiment group. PSQI score of patients who had relapse was still better than that before the intervention(P<0.01).Conclusion(1) The model of self-management for insomnia could improve the sleep quality of community elderly and decrease medication abuse. It was easy to operate and proved to be feasible, economic, safe and effective.(2) Patient's age and disease course should be considered when the model of self-management for insomnia was implemented to ensure the effect.