Effects Of Intervention Based On Roy Adaptation Model On Elderly Chronic Heart Failure Patients With Sleep Disorder

ObjectiveThis study aimed to explore impact factors of elderly chronic heart failure patients causing sleep disorder and the correlation between sleep quality and qulity of life. Roy Adaptation Model (RAM) is used to guide intervention, improved patients’sleep qulity and qulity of life, was also verified.MethodsThe study was a field experiment reasearch.80patients were selected by convenience sampling in department of cardiology in the first affiliated hospital of Zhengzhou University.80patients were divided into control group and experimental group,40cases respectively.Control group only received route nursing on sleeping; based on the control group, the experimental group received special care was guided by RAM. Both two groups were measured by Pittsburgh Sleep Quality Index (PSQI), Minnesota Living with Heart Failure Questionnaire (MLWHFQ), Social Support Rating Scale (SSRS) and clinical indicator Brain Natriuretic Peptide (BNP), Ejection Fraction (EF) in the admission of the stable condition, three month and six month follow-up.A database was established using SPSS13.0, statistical methods including: statistical description, multiple linear regression, chi-square, nonparametric test, single factor analysis of variance, repetitive measure anova, two independent sample t-test.Results1.78patients completed the study.Sleep disorder condition of elderly CHF patients results revealed that55.13%of patients were in severe level in sleep time,64.10%of patients were in moderate level in sleep qulity,78.10%of patients were in mild level in sleep medication,46.15%of patients were in severe level in sleep latency,69.23%of patients were in severe level in sleep efficiency,66.67%of patients were in mild level in sleep dysfunction,57.69%of patients were in severe level in daytime dysfunction.2.Spearman correlation analysis indicated:PSQI, MLWHF physical, MLWHF social and MLWHF total were related positively (r=0.485, P<0.01; r=0.298, P<0.01; r=0.381, P<0.01). MLWHF total, sleep time, sleep latency, sleep dysfunction and daytime dysfunction were ralated positively(r=0.339, P<0.01; r=0.243, P<0.05; r=0.324, P<0.01; r=0.324, P<0.01). MLWHF physical, sleep time, sleep latency, sleep efficiency,sleep dysfunction and daytime dysfunction were ralated positively (r=0.393, P<0.01;r=0.297, P<0.01;r=0.238, P<0.05; r=0.441, P<0.01; r=0.275, P<0.05). MLWHF emotional and daytime dysfunction were ralated positively (r=0.237, P<0.05), MLWHF social, sleep time, sleep dysfunction and daytime dysfunction were ralated positively (r=0.269, P<0.05; r=0.260, P<0.05; r=0.253, P <0.05).3.Baseline characteristics did not differ significantly between two groups (P>0.05). After6month, there were different in both BNP and EF between two groups (P>0.05). Repeated measures analysis of variance showed:The main effects of time on PSQI total, sleep time, sleep efficiency, sleep dysfunction, daytime function, MLWHFQ total, SSRS total were statistical (P<0.05)between control group and experimental group on the admission of stable condition,3momth and6month follow-up, above variables were different with the change of time without considering intervention. The main effects of intervention on PSQI total, sleep time, sleep qulity, sleep efficiency, sleep dysfunction, daytime dysfunction, MLWHFQ total were statistical significance (P<0.05), above variables were different with the change of intervention without considering time. There were significance interaction between time factors and intervention level. Interactive plot indicated:after intervention, the experimental group obtain scores of PSQI and MLWHF declined and were lower than those of the control group.The scores of SSRS increased and were higher than those of the control group. Sleep condition, qulity of life and social support of experimental group were improved.Conclusion1. Sleep disorder of elderly CHF patients is in moderate or severe level and influenced by cardiac function grade and number of complication.2. Sleep condition and qulity of life are related positively for elderly CHF patients with sleep disorder (r=0.381, P<0.01).3. Intervention based on RAM could promote sleep condition and qulity of life in elderly CHF patients with sleep disorder.