Latent Classes Of Sleep And Its Relationship With Quality Of Life Among Elderly Residents In Nursing Homes

Objectives 1)To identify latent classes of sleep among elderly residents in nursing homes based on latent class model;2)to characterize each resulting latent class in sociodemographic,physical,mental and psychological,and environmental variables;and 3)to determine the relationship between the latent classes and quality of life(QOL).Methods This cross-sectional study,investigated by convenient sampling,was conducted in 27 nursing homes in Jinan from March to June in 2018.A total of 350 residents were surveyed with 326 effective questionnaires.The survey contents included:?General information about nursing homes.?Residents information on sociodemographics,sleep,QOL,physical health(such as lower-extremity function,activity of daily living),mental and psychological health(such as cognitive function,depression),and environmental information(such as room arrangement).The latent profile analysis of sleep among residents in nursing homes was conducted using Mplus 7.0.The characteristics of different latent classes were analyzed using SPSS 20.0.The comparison of QOL between different latent classes was completed using Stata 14.0.The statistics methods included:descriptive analysis,one-way ANOVA,chi-square test,latent profile analysis,multiple logistic regression,and multiple linear regresion.Results1.The prevalence of poor sleep quality among all the participants was 62.9%and the top three high-score dimensions were sleep onset latency,total sleep time and sleep efficiency.2.Latent profile analysis showed that there were three latent classes of sleep among the participants:Good Sleepers(GS,39.9%),Poor Sleepers Without Hypnotics(PSWOH,43.5%),and Poor Sleepers With Hypnotics(PSWH,16.6%).3.Multiple logistic regressions revealed:There were significant diferences between these three latent classes in sociodemographic characteristics(gender,education),physical health characteristics(medicine,pain,IADL),mental and psychological health characteristics(depression,anxiety),and environmental characteristics(recreational and social activities held by institution,outdoor living space,working hours of nursing assistant)among the participants(P<0.05).Compared with GS,PSWOH tended to be illiterate,take more medicine,suffer from moderate-severe pain,be dependent in IADL,and have depression symptom.Moreover,PSWOH were living in the nursing homes that provided no recreational and social activities and had nursing assistants with more working hours than GS.Compared with GS,the female,and those who took more medicine,suffered from moderate-severe pain,and had depression symptom tended to be PSWH.4.Multiple linear regressions showed:PSWOH and PSWH had significantly lower scores of QOL than GS(P<0.05),respectively,but the scores between these two groups of poor sleep showed no significantly difference(P>0.05).Conclusions1.The sleep quality of residents in nursing homes was relatively poor,which could be reflected in sleep onset latency,total sleep time,and sleep efficiency.2.The sleep of residents in nursing homes showed obvious heterogeneity and could be divided into three classes:GS,PSWOH and PSWH.3.The three latent classes of sleep had significant difference in resident-related characteristics(gender,education,number of medication,pain,IADL,depression,anxiety)and facility-related characteristics(recreational and social activities held by institution,outdoor living space,and working hours of nursing assistants).4.The QOL between PSWOH and PSWH were poorer than that in GS,separately.However,these two classes of poor sleep had no significantly difference in QOL.