PURPOSE: The purpose of this study was to identify sleep disorder experience in older patients living in the community and acknowledging being depressed. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Activities of Daily Living ; Adaptation, Psychological ; Aged ; Depression/complications/*diagnosis ; Family Relations ; Female ; Humans ; Interviews as Topic ; Male ; Sleep Disorders/complications/diagnosis/*psychology ; Stress, Psychological

PURPOSE: 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. METHODS: 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. RESULTS: It appeared that overall fit index was good as chi2/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. CONCLUSION: 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.
Anxiety ; Depression ; Female ; Hospitals, University ; Humans ; Male ; Middle Aged ; *Models, Theoretical ; Neoplasms/*complications/*diagnosis/psychology ; Questionnaires ; Self Concept ; Sleep Disorders/epidemiology/*etiology/*psychology ; Social Support

INTRODUCTIONIn this study, the pathways patients followed to treatment in an Insomnia Clinic in a psychiatric hospital were compared over 2 periods. The time interval to specialist referrals and patient clinical presentations were also studied. The aim was to better understand referrers' knowledge, needs and accessibility to services.

MATERIALS AND METHODSA retrospective review of cases seen between 2002 and 2005 was compared with an earlier review of cases referred between 1997 and 2000. The information gathered from medical records was similar for the 2 periods.

RESULTSThere were no significant differences in the socio-demographic profiles of patients in the 2 periods. Primary Insomnia was diagnosed in 48.2% of the first period cohort and in 47.5% of the second period cohort. However, among the remaining patients there was a shift from more depressive disorders in the first period to neurosis in the second period. Significantly, there was no difference in alcohol or substance abuse or dependence between the 2 periods. More than three-quarters of the patients had received treatment prior to the referral and for 51.8% in both periods, the providers were family physicians. Treatment was mainly pharmacotherapy with an increase in the use of Sleep Hygiene measures in the second period.

CONCLUSIONThere is a need for continuing medical education on insomnia as well as a need to highlight the risks of untreated insomnia and assessment for other psychiatric disorders in this common complaint.

Adult ; Ambulatory Care Facilities ; Depressive Disorder ; complications ; diagnosis ; Female ; Hospitals, Psychiatric ; Humans ; Male ; Middle Aged ; Neurotic Disorders ; complications ; diagnosis ; Patient Acceptance of Health Care ; psychology ; Referral and Consultation ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders ; complications ; diagnosis ; therapy ; Young Adult