2021 Volume 25 Issue 2 Pages 51-60
In this study, the frequency of night-time diaper changes conducted at fixed times at a single nursing care insurance facility was reduced from twice to once per night and the resulting changes in sleep variables were considered along with the characteristics of the elderly residents, with the goal of acquiring hints for diaper-changing methods that could improve sleep quality. The baseline and intervention durations were set at 2 weeks each, and Actigraph devices were used for 24-hour continuous measurement of sleep variables and environmental factors such as temperature. The participants were 13 elderly female residents aged 92.3±7.3 years, and Nishimura’s mental (NM) and activity of daily living (N-ADL) scale scores of 9.9±7.1 and 9.8±3.5 points, respectively. There were no differences in health status or environmental factors observed between the two periods. No differences in median sleep values were observed, but the range from minimum to maximum values within the sample was large. Based on the participants’ average age, duration of the standard estimated nocturnal awakening time was set as 80 minutes, and the participants’ characteristics were considered based on the number of days with decreases from this standard value during the intervention period. Of the reduction group, 7 participants had a significantly higher NM scale (p=.026), and had a higher tendency of N-ADL (p=.050). The intervention effect of reducing the number of night-time diaper changes was estimated to be related to cognitive functions or ADL levels. The results of this study suggest that cognitive function and ADL need to be considered in the examination of excretion assistance for sleep improvements among the elderly in institutionalized facilities.
