東華大學圖書館 |

語系: 繁體中文

說明(常見問題)

回圖書館首頁

手機版館藏查詢

登入

回首頁

切換: 標籤 | MARC模式 | ISBD

The relationships between sleep dist...

Knechel, Nancy Alice.

FindBook

Google Book

Amazon

博客來

The relationships between sleep disturbance and falls among Veterans who have experienced strokes.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	The relationships between sleep disturbance and falls among Veterans who have experienced strokes./
作者:	Knechel, Nancy Alice.
面頁冊數:	177 p.
附註:	Source: Dissertation Abstracts International, Volume: 77-06(E), Section: B.
Contained By:	Dissertation Abstracts International77-06B(E).
標題:	Nursing. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10012503
ISBN:	9781339475325

The relationships between sleep disturbance and falls among Veterans who have experienced strokes.
Knechel, Nancy Alice.

The relationships between sleep disturbance and falls among Veterans who have experienced strokes. - 177 p.

Source: Dissertation Abstracts International, Volume: 77-06(E), Section: B.

Thesis (Ph.D.)--Yale University, 2015.

Falls result in more than 2.4 million injuries each year and are the most common adverse events after a stroke. Sleep disturbance is common after stroke and may be a risk factor for falls. The purpose of this study was to determine the predictive value of sleep disturbance for falls among Veterans who experienced ischemic strokes. The study was a secondary analysis of the data from the Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease (GoToSleep) Study, a longitudinal multi-site randomized controlled strategy trial. The sample included 187 post-stroke Veterans, with a mean age of 70 years, which was predominately male (96.8%) and White (81.3%). The mean Charlson Comorbidity Index score was 2.5, and mean number of comorbid conditions was 6.3. The sample did not have significant stroke-related disability (NIHSS M= 1.9), or physical dependence (Modified Rankin Scale M = 1.0) Data included PSG, medical record review, questionnaires (Epworth Sleepiness Scale, Berlin, Saint Louis University Mental Status), and self-reported falls and injuries. Seventy-two participants had CPAP treatment. Univariate frequency distributions with summary statistics for central tendency and variability, t-tests, Chi-square tests, Fisher's Exact tests, Pearson correlations, and binary and multivariate logistic regression analyses were conducted. Fallers had shorter sleep duration, more frequent awakenings, longer time in bed, more N1 sleep, more spontaneous arousals and respiratory-event related arousals (RERAs), and Periodic Limb Movements (PLMs) per hour than non-fallers. Only the associations between frequency of awakenings per hour and PLM index and falls remained statistically significant in the fully adjusted multivariate model that accounted for approximately 13% of variance beyond the clinical and demographic variables. The odds of a fall increased by 40% for each awakening and 2% for each PLM per hour. After controlling for use of continuous positive airway pressure (CPAP) treatment among the patients with significant sleep apnea, the effects of the sleep variables were not statistically significant. This suggests that treatment of sleep disordered breathing may reduce the odds of falling. Future research is needed to improve confirm and extend these findings, understand the biobehavioral mechanisms for these relationships, and to evaluate the effects of sleep treatment on falls risk.

ISBN: 9781339475325Subjects--Topical Terms:

528444
Nursing.

The relationships between sleep disturbance and falls among Veterans who have experienced strokes.
LDR:03334nmm a2200289 4500 001 2077112
005 20161114130224.5
008 170521s2015 ||||||||||||||||| ||eng d
020 $a 9781339475325
035 $a (MiAaPQ)AAI10012503
035 $a AAI10012503
040 $a MiAaPQ $c MiAaPQ
100 1 $a Knechel, Nancy Alice. $3 3192603
245 1 4 $a The relationships between sleep disturbance and falls among Veterans who have experienced strokes.
300 $a 177 p.
500 $a Source: Dissertation Abstracts International, Volume: 77-06(E), Section: B.
500 $a Adviser: Nancy Redeker.
502 $a Thesis (Ph.D.)--Yale University, 2015.
520 $a Falls result in more than 2.4 million injuries each year and are the most common adverse events after a stroke. Sleep disturbance is common after stroke and may be a risk factor for falls. The purpose of this study was to determine the predictive value of sleep disturbance for falls among Veterans who experienced ischemic strokes. The study was a secondary analysis of the data from the Diagnosis and Treatment of Sleep Apnea in Cerebrovascular Disease (GoToSleep) Study, a longitudinal multi-site randomized controlled strategy trial. The sample included 187 post-stroke Veterans, with a mean age of 70 years, which was predominately male (96.8%) and White (81.3%). The mean Charlson Comorbidity Index score was 2.5, and mean number of comorbid conditions was 6.3. The sample did not have significant stroke-related disability (NIHSS M= 1.9), or physical dependence (Modified Rankin Scale M = 1.0) Data included PSG, medical record review, questionnaires (Epworth Sleepiness Scale, Berlin, Saint Louis University Mental Status), and self-reported falls and injuries. Seventy-two participants had CPAP treatment. Univariate frequency distributions with summary statistics for central tendency and variability, t-tests, Chi-square tests, Fisher's Exact tests, Pearson correlations, and binary and multivariate logistic regression analyses were conducted. Fallers had shorter sleep duration, more frequent awakenings, longer time in bed, more N1 sleep, more spontaneous arousals and respiratory-event related arousals (RERAs), and Periodic Limb Movements (PLMs) per hour than non-fallers. Only the associations between frequency of awakenings per hour and PLM index and falls remained statistically significant in the fully adjusted multivariate model that accounted for approximately 13% of variance beyond the clinical and demographic variables. The odds of a fall increased by 40% for each awakening and 2% for each PLM per hour. After controlling for use of continuous positive airway pressure (CPAP) treatment among the patients with significant sleep apnea, the effects of the sleep variables were not statistically significant. This suggests that treatment of sleep disordered breathing may reduce the odds of falling. Future research is needed to improve confirm and extend these findings, understand the biobehavioral mechanisms for these relationships, and to evaluate the effects of sleep treatment on falls risk.
590 $a School code: 0265.
650 4 $a Nursing. $3 528444
650 4 $a Aging. $3 543123
650 4 $a Medicine. $3 641104
690 $a 0569
690 $a 0493
690 $a 0564
710 2 $a Yale University. $3 515640
773 0 $t Dissertation Abstracts International $g 77-06B(E).
790 $a 0265
791 $a Ph.D.
792 $a 2015
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10012503