Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER)

项目摘要/摘要 这项研究的目标是测试一项旨在教育护理机构工作人员改善普通睡眠的计划。 居民中的相关症状。睡眠障碍在熟练的护理设施中相当常见，并影响 多达69%的居民，而工作人员不完全了解如何在不使用 药物。睡眠药物通常被用作老年人的一线治疗方法，但这是 这是有问题的，因为这些药物会导致更大的思维问题，更频繁的摔倒，以及 随着时间的推移，睡眠会变得更糟。此外，睡眠不佳会导致情绪低落，思维出现更大困难 和记忆力，更严重的疼痛，以及更多的日常活动需要帮助。 已经努力减少睡眠药物的使用，但仍有必要改善 继续存在困难的居民的睡眠质量。因为护理机构的居民依赖于 关于照顾工作人员以满足他们的基本日常需要，工作人员参与睡眠是至关重要的 改进的努力。这项研究将指导护理机构的工作人员改善住院医生的睡眠和相关 通过使用一项名为：通过指导行为改善睡眠和改善睡眠的睡眠改善计划 环境重组(休眠)。该计划为设施工作人员提供来自睡眠专家的指导 为了改善夜间睡眠环境，增加白天的活动水平和光照，减少 白天的行为会在晚上造成睡眠障碍，并帮助那些有 睡眠困难。这项研究将随机在三个护理机构内的每个机构中的两个单元进行 秩序。 除了指导员工改善睡眠的策略外，这项研究还将使用技术来辅助设施 工作人员。这包括用来记录噪音水平的分贝计和用来测量居民睡眠的手腕活动计。 质量、活动水平和光照。设施工作人员还将收到一份将使用的有针对性的策略清单 有睡眠困难的居民。工作人员将能够记录睡眠障碍的插曲，并看到 这些数据的可视化显示，以支持他们的工作。这项研究将测试睡眠干预是否 改善夜间睡眠质量，居民报告睡眠不佳、情绪低落、焦虑和 疼痛，以及干预是否改善认知和活动水平。这项研究还将衡量 工作人员创造了更好的睡眠环境，减少了夜间噪音，增加了日光暴露， 更多地使用策略来促进更好的睡眠。

PROJECT SUMMARY/ABSTRACT The goal of this study is to test a program designed to teach nursing facility staff to improve common sleep- related symptoms among residents. Sleep disturbances are quite common in skilled nursing facilities and affect as many as 69% of residents while staff do not fully understand how to improve sleep without using medications. Medications for sleep are commonly used as first-line therapy for older adults but this is problematic because these medications can lead to greater problems with thinking, more frequent falls, and even worse sleep over time. In addition, poor sleep can lead to depressed mood, greater trouble with thinking and memory, worse pain, and greater need for help with daily activities. There have been efforts to reduce the use of medications for sleep, yet there is still a need to improve the quality of sleep among residents who continue to have difficulties. Because nursing facility residents depend on caregiving staff to meet their basic day-to-day needs, it is essential that staff members participate in sleep improvement efforts. This study will “mentor” nursing facility staff to improve residents’ sleep and related symptoms by using a sleep improvement program called: Improving Sleep Using Mentored Behavioral and Environmental Restructuring (SLUMBER). This program provides mentoring to facility staff from sleep experts to improve the nighttime sleep environment, increase daytime activity levels and light exposure, reduce daytime behaviors that cause sleep disturbances at night, and to help individual residents who are having difficulty with sleep. The study will take place in two units per facility within three nursing facilities in random order. In addition to mentoring staff on strategies to improve sleep, this study will use technology to assist facility staff. This includes decibel meters to record noise levels and wrist actigraphs to measure residents’ sleep quality, activity levels and light exposure. Facility staff will also be given a list of targeted strategies to be used with residents having difficulty with sleep. Staff will be able to record episodes of sleep disturbance and to see a visual display of these data to support their work. This study will test whether the SLUMBER intervention improves nighttime sleep quality, resident reported symptoms of poor sleep, depressed mood, anxiety and pain, and whether the intervention improves cognitive and activity levels. This study will also measure whether staff have created a better sleep environment with decreased nighttime noise, increased daylight exposure and greater use of strategies to promote better sleep.