Older People Clinical Trial
Official title:
Effect of Warm Foot Bath on Their Sleep Quality and Comfort Level in Elderly Individuals: A Randomized-controlled Trial
Objectives: To determine the effectiveness of a warm foot bath on sleep quality and comfort
level among elderly individuals with sleep problems.
Design and methods: This study was a randomized controlled trial. A total of 217 elderly
individual who stayed in two nursing homes. The sample consisted of 60 elderly individuals
with sleep problem who were randomly assigned to either the warm foot bath group (n= 30) and
control group (n=30).The study was completed with 60 elderly individuals. The primary outcome
was an information questionnaire, the Pittsburgh Sleep Quality Index, the General Comfort
Questionnaire and the Numerical Rating Scale.
The age pyramid of the world population is changing, and as it does so, the percentage of
elderly people is rapidly increasing. As one advances in age, it has been found that they
tend to sleep latency later, have reduced time spent within crucial rapid eye movement (REM)
sleep, and have reduced total duration and quality of sleep and sleep-related problems start
to occur. The National Sleep Foundation The national sleep federation recommends 7-8 hours of
sleep per day for the elderly. However, many elderly report that they sleep less than
recommended and have difficulty sleep latency.
Sleeping is a significant action that affects individuals' daily lives as well as their
quality of life. Sleep is required to meet the basic needs of daily life and comprises
physiological, psychological, environmental and sociocultural dimensions. Sleep quality,
which has been considered as increasingly significant in recent years, can be defined as
feeling physically-fit, refreshed, and ready for a new day when waking up. Sleep quality
consists of several quantitative aspects and measurements of sleep itself, such as the
duration before sleep latency, the duration of sleep, the number of times a person wakes up
in the night, as well as more subjective aspects such as the depth of sleep and the relaxing
characteristic of sleep.
Such sleep-related problems may negatively affect an individual's comfort. Comfort is a basic
need that comprises one of the cornerstones of holistic nursing care practice. Accordingly,
solving sleep-related problems, increasing sleep quality, and ensuring comfort for the
individuals concerned will require comprehensive nursing care. Pharmacological methods are
the most commonly used approach in trying to resolve sleep-related problems. However, these
methods have been insufficient as they do not provide a complete solution for sleep-related
problems. Additionally, the side effects of these methods, which are obligatory for the
affected individuals, are numerous, and this has paved the way for the development of
non-pharmacological treatment methods. Relevant literature indicates methods such as eye
masks, music therapy, massages, alternative and supplementary therapies, aromatherapy, and
warm foot bath have all been successfully used to solve sleep-related problems among elderly
people, thereby boosting their sleep quality and comfort.
Warm foot bath causes peripheral vasodilation and decreases core body temperatures. A
negative relationship was found between core body temperature and inclination to sleep.
Individuals' sleep latency decreases when body core temperature decreases thus, individuals'
sleep quality and comfort level are increased. Warm foot bath as a non-pharmacological
methods is a more practical and less expensive approach when compared with others.
The relevant literature demonstrated that the number of studies examining sleep quality and
comfort among elderly people was limited. The literature included some studies that examined
the use of relaxation exercises, back-massage practices, aromatherapy, and music therapy to
improve sleep quality and comfort. However, the number of studies examining the effect of
warm foot bath on sleep quality was found to be limited . The purpose of the trial was to
investigate the effect of a warm foot bath on sleep quality and comfort level among elderly
individuals with sleep problems. Our primary hypothesis was that the sleep quality of the
intervention group would be better after 6 weeks than the control group. The secondary
hypotheses were that the comfort levels of the intervention group would be better after 6
weeks than the control group
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