KUALITAS TIDUR DAN FAKTOR-FAKTOR GANGGUAN TIDUR KLIEN LANJUT USIA YANG DIRAWAT INAP DI RUANG PENYAKIT DALAM RUMAH SAKIT, MEDAN 2003

Abstract

AbstrakPenelitian deskriptif ini bertujuan untuk mengeksplorasi kualitas tidur dan faktor-faktor gangguan tidur klien lanjut usia yang dirawat di ruang penyakit dalam. Seratus klien sesuai dengan kriteria diambil sebagai sampel dari 2 rumah sakit di Medan. Penelitian menggunakan kuisioner dengan wawancara terstruktur meliputi personal data, informasi kesehatan, riwayat tidur di rumah, kualitas tidur, dan faktor yang mempengaruhi gangguan tidur di rumah sakit. Mayoritas klien memulai tidur >60 menit (57%), total jam tidur malam <5 jam (62%), frekuensi terbangun tiga kali atau lebih (80%), tidur tidak nyenyak (55%), tidak puas terhadap tidur (51%), tidak merasa segar bangun pagi (52%), merasa lelah dan mengantuk siang hari (46%). Mayoritas klien (77%) melaporkan kualitas tidur mereka buruk di rumah sakit. Analisis paired t-test menunjukkan ada perbedaan signifikan antara kualitas tidur klien di rumah dengan di rumah sakit (p < 0.001). Faktor-faktor gangguan tidur selama perawatan di rumah sakit adalah faktor fisiologis, rutinitas tindakan perawat, lingkungan, dan psikologis. Dari faktor fisiologis, yang menyebabkan gangguan tidur tingkat tinggi adalah nyeri, sesak napas, dan batuk. Mayoritas klien mempersepsikan rutinitas tindakan perawat di malam hari umumnya hanya gangguan tidur ringan, termasuk tindakan perawat terhadap klien lain, mengukur tanda vital, dan memberikan obat. Selanjutnya, faktor lingkungan yang mengganggu tidur klien pada tingkat ringan-sedang yaitu suara bising dari berbagai sumber, suhu ruangan panas, dan lampu terlalu terang. Faktor psikososial menunjukkan 24% klien mengalami cemas dan 43% depresi. Hasil penelitian ini menunjukkan kualitas tidur klien buruk selama dirawat di rumah sakit. Untuk itu perawat perlu memberikan perhatian khusus kepada klien dengan gejala penyakit tertentu, keluhan rasa tidak nyaman, gangguan lingkungan, cemas, depresi, dan juga memberikan tindakan keperawatan untuk mengeliminasi faktor-faktor tersebut. Abstract:This descriptive study is aimed to explore sleep quality of elderly during hospitalization and describe factors perceived by hospitalized elderly as sleep interference. One hundred elderly clients who met the inclusion criteria were recruited from medical wards of two hospitals in Medan. Subject’s personal data, health information, sleep history, sleep quality, and factors interfering with sleep were obtained by structured interview. The majority of subjects reported experiencing sleep latency > 60 minutes (57%), total sleep time less than 5 hours (62%), awakening three times or more (80%), very shallow sleep (55%), not at all satisfied with sleep (51%), not feeling refreshed in the morning (52%), and feeling fatigued and sleepy during the daytime (46%). Moreover, 77% of the clients considered their sleep as poor. In addition, paired t-test analysis revealed that the sleep quality of the clients during hospitalization and at home were significantly different (p < .001). Factors interfering with sleep during hospitalization included physiological, routine nursing interventions, environmental, psychological factors. The most prevalent and highest level sleep interference in physiological factors were caused by pain, dyspnea, cough. The majority of clients perceived that routine nursing interventions, checking vital signs, nurses attending to other clients, and giving treatments interfered with their sleep at a low level of sleep interference. Likewise, environmental factors including noise from all sources, hot room temperature, and bright light were commonly reported as sleep interference at the low and moderate level. In psychological factors, 24% of the subjects experienced anxiety, while 43% reported depression. The results study found that sleep quality of the subject was poorer during hospitalization. Thus, nurses should pay more attention to the clients having symptom of diseases, discomfort, environment disturbances, anxiety, depression and also give interventions to eliminate these factors.