Purpose: A strong association between stress due to loneliness and sleep problems has been reported. Social interactions when patients are hospitalized for weeks or longer may decrease or be limited. Elderly patients in skilled care units receive daily physical, occupational, and/or speech therapy often requiring longer hospitalization, which can lead to increased social isolation. However, this has not been studied in the inpatient skilled care unit or during the COVID-19 pandemic. The purpose of this study is to prospectively evaluate changes of loneliness, sleep quality, and quality of life in elderly in-patients (>65 years) admitted to a skilled care unit at a midwestern Magnet®- recognized hospital.
Methods: A longitudinal research design measured subject’s loneliness, sleep patterns, and quality of life. Subjects were asked to complete the Pittsburg Sleep Quality Index (PSQI), UCLA Loneliness Scale (ULS), (version 3) Ferrans and Powers Quality of Life Index (QLI) Nursing Home version III at admission and weekly until discharge.
Results: Descriptive statistics and repeated measures ANOVA (SPSS for windows version 16) were used to determine effect sizes, Cohen D, at baseline and weekly until discharge (level of significance p < 0.05 for all analyses). Twelve subjects (mean age 77 years; 84% female, white, college educated; 42% married) completed the study. Improvements from baseline to week 2 were consistently positive for the QLI and ranged from small (d=.2) to medium (d= .5). The overall improvement in total scores was a d=.184. For the loneliness scale the week 1-2 effect was very small and this was similar for the PSQI.
Conclusions: COVID-19 pandemic changed the whole dynamics in the healthcare environment and the skilled care unit was not an exception. This study was started before the visitor restrictions and continued to when visitors were prohibited. Opportunities to decrease loneliness, improve sleep habits, and quality of life were identified in the elderly population requiring inpatient skilled care. Providers should consider objective assessment loneliness, sleep, and QOL to promote optimal care for this population. The results from this study will be used to inform future interventional research aimed at decreasing loneliness for older patients requiring skill care.
Learning Outcome: After completing this learning activity, the participant will be able to assess innovations being used by other professionals in the specialty and evaluate the potential of implementing the improvements into practice.