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Nasir NFM, Draman N, Zulkifli MM, Muhamad R, Draman S. Sleep Quality among Patients with Type 2 Diabetes: A Cross-Sectional Study in the East Coast Region of Peninsular Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095211. [PMID: 35564603 PMCID: PMC9105183 DOI: 10.3390/ijerph19095211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
Poor sleep is related to type 2 diabetes and adversely influences a person’s quality of life. This study aimed to evaluate sleep quality in patients with type 2 diabetes (T2DM), its associated factors, and its relationship with quality of life. A cross-sectional study was conducted at a primary care clinic in a tertiary hospital on the east coast of Malaysia. This study included 350 participants (175 men and 175 women). Data were collected using the Malay version of the Pittsburgh Sleep Quality Index (PSQI-M) with a cut-off point of >5 as poor sleep, the Malay version of Diabetes Distress Scale (MDDS-17) and the revised Malay version of T2DM-related quality of life (Rv-DQOL). Statistical analysis was conducted using the SPSS software version 26.0. The respondents’ median (interquartile range (IQR)) age was 62.0 (11.0) years, and poor sleep was reported in 32% (95% confidence interval (CI) = 27.1, 36.9) of the participants. Multivariate logistic regression analysis revealed that poor sleep quality was significantly associated with nocturia (odds ratio (OR) = 2.04; 95% CI = 1.24, 3.35), restless legs syndrome (OR = 2.17; 95% CI = 1.32−3.56) and emotional burden (OR = 2.37; 95% CI = 1.41−3.98). However, no statistically significant association was observed between sleep quality and quality of life among our participants.
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Affiliation(s)
- Nor Fareshah Mohd Nasir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Nani Draman
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
- Correspondence:
| | - Maryam Mohd Zulkifli
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Samsul Draman
- Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan 25200, Malaysia;
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Van Besien W, Shire S, Decalf V, Ervin CE, King S, Baldrey C, Da Silva A, Wagg A, Everaert KE, Bower WF. The Bladder at Night during Hospitalisation: Towards optimal care for elderly patients with nocturia. Int J Clin Pract 2021; 75:e14876. [PMID: 34525254 DOI: 10.1111/ijcp.14876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/20/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to describe the characteristics of nocturia in older hospitalised patients and to explore knowledge, beliefs and experiences associated with night toileting while in hospital in order to identify unmet care needs. METHODS A multisite mixed methods cross-sectional study of older hospitalised adults who were admitted for ≥2 days was conducted using a standardised researcher-administered questionnaire. An additional cohort 16 older hospitalised adults with nocturia >twice per night were interviewed to understand the experience and impact of nocturia during hospitalisation. RESULTS Nocturia was experienced by 260 out of 308 participants. In-hospital nocturia was significantly correlated with nocturia in the month preceding admission, high diurnal voiding frequency and nocturnal urinary urgency. Bother was attributed to multiple nocturia episodes. Participants had poor knowledge and understanding of nocturia and believed the symptom to be a normal occurrence; only 20% had discussed management with staff. Disrupted sleep and fear of falling were common in older immobile participants with nocturia. CONCLUSION Nocturia is highly prevalent in hospitalised older people. Toileting multiple times at night bothers patients, disrupts sleep, heightens a fear of falling yet is rarely addressed in ward management plans. A screening process to identify, assess, provide education and intervene for nocturia has the potential to improve wellbeing, safety at night and to address risk factors.
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Affiliation(s)
- Wouter Van Besien
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Samia Shire
- Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Veerle Decalf
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Claire E Ervin
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Sharyn King
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Christine Baldrey
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Alisha Da Silva
- Department of Allied Health, Discipline of Physiotherapy, Royal Melbourne Hospital, Parkville, Australia
| | - Adrian Wagg
- Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Karel E Everaert
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Wendy F Bower
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- Department of Allied Health, Discipline of Physiotherapy, Royal Melbourne Hospital, Parkville, Australia
- Department of Aged Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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Rose G, Decalf V, Everaert K, Bower WF. Toileting-related falls at night in hospitalised patients: The role of nocturia. Australas J Ageing 2019; 39:e70-e76. [PMID: 31321899 DOI: 10.1111/ajag.12696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/21/2019] [Accepted: 06/11/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the prevalence and characteristics of toileting-related falls in hospitalised older people. METHODS Retrospective analysis of falls related to night-time toileting in patients 60 years or over in a tertiary hospital during a one-year period. RESULTS Overall 34% of falls were related to toileting with at least 44% of these falls occurring during the night. Toilet-related falls peaked between 11 pm and 1 am, a period that coincides with maximum supine-induced diuresis. Almost half of night falls occurred at the bedside. In 80% of night toileting-related falls, patients were mobilising without the recommended level of assistance. Half of all patients had no strategies for toileting documented in their care plan. CONCLUSION Findings support screening for nocturia in older inpatients and implementation of strategies to reduce both the need for toileting at night and risk factors for falling.
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Affiliation(s)
- Georgie Rose
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Veerle Decalf
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Wendy F Bower
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
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Everaert K, Anderson P, Wood R, Andersson FL, Holm-Larsen T. Nocturia is more bothersome than daytime LUTS: Results from an Observational, Real-life Practice Database including 8659 European and American LUTS patients. Int J Clin Pract 2018; 72:e13091. [PMID: 29767479 DOI: 10.1111/ijcp.13091] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 03/25/2018] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Lower urinary tract symptoms (LUTS) encompass several diagnoses, including overactive bladder (OAB) and benign prostatic hyperplasia (BPH). Nocturia is a standalone symptom, but also included in OAB and BPH. Current discussion addresses whether the overlap of the diagnoses is too broad, leading to misdiagnosis. This study explored the differences in level, causes and consequences for patients with a diagnosis of daytime LUTS compared with a diagnosis of nocturia, and discussed whether people are being treated for the symptoms that truly bother them the most. PATIENTS AND METHODS Data were drawn from a survey of physicians and patients in France, Germany, Spain, UK and USA. Physicians filled out patient record forms (PRFs) for patients with LUTS diagnosis. The patients completed the patient self-completion form (PSC). Three PRO questionnaires were included; the OAB-q SF, NI-Diary and WPAI. Patients were grouped based on the diagnoses assigned to them by their physicians in a real-life setting. RESULTS Eight thousand seven hundred and thirty eight patients had a LUTS diagnosis and 5335 completed a PSC. Patients diagnosed with night-time symptoms were significantly more bothered by their LUTS than only daytime LUTS patients (all questionnaires P < .0001). Patients with nocturia reported being tired "always" or "usually" more often than patients with daytime problems only (P < .0001). Only 13% of patients with nocturia had an initial sleep period of more than 2-3 hours. CONCLUSION In this population of real-life patients, those with a diagnosis of nocturia reported significantly higher impact on their quality of life than patients with a diagnosis of daytime LUTS only. The underlying causes of bother were related to sleep problems. It is essential that nocturia is understood, treated and monitored as a distinct problem from OAB and BPH, to ensure that patients are treated for their main symptom.
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Affiliation(s)
- Karel Everaert
- Nopia research group, Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Peter Anderson
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, UK
| | - Robert Wood
- Adelphi Real World, Adelphi Mill, Bollington, Macclesfield, UK
| | - Fredrik L Andersson
- Ferring Pharmaceuticals A/S, Copenhagen, Denmark
- Center for Medical Technology Assessment (CMT), Linköping University, Linköping, Sweden
| | - Tove Holm-Larsen
- Nopia research group, Department of Urology, Ghent University Hospital, Ghent, Belgium
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Bower WF, Rose GE, Ervin CF, Goldin J, Whishaw DM, Khan F. TANGO - a screening tool to identify comorbidities on the causal pathway of nocturia. BJU Int 2017; 119:933-941. [PMID: 28075514 DOI: 10.1111/bju.13774] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To develop a robust screening metric for use in identifying non-lower urinary tract comorbidities pertinent to the multidisciplinary assessment of patients with nocturia. METHODS Variables having a significant risk association with nocturia of greater than once per night were identified. Discriminating items from validated and reliable tools measuring these comorbidities were identified. A self-completed 57-item questionnaire was developed and a medical checklist and pertinent clinical measures added. Pre-determined criteria were applied to retain or remove items in the development of the Short-Form (SF) screening tool. The tool was administered to 252 individuals with nocturia who were attending either a tertiary level Sleep, Continence, Falls or Rehabilitation service for routine care. Data collected were subjected to descriptive analysis; criteria were applied to reduce the number of items. Using pre-determined domains, a nocturia screening metric, entitled TANGO, was generated. The acronym TANGO stands for Targeting the individual's Aetiology of Nocturia to Guide Outcomes. RESULTS The demographic characteristics of the sample are described, along with item endorsement levels. The statistical and structural framework to justify deleting or retaining of items from the TANGO Long-Form to the SF is presented. The resultant TANGO-SF patient-completed nocturia screening tool is reported. CONCLUSIONS A novel all-cause diagnostic metric for identifying co-existing morbidities of clinical relevance to nocturia in patients who present across disciplines and medical specialties has been developed. TANGO has the potential to improve practice and smooth inequalities associated with a siloed approach to assessment and subsequent care of patients with nocturia.
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Affiliation(s)
- Wendy F Bower
- Department of Rehabilitation, Royal Melbourne Hospital, Parville, Vic., Australia
- Sub-Acute Community Services, Royal Melbourne Hospital, Parville, Vic., Australia
| | - Georgie E Rose
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parville, Vic., Australia
| | - Claire F Ervin
- Sub-Acute Community Services, Royal Melbourne Hospital, Parville, Vic., Australia
| | - Jeremy Goldin
- Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Parville, Vic., Australia
| | - David M Whishaw
- Department of Aged Care, Royal Melbourne Hospital, Parville, Vic., Australia
- Department of Urology, Royal Melbourne Hospital, Parville, Vic., Australia
| | - Fary Khan
- Department of Rehabilitation, Royal Melbourne Hospital, Parville, Vic., Australia
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Bower WF, Whishaw DM, Khan F. Nocturia as a marker of poor health: Causal associations to inform care. Neurourol Urodyn 2016; 36:697-705. [DOI: 10.1002/nau.23000] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 02/29/2016] [Indexed: 01/22/2023]
Affiliation(s)
- Wendy F. Bower
- Department of Rehabilitation Services; The Royal Melbourne Hosital; Melbourne Victoria Australia
| | - D. Michael Whishaw
- Departments of Aged Care and Urology, Royal Park Campus; Royal Melbourne Hospital; Parkville Victoria Australia
| | - Fary Khan
- Department of Rehabilitation Services; The Royal Melbourne Hosital; Melbourne Victoria Australia
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Jayadevappa R, Newman DK, Chhatre S, Wein AJ. Medication adherence in the management of nocturia: challenges and solutions. Patient Prefer Adherence 2015; 9:77-85. [PMID: 25609929 PMCID: PMC4298292 DOI: 10.2147/ppa.s51482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE Nocturia affects millions of men and women. No prior reviews or meta-analyses have explored the issue of adherence in nocturia patients. The objective of our study was to examine the attributes and their interaction that might impact pharmacological adherence in nocturia care using a conceptual model of adherence. MATERIALS AND METHODS A literature search of the Medline, PubMed, Embase, PsycInfo, and CINAHL databases for studies published between January 1990 and June 2014 was conducted. We developed a conceptual model in order to facilitate our review. RESULTS Currently, multiple treatment options for nocturia exist, depending on the underlying cause. Adherence to nocturia treatment and outcomes are complex and intertwined, and nonadherence to nocturia treatment is common. In 15 studies meeting eligibility criteria, behavioral and pharmacologic interventions for nocturia were associated with reduced nocturia symptoms. Urinary symptoms that are associated with nocturia need individualized management depending on renal and hepatic function, medical comorbidities, and ongoing medication use in a patient. Another important factor related to adherence is the bother. Although nocturia is defined as nighttime-voiding frequency of one or more, not all persons may find this bothersome. The degree of bother is subjective, and may change from person to person. However, there is no information related to the association between bother and adherence to medication or behavioral treatments for nocturia. Medication dosing convenience, preference, and cost play important roles in adherence. We present a patient-centered conceptual model that brings together the various dimensions of medication adherence for nocturia. CONCLUSION Few studies have explored adherence to medication and related factors in the care of nocturia. Our conceptual model can aid development of interventions to improve adherence to nocturia medications.
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Affiliation(s)
- Ravishankar Jayadevappa
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Sumedha Chhatre
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alan J Wein
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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