Association between elder abuse and poor sleep: A cross-sectional study among rural older Malaysians

Abstract

ObjectivesTo examine the association between elder abuse and poor sleep using a Malay validated version of Pittsburgh Sleep Quality Index (PSQI).DesignThis study was divided into two phases. Phase I tested the construct validity and reliability of the Malay version of PSQI. Phase II was a population-based, cross-sectional study with a multi-stage cluster sampling method. Home-based interviews were conducted by trained personnel using a structured questionnaire, to determine exposure and outcome.SettingKuala Pilah, a district in Negeri Sembilan which is one of the fourteen states in Malaysia.Participants1648 community-dwelling older Malaysians.ResultsThe Malay version of PSQI had significant test re-test reliability with intra-class correlation coefficients of 0.62. Confirmatory factor analyses revealed that one factor PSQI scale with three components (subjective sleep quality, sleep latency, and sleep disturbances) was most suitable. Cronbach’s Alpha was 0.60 and composite reliability was 0.63. PSQI scores were highest among neglect (4.11), followed by physical (4.10), psychological (3.96) and financial abuse (3.60). There was a dose-response relationship between clustering of abuse and PSQI scores; 3.41, 3.50 and 3.84 for “no abuse”, “1 type of abuse” and “2 types or more”. Generalized linear models revealed six variables as significant determinants of sleep quality–abuse, co-morbidities, self-rated health, income, social support and gait speed. Among abuse subtypes, only neglect was significantly associated with poor sleep.ConclusionThe Malay PSQI was valid and reliable. Abuse was significantly associated with poor sleep. As sleep is essential for health and is a good predictor for mortality among older adults, management of abuse victims should entail sleep assessment. Interventions or treatment modalities which focus on improving sleep quality among abuse victims should be designed.

Association between night-shift work, sleep quality and metabolic syndrome

“…The tool comprises 18 questions assessing subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, use of sleep medication and daytime dysfunction. The PSQI has been translated into several languages, including the Malay language (PSQI-M), and is proven to be a valid and reliable questionnaire 26. Each component of the questionnaire is rated on a 4-point scale (0–3), which generates a total score ranging between 0 and 21.…”

Does abuse in late life worsen sleep quality? A two‐year prospective cohort study among rural older adults

“…One of the dimensions of neglect—physical abandonment and deprivation of basic necessities—can force older adults into unfit living conditions which make adequate, comfortable sleep impossible. Another dimension of neglect, deprivation of access to health care or medication supply (especially in case of chronic diseases), can lead to exacerbation of existing illnesses and deterioration of health, which subsequently worsen sleep quality . In addition, emotional loneliness—a phenomenon likely to accompany neglect—has been shown to negatively affect sleep …”

“…To date, we know of only two studies which have investigated the relationships between EAN and sleep disturbances. Olofsson et al reported an association between sleeping disturbances and elder abuse among Swedish older adults, while Yunus et al reported a similar finding among abused Malaysian elders . However, both studies employed a cross‐sectional design, thus making causal relationships difficult to establish.…”

“…The Pittsburgh Sleep Quality Index (PSQI), on the other hand, is a validated, 19‐item questionnaire which is widely used to measure sleep quality . It has seven components—subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction—and has been cross‐culturally validated . Our study aims at examining the longitudinal relationship between EAN and sleep quality among a cohort or rural Malaysian elders.…”

“…10 It has seven components-subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction-and has been cross-culturally validated. 8,[11][12][13] Our study aims at examining the longitudinal relationship between EAN and sleep quality among a cohort or rural Malaysian elders. We believe that this is the first such longitudinal study of its kind.…”