ARTICLE INFO

Article Type

Original Research

Authors

Soheyli   M. (1 )
Rahimi   A. (* )
Chavoshi   A. (2 )






(* ) “Chemical Injuries Research Center” & “Medical Surgical Department, Nursing Faculty”, Baqiyatallah University of Medical Sciences, Tehran, Iran
(1 ) Military Nursing Department, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
(2 ) Islamic Studies Department, Medical Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran

Correspondence

Article History

Received:  July  21, 2013
Accepted:  April 30, 2014
ePublished:  July 20, 2014

BRIEF TEXT


… [1-4] Poor mental and physical health can affect chemically-injured veterans’ quality of sleep [5, 6]. Some factors, leading to insomnia, are chronic obstructive pulmonary diseases, reduction in saturation of arterial oxygen during night, and medications consumption like theophylline [4]. … [7] According to the results of some studies, chemically-injured veterans’ quality of sleep is not only lower than society average value, but also is lower than other veterans [8]. Medication methods, as well as non-medication methods, have been used to enhance sleep quality [1]. … [9-12] Recently, according to prevent medication complications, non-medication methods have been attended [13].

… [14] Mehdizadeh et al. used non-medication method to enhance chemically-injured veterans’ sleep quality which is the only research concerning sleep quality among chemically-injured persons in Iran [15].

The aim of this study was to evaluate the impact of sleep based on Islamic patterns on quality of sleep in mustard gas victims.

This is a case-controlled two-group clinical trial study.

168 mustard gas victims at Ilam City, Iran were studied in 2012.

Samples were selected, using available sampling method. Sample size was estimated 34 persons per each group, using Altman formula and the Mehdizadeh study [15], considering 10% loss for each group. 70 persons were selected. The inclusion criteria included being male, literate, willing to participate in the study, injured by mustard gas, and residence in Ilam City.

Demographic and Pittsburgh Sleep Quality Index (PQSI) questionnaires were used to collect data. The latter assesses patient’s point of view on quality of sleep four weeks to the study. It assesses quality of sleep in the 7 domains including “sleep’s mental quality”, “delay in falling asleep”, “effective sleep duration”, “sleep efficiency”, “sleep disorders”, “level of hypnotic drugs consumption”, and “the morning performance”. Each question scale has zero to three score. Achieving the score 6 and more show the poor quality of sleep. Its reliability has been confirmed using Cronbach’s Alpha [17]. Its validity has been confirmed in Iran as well [14, 16-18]. The samples were divided into two groups of 35 persons. Based on demographic information, the groups were homogenized. Islamic pattern for sleeping was codified, based on Islamic religious sources. Some experts confirmed validity of the pattern. Intervention for experiment group was performed in four-hour theoretical classes presenting notes. No intervention was done on control group. The questionnaire was presented to the groups after one month again. SPSS 16 software using Chi Square test (to compare demographic characteristics), Paired-T test (to compare before and after intervention data, as well as demographic characteristics of two groups), and Independent-T test (to compare total numbers of sleep quality between two groups), were used to analyze data.

The mean ages of control group and experiment group were 51.57±7.65years and 51.9±5.36years, respectively. There was no significant difference between two groups in the following items: Injury percentage (28.71±7.21% and 29.71±6.41%in ‘control’ and ‘experiment’ groups, respectively); time spent in the war (47.20±31.40and 52.29±30.81 in ‘control’ and ‘experiment’ groups, respectively); number of family members (5.23±1.37 and 5.60±1.68 in ‘control’ and ‘experiment’ groups, respectively). Educational level of most samples (38.6%) was lower than a high school diploma. 54.7% of the participants were retired. 75.7% had chronic sputum, 90.3% had breath shortness, and 88.6% suffered from chronic cough. There was no significant change in average scores of seven phases of sleep quality at the stage after performing Islamic pattern for sleep than before education phase in control group. Nevertheless, at the stage after intervention, there was significant impact in average scores of all the sleep quality domains, than the stage before education did (Table 1). Before intervention, there was no significant difference in total scores of quality of sleep (a composition of seven phases scores of Pittsburgh questionnaire) between ‘experiment’ (12.57±4.29) and ‘control’ (11.9±4.67) groups. However, after intervention, there was a significant difference between ‘control’ (11.43±5.00) and ‘experiment’ (7.00±2.49) groups scores.

Poor sleep quality among chemically-injured veterans has been reported [5, 8, 15, 18], which is consistent with the results of the present study. Enhancement in nurses’ quality of sleep in all domains after intervention has been stated which is consistent with this study [19]. There was no significant correlation between demographic information and injury percentage, as well as sleep quality, which are consistent with the results of some other studies [5, 15, 18]. In addition, on lack of any significant correlation between age and sleep quality, results of the present study are consistent with results of some other studies [16, 20, 21]. There was no significant correlation between time spent in war and quality of sleep that is consistent with results of another study [18]. There was no significant correlation between educational level and quality of sleep which is in line with some other studies [15, 18]. … [22, 23]. However, results of some other studies show the correlation between the two mentioned items [24-26].

Observations like polysomnography ought to be considered and other effective variables on quality of sleep like some diseases must be considered.

Pittsburgh Sleep Quality questionnaire assesses quality of sleep mentally, which was one of the limitations of the present study.

Using Islamic pattern of quality of sleep is effective on veterans injured by mustard gas.

The researchers feel grateful to the personnel of Nursing Faculty of Baqiyatallah University of Medical Sciences, Foundation of Martyrs and Veterans Affairs of Ilam City, and all the participants.

Non-declared

Non-declared

Research Deputy of Baqiyatallah University of Medical Sciences funded the study.

TABLES and CHARTS

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CITIATION LINKS

[1]Froutan SA. Efficacy of pharmacotherapy and behavior therapy for chronic insomnia. Behav Sci. 2011:5(1):27-32. [Persian]
[2]Mousavi ZB, Ebrahimi A, Mirian M. Long-term effects of Sulfur Mustard gas exposure on the skin of Iranian combaters. Iran J Dermatol. 2001;5(17):9-19. [Persian]
[3]Salari M. Nursing in modern warfare. Tehran: Publications ISBN; 2011. [Persian]
[4]Ghanei M, Adibi I. Clinical review of Mustard lung. Iran J Med Sci. 2007;32(2):58-65. [Persian]
[5]Tavalaei A, Assari Sh, Najafi M, Habibi M, Ghanei M. Study of sleep quality in chemical-warfare-agents exposed veterans. J Mil Med. 2005;6(4):241-8. [Persian]
[6]Ahmadvand A, Sepehrmanesh Z, Ghoreishi FS, Mousavi SGA. Prevalence of insomnia among 18 years old people and over in Kashan city, Iran in 2008. J Kashan Univ Med Sci. 2010;13(4):313-20. [Persian]
[7]Romano JA Jr, King JM. Psychological casualties resulting from chemical and biological weapons. Mil Med. 2001;166(12 Supp l):21-2.
[8]Madarshahian F. Comparison of coping with direct and indirect consequences of war stress in later life betweenchemical and physical war injureds. J Mill Med. 2003;5(2):117-20. [Persian]
[9]Sadock B, Sadock VA, Ruiz P (Editors). Kaplan & Sadocks comprehensive textbook of psychiatry. 9th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.
[10]Palma BD, Tiba PA, Machada RB, Tufik S, Suchecki D. Immune outcomes of sleep disorder. Rev Bras Psiquiatr. 2007;29(Suppl 1):S33-8. [Portuguese]
[11]Hoseinabadi R, Nourozi K, Pouresmail Z, Karimlu M, Sadat Seyed Bagher M, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract. 2010;16(2):81-5.
[12]LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005;115(Suppl 1):257-65.
[13]Peritcard S. Tui na: A manual of Chinese massage therapy. Edinburgh: Churchill Livingstone; 2010.
[14]Zeraaati F, Seif Rabiee MA, Araghchian M, Sabouri T. Assessment of quality of sleep and use of drugs with sedating properties in adult patients hospitalized in Hamadan Ekbatan Hospital. Sci J Hamedan Univ Med Sci. 2009;16(4):31-6. [Persian]
[15]Mehdizadeh S, Salari M, Ebadi A, Naderi Z, Jafari Verjoshany N. Effect of using continuous care model on sleep quality of chemical warfare victims with bronchiolitis obliterans. Hayat. 2010;16(2):5-14. [Persian]
[16]Mahdavi Kani MS. Religion and lifestyle. 3rd ed. Tehran: Imam Sadiq University Publication; 2008. [Persian]
[17]Behrouzifar S, Zenouzi Sh, Nezafati MH, Esmaily H. Factors affecting the quality and quantity of sleep in coronary artery bypass graft patients. J Shahid Sadooghi Univ Med Sci. 2008;16(3):57-66. [Persian]
[18]Tavalaei SA, Habibi M, Assari Sh, Ghanei M, Naderi Z, Khateri Sh, et al. Quality of life among veterans 15 years after exposure to Sulfur mustard. J Behav Sci. 2007;1(1):17-25. [Persian]
[19]Sayyari R, Asdzndy M, Ebadi A. Application of precede-proceed [Dissertation]. Model of sleep disorders with emphasis on the practice of nurses in other Baqiyatallah Hospitals University; 2009. [Persian]
[20]Ameli J, Ghanei M, Aslani J, Karami G, Ghoddousi K, Kachoei H, et al. Polysomnography of 31 mustard gas exposed veterans with complaint of respiratory sleep problem in Baqiyatallah (a.s.) Hospital. J Mil Med. 2007;9(1):7-14. [Persian]
[21]Espahbodi F, Emami Zeydi A, Gholipour Baradari A, Khademloo M. Effect of intravenous vitamin C on sleep quality in hemodialysis patients. J Gorgan Univ Med Sci. 2011;13(2):44-52. [Persian]
[22]Saremi M, Khani Jazani R, Tassi P. Comparison of fatigue level, sleep quality and quantity in old and young shift workers. Pejouhesh. 2008;32(2):135-9. [Persian]
[23]Pokrzywinski RF, Meads DM, McKenna SP, Glendenning GA, Revicki DA. Development and psychometric assessment of the COPD and Asthma Sleep Impact Scale (CASIS). Health Qual Life Outcomes. 2009;7:98.
[24]Moore PJ, Adler NE, Williams DR, Jackson JS. Socioeconomic status and health: The role of sleep. Psychosom Med. 2002;64(2):337-44.
[25]Friedman EM, Love GD, Rosenkranz MA, Urry HL, Davidson RJ, Singer BH, et al. Socioeconomic status predicts objective and subjective sleep quality in aging women. Psychosom Med. 2007;69(7):682-91.
[26]Adams J. Socioeconomic position and sleep quantity in UK adults. J Epidemiol Community Health. 2006;60(3):267-9.