INTRODUCTION:

¹Sleep quality is a very important factor in quality of life. Sleep disorders may result in fatigue, tiredness, depression and problems in day time functioning, several studies have focused on the effects of music on sleep quality and researchers have found in a variety of study settings and population, that music positively affects the sleep.

²Music can reduce sympathetic nervous system activity, decrease anxiety, blood pressure, heart and respiratory rate.

Chan. MF., Chan EA, Mok E, (2010) conducted a study to determine the effect of music therapy on quality of sleep among 42 elderly people(21 each in experimental and control group) in selected old age home, Hong Kong. Hence the author concluded that music therapy was effective in reducing depression and improving the quality of sleep among elderly.

Current management of sleep problems mainly focus on medication. But medications may create adverse consequences with physical and psychological effects, such as deterioration of emotional and mental condition, impaired psychomotor and cognitive functioning result. Their safety and efficacy for sleep problems in older people has not been established. Therefore, non-pharmacological methods that promote a mind–body interaction without side effects should be tested. Additionally, listening to music, a less costly and possibly a more feasible intervention, is one of the alternative methods proposed to address this problem.

Music therapy as a nursing intervention is simple to realize, follow and worth trying. Thus, investigator felt the need to examine the effectiveness of music therapy as a nursing intervention in managing quality of sleep among the elderly.

OBJECTIVES OF THE STUDY:

1. To determine the effectiveness of music therapy on the quality of sleep among the elderly at selected old age homes.

2. To associate the quality of sleep among the elderly at selected old age homes with their selected demographic variables.

HYPOTHESES:

H₁: There will be a significant difference in the pre and post test scores on quality of sleep among elderly at 0.05 level of significance.

H₂: There will be a significant association in the quality of sleep among elderly and their selected demographic variables at 0.05 level of significance.

METHODS:

Research Approach

Quantitative Evaluative Research Approach was adopted for this study.

Research Design

³The research design chosen for this study was pre experimental (one group pre and post test) research design. The design can be represented as,

E = O₁X O₂

E = Experimental group.

O₁= Pre-test.

O₂= Post-test.

X = Intervention

Population

Population refers to those who are residing in old age homes.

Sampling

Sample:

Elderly people who were all present in the selected old age homes during the study period, Salem.

Sample size:

The sample size of this study was 60.

Sampling technique:

⁴The technique adopted for this study was Non probability convenience sampling technique.

Criteria for sample selection

Inclusion Criteria:

· Those who are in the age group of 50-85 years.

· Both Male and female participants.

· Those who are willing to participate in the study

Exclusion Criteria:

· Those who have hearing impairment.

· Those who are seriously ill during the period of data collection.

· Those who are previously exposed to music therapy.

· Those who are already practicing any other relaxation therapies.

Variables

Independent variable: Music therapy

Dependent variable: Quality of sleep

Data Collection Procedure

The data was collected between 13.07.2011 to 7.08.2011. Two old age homes were selected for this study. They were Henry old age home, Salem andSaradha old age home, Salem.In Henry old age home, the investigator selected a list of 37 samples that fulfilled the sampling criteria from a total of 57 samples by using non probability convenience sampling technique. Similarly in Saradha old age home the investigator selected a list of 23 samples who fulfilled the sampling criteria from a total of 52 samples by using non probability convenience sampling technique. Pre-test was conducted from 13.07.2011 to 14.07.2011 to assess the quality of sleep with the help of a structured interview schedule (Modified Pittsburgh Quality of sleep index scale).music therapy was started on 15.07.2011 and continued for 21 days. Music therapy session was given during morning 10 am and evening 7 pm for 30 minutes with the help of CD player. The post-test was conducted on 05.08.2011.

Method of data collection

Self report

Tool used for the study:

Structured interview schedule

Descriptions of the Tool

Section I: Demographic variables

This section deals with demographic data in relation to age, sex, religion, marital status, education, present medical illness, duration of stay in old age home, frequency of visit and mode of entry into the old age home.

Section II: Modified Pittsburgh Sleep Quality Indexto assess the quality of sleep among the elders

Modified Pittsburgh Sleep Quality Index, (reliability was established by split half technique {0.76}) was used to assess the quality of sleep among elders. It is a 4 point rating scale and the score ranges between 0 – 3.

The above fig.1 shows that in pretest, 5% of them had good quality of sleep, 48.33% of them had fair quality of sleep and 46.67% of them had poor quality of sleep. In posttest 10% of them had good quality of sleep, 65% of them had fair quality of sleep and 25% of them had poor quality of sleep.

Table -1:

Comparison of Mean, Standard deviation and Mean difference on quality of sleep among elderly. n=60

Observation	Maximum possible score	Mean	SD	Mean difference
O₁	45	28.30	4.89	3.5
O₂	45	25.15	5.37	3.5

O_{1 –}pretest; O_2,– posttest.

The above table shows that the pretest (O₁) mean and standard deviation was 28.30 + 4.89 and the post test (O₂₎mean and standard deviation were 25.15+5.37 respectively.

Effectiveness of Music Therapy on quality of sleep among elderly.

Table -2:

Comparison of Mean, Standard deviation and ‘t’ value on quality of sleep among elderly in pretest and post test. n=60

Observation	Mean	SD	‘t’ value
O₁	28.30	4.89	10.45 *
O₂	25.15	5.37	10.45 *

* At 0.05 level of significance, table value – 1.96;

O_{1 –}pretest; O_2,– posttest.

The above table shows that the pre-test mean score was 28.30±4.89, whereas the average post-test mean score was 25.15±5.37and paired ‘t’ test value was 10.45 at 0.05 level of significance. The ‘t’ obtained value is higher than the table value (1.96). So it is proved that music therapy is effective on the quality of sleep among elderly.

Part-III

Table -3:

Association between the quality of sleep among elderly and their selected personal variables

S. No	Personal Variables	Chi-square	Table value	Level of significant
1	Age in years
	50 – 60 61-70 71-80 81and above	5.45	12.59
2.	Sex
	Male Female	2.41	5.69
3.	Religion	2.41	12.59
	Hindu
	Christian
4.	Marital status Married Single Widow/widower Separated or divorced	13.56 *	12.59	Significant
5.	Education Illiterate Primary education Secondary education	21.38 *	12.59	Significant
6.	Any present medical illness Diabetes mellitus Hypertension Cardiac problem Ortho problem Other problem	6.63	15.5

The above table shows that there is significant association between the quality of sleep among elderly and their demographic variables like marital status, and educational status. Shows that there is significant association between the quality of sleep among elderly and their demographic variables like age, sex, religion and medical illness.

Table -4:

Association between the quality of sleep among elderly and their selected Habitat variables.

S. No	Habitat variables	Chi-square	Table value	Level of significant
1.	Duration of stay in old age home 0-1 years 2-3 years 4-5 years Above 5 years	14.39*	12.59	Significant
2.	Frequency of visit by family members. Daily Frequently. Occasionally	9.07	12.59
3.	Mode of entry into old age home Voluntary By force Brought by police	2.486	12.59

The above table shows that there is significant association between the quality of sleep among elderly and their duration of stay in old age home. It shows that there is no association between the quality of sleep among elderly and their demographic variables like mode of entry and frequency visit by family members.

DISCUSSION:

The objective of the study was to determine the effectiveness of music therapy on the quality of sleep among the elderly at selected old age homes.

The pre-test mean score was 28.30±4.89, whereas the average post-test mean score was 20.66 ± 7.26 and paired‘t’ test value was 12.34 at 0.05 levelof significance. So it shows that the music therapy was effective in improving the quality of sleep among elderly.

The present study was supported by Showrilu, (2009), who conducted a study to evaluate the effectiveness of music therapy among older people on quality of sleep using modified Pittsburgh quality of sleep index scale. They concluded that the pre-test mean score was 10.6±0.89, whereas the post-test mean score was 2.46 ± 0.86 and paired ‘t’ test value was 34.11 at p≤0.05. The difference in mean score was 8.14 which indicate that music therapy was effective in promoting the quality of sleep.

CONCLUSION:

The study was done to determine the effectiveness of Music Therapy on quality of sleep among elderly at selected old age homes in Salem. The result of this study showed that most of the elderly had good quality of sleep after implementation of Music Therapy. Music therapy is an effective in improving the quality of sleep.

REFERENCES:

Journal

Chan MF., Chan EA, Mok E..,. Effects of music on depression and sleep quality in elderly people, Complementary Therapy Of Medicine, 18(3-4):2010: 150-9.

Book

1. Bhatia. M.S. Text Book of Psychiatry. C.B.S Publishers and Distributors, New Delhi, 2007; 3^rded.

2. BT Basavanthappa. Psychology for nursing, Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, 2010; 1^sted

3. Polit Beck. Nursing research generating and assessing evidence for nursing practice. Wolters Kluwer Lippincott Williams & Wilikins Publications. 2012; 9^thed.

4. BT Basavanthappa. Nursing research, Jaypee Brothers Medical Publishers (P) Ltd. New Delhi, 2007; 2^sted

Received on 24.11.2013 Modified on 12.01.2014

Int. J. Nur. Edu. and Research 2(2): April- June 2014; Page 89-92