Volume 14, Issue 2 (Summer 2019)                   Salmand: Iranian Journal of Ageing 2019, 14(2): 236-247 | Back to browse issues page


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Hossini A, Azimian J, Motalebi S A, Mohammadi F. The Effect of Holy Quran Recitation on the Quality of Sleep Among Older People Residing in Nursing Homes . Salmand: Iranian Journal of Ageing 2019; 14 (2) :236-247
URL: http://salmandj.uswr.ac.ir/article-1-1377-en.html
1- Departement of Nursing, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
2- Department of Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran.
3- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran.
4- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. , mohammadi1508@gmail.com
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Extended Abstract
1. Objectives

Sleep is among the most important night cycles and a complex biological pattern [1]. Poor sleep is in the third problem after headache and gastrointestinal diseases among the elderly [2]. The lack of sleep is associated with illnesses and death in the elderly [3]. To cope with sleep disorders, older adults usually consume sleeping pills; however, these medications usually treat sleep disorders temporarily and cause dependence [4]. Music therapy is a complementary approach that can improve sleep quality by inducing relaxation [5]. One of the pleasant and beautiful sounds is the voice of Quran recitation. It is considered as mystical music with its unique rhythm in Islamic societies [6]. This research aimed to investigate the effect of listening to the voice of the Holy Quran on the sleep quality of elderly living in nursing homes.
2. Methods & Materials  
This was a randomized clinical trial study. The study participants were 70 elderly living in Imam Ali nursing home in Malayer County, Iran. They were randomly divided into two groups of control (n=35) and test (n=35). The elderly in the test group listened to the voice of Surah Al-Mu’minūn recitation by Master Parhizkar using headphones for 15 minutes per night before bedtime, for 4 weeks. Surah Al-Mu’minūn was selected after the consultation with the seminary teachers of Qom and Hamadan. The caregivers in nursing homes were requested to remind and educate the use of music players to the studied elderly. The control group only received routine interventions at the department. Before conducting the intervention, a demographic form and the Glock and Stark Religion Questionnaire were completed by the study participants. Pittsburgh Sleep Quality Index (PSQI) was completed by the researcher via interviewing for both groups before and after the intervention. The study had an approximately (8%) sample drop; 5 study participants (2 from the test group and 3 from the control group) discontinued participation in the study. Finally, 65 subjects (33 in the test group, and 32 in the control group) were studied. Parametric tests like Dependent Samples t-test were used for data analysis with a normal distribution. Moreover, nonparametric tests like the Mann-Whitney U test were used for analyzing the non-normally distributed data. To eliminate the effects of confounders (e.g. sleep quality, religiosity, age, gender, chronic diseases, residential status, and a history of sleep disorders) on the observed difference after the intervention, Analysis of Covariance (ANCOVA) was performed. Data analysis was conducted in SPSS and the significance level was set at 0.05.
3. Results 
Of 65 elderly participating in the study, 33 were in the test group with the mean±SD age of 73.97±9.91 years. Additionally, 32 participants were in the control group with the Mean±SD age of 64.53±12.75 years. More than half (55.4%) of the study participants were female; (43.1%) of them were married, and the rest were single, widowed or divorced (56.9%). More than (80%) of them had elementary education, and only (9.1%) reported high school education or higher. Approximately (78.5%) of the study participants reported having one or more chronic diseases. The majority of study participants have been living in a nursing home for ≥6 months (95.4%), and their residence status was permanent (67.7%). Most of them (83.1%) reported a history of sleep disorders. The mean±SD religiosity value of the test and control groups were 96.39±10.41, and 101.09±5.73, respectively. Such finding indicates the high level of religiosity among them. 
The Chi-squared test results suggested a significant difference in quality, religiosity, age, gender, chronic diseases, residency status, and the history of sleep disorders between the two groups at Pre-test phase (P<0.05). Based on the results of t-test and Mann-Whitney U test, the total score of sleep quality and the scores of its two sub-scales including habitual sleep efficiency (P<0.05) and total sleep quality (P=0.001) significantly improved after 4 weeks of intervention. The total mean±SD score of sleep quality of the elderly in the test group reduced (improved) from 9.27±3.37 to 6.60±3.87. This is while in the control group, the same value increased from 7.16±3.16 to 7.81±2.92 (aggravated). Neither total sleep quality variable nor its subscales changed significantly after one month from the onset of intervention (P>0.05). According to the ANCOVA results, the two groups significantly differed in terms of habitual sleep efficiency (P<0.001), daytime dysfunction (P>0.05), as well as total sleep quality (P<0.001) at the Post-test phase. Thus, after the completion of the program, the level of habitual sleep efficiency and daytime dysfunction, as well as the total sleep quality was significantly better in the test group than those of the controls (Table 1).
4. Conclusion
Elderly living in nursing homes usually have poor sleep quality, leading to biopsychological problems and decreased quality of life. Pharmacological treatment is associated with complications and causes dependence; thus, this group requires effective non-pharmacological treatment to improve sleep quality. The obtained data suggested that listening to the voice of Quran recitation can affect sleep quality (i.e. habitual sleep efficiency and daytime dysfunction), as well as the total sleep quality of the elderly living in nursing homes. In fact, the state of relaxation resulted from listening to the desirable sound of Quran facilitates a high quality sleep in the elderly. This intervention before bedtime can be used as a safe, inexpensive, affordable, and valuable approach. It could improve the quality of sleep in the elderly, along with other non-pharmacological treatments.

Ethical Considerations
Compliance with ethical guidelines
The study has been approved by the Ethics Committee of Qazvin University of Medical Sciences. (IR.QUMS.REC.1395.114).
Funding
The present paper was extracted from the MSc thesis of the first author, Department of Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences.
Authors' contributions
Conceptualization & validation: Abbas Hossini, Fatemeh Mohammadi; Methodology: Abbas Hossini, Fatemeh Mohammadi, Jalil Azimian; Data analisys: Seyedeh Ameneh Motalebi; Resources and firs dratf: Abbas Hossini, Fatemeh Mohammadi, Jalil Azimian; Editing & writing the final dratf: Fatemeh Mohammadi, Seyedeh Ameneh Motalebi; Supervision: Fatemeh Mohammadi. 
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank Qazvin University of Medical Sciences, the authorities of Imam Ali Nursing Home in Malayer City, and all participants for their cooperation.
Type of Study: Research | Subject: gerontology
Received: 2017/07/22 | Accepted: 2018/01/10 | Published: 2019/07/31

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