title: The Effect of Continuous Care Model on the Sleep Quality of Hemodialysis Patients.
abstract: BACKGROUND
  One of the most prevalent problems in hemodialysis patients is sleep disturbance. Poor sleep quality has unpleasant bio-psycho-social outcomes. The positive effects of implementing the continuous care model (CCM) were verified with different variables, including sleep quality. This study was done with different populations, using two groups.
  
  
  OBJECTIVE
  This study aims to identify the sleep quality of hemodialysis patients in the city of Ilam and determine the effects of CCM on sleep quality.
  
  
  METHODS
  We performed a quasi-experimental research study with 56 hemodialysis patients at the Shahid Mostafa Hospital in Ilam during 2014 and 2015. Pretests and posttests were conducted with the study groups and the control groups. Pretests were conducted over a one-month period, then repeated immediately before the study. Posttests were conducted immediately after the study and then repeated one month later. Participants were selected by census method and randomly divided into two groups. Ethical considerations were observed. Based on the continuous care model, interventions were performed through educational sessions over a three-week period. Consultations for continuous sleep monitoring, controls, and evaluations were conducted with the study group over the next nine weeks. Data were gathered from patient demographics questionnaires and PQSI, then introduced in SPSS 22 and analyzed with descriptive and analytic statistics (t-paired, ANOVA with repeated measures, follow-up tests such as S-N-K, Duncan, Sheffe and Tukey).
  
  
  RESULTS
  One month prior to the study, 94.6% of the participants suffered from poor sleep quality. Immediately before and after the study, 91% complained of poor sleep quality. And one month after intervention, the figure dropped to 82%. Applying the CCM positively affected the sleep quality of hemodialysis patients in Ilam, and was statistically meaningful one month after intervention (P = 0.001).
  
  
  CONCLUSIONS
  Hemodialysis patients need a consistent care plan to manage poor sleep quality. This research has proven the effectiveness of implementing CCM as an intervention for improving the sleep quality of hemodialysis patients. CCM provides a comprehensive model for caring for hemodialysis patients, and its executive stages are congruent with the many stages of the nursing process. Practitioners in different domains of nursing care, education, and management can derive great benefit from this valuable care model.
authors: Research Center of Prevention of Psychosocial Damages, Ilam University of Medical Sciences, Ilam, IR Iran; Nursing Department, Ilam University of Medical Sciences, Ilam, IR Iran.
authors: Masoumeh
authors: M
authors: Otaghi
authors: Research Center of Prevention of Psychosocial Damages, Ilam University of Medical Sciences, Ilam, IR Iran; Nursing Department, Ilam University of Medical Sciences, Ilam, IR Iran.
authors: Mohamadreza
authors: M
authors: Bastami
authors: Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran.
authors: Milad
authors: M
authors: Borji
authors: Department of Medical-Surgical, School of Nursing, Baqiatallah University of Medical Sciences, Tehran, IR Iran.
authors: Ali
authors: A
authors: Tayebi
authors: Student Research Committee, Ilam University of Medical Sciences, Ilam, IR Iran.
authors: Milad
authors: M
authors: Azami
keywords: Continuous Care Model; Hemodialysis Patients; Sleep Quality