Sleep disturbances are very common in patients with rotator cuff injury. Improvement of sleep quality in these patients can be considered a significant factor for healing in conjunction with surgery. The primary objective of this prospective study was to evaluate changes in sleep quality after surgery in patients with rotator cuff repair by analyzing the PSQI (Pittsburgh Sleep Quality Index) score. The secondary aim was to evaluate the improvement in quality of life in terms of functional limitations and shoulder pain after surgery. Fifty-eight patients with rotator cuff tears treated by arthroscopic surgery were included. All the patients completed the PSQI, the 36-Item Short Form Survey (SF-36), the Simple Shoulder Test (SST), the American Shoulder and Elbow Surgeons Shoulder Score (ASES), the Oxford Shoulder Score (OSS) and the Constant-Murley Score (Constant) before and at one, three and six months after surgery. Overall improvement in all the scores analyzed (p < 0.001) was found. Preoperative and postoperative PSQI scores correlated with SF-36, SST, ASES and Constant scores at each follow-up. Preoperative and one-month postoperative OSS correlated with the PSQI score. Using the Friedman test, we found an overall improvement in all score analyses (p < 0.001). The results prove that after rotator cuff repair, sleep disturbances improve three to six months after surgery improving the quality of life of these patients.

Anxiety and depressive symptoms adversely affect surgical outcomes in patients with rotator cuff tear (RCT) undergoing surgical repair. Patients without a diagnosis of mood disorders, such as anxiety and depression, before rotator cuff repair (RCR) can be considered an optimal candidate for surgery. The objective of this prospective observational study was to evaluate the relationship between anxiety and depressive symptoms, using the Hospital Anxiety and Depression Scale (HADS) as an assessment tool, and patient-reported outcome measures in RCT after repair surgery. This study included patients with RCT undergoing arthroscopic rotator cuff repair (RCR). Forty-three patients were included who had completed the HADS, Constant Murley Score (CMS), and Short Form Health Survey 36 (SF-36) questionnaires before surgery and in the postoperative follow-up, at 1 month, 3 months, and 6 months. The Friedman test showed that there were statistically significant changes in the different times point for HADS (p < 0.001), anxiety subscale of HADS, i.e., HADS-A (p < 0.001), depression subscale of HADS, i.e., HADS-D (p < 0.001), CMS (p < 0.001), and SF-36 (p < 0.001). The average scores of HADS, HADS-A, and HADS-D improved at each follow-up, showing improvement in discomfort. From the third month after surgery, there was an improvement in anxiety and depression disorders related to improved quality of life, functionality, and pain perception. The trend remained stable until the sixth month of follow up. This study shows that anxiety and depressive symptoms in RCT patients are significantly reduced after RCR with subsequent important improvements in terms of functionality, ability to carry out activities of daily living, perceived pain, and quality of life.

Sleep quality significantly impacts individuals’ overall health, especially in older adults. Older adults often face comorbid conditions, polypharmacy (the intake of five or more medications per day), and medication non-adherence, which are common among those with sleep disorders. The purpose of this systematic review is to examine the relationship between sleep quality and medication adherence in older adults and to describe the measuring instruments used. A systematic review was performed following the PRISMA guidelines. The PubMed, Scopus, Cochrane Library, and CINAHL databases were screened from January 2024 to March 2024. Nine articles were included in the final synthesis based on the inclusion and exclusion criteria. The review found that poor sleep quality is significantly associated with reduced medication adherence in older adults. The key sleep determinants linked to medication non-adherence include sleep disorders, sleep efficiency, sleep duration, and daytime dysfunctions. Inappropriate medication prescriptions have been associated with reduced sleep efficiency. The tools for assessing sleep quality and medication adherence are predominantly subjective and varied. To address these challenges, a comprehensive geriatric assessment should include investigations into sleep disorders and comorbidity factors. Additionally, nursing educational interventions could be pivotal in improving medication adherence among older adults.

Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based on Husserl’s perspective, a qualitative descriptive study was conducted utilizing the phenomenological approach, specifically Interpretative Phenomenological Analysis (IPA). The data analysis followed Giorgi’s phenomenological approach and the inductive content analysis method. Approval for the study was obtained from the relevant Ethics Committee. Results: Themes emerged when participants described experiences about their own adherence to therapy. The following general theme emerged from the interviews and the phenomenological analysis: Generating awareness: taking therapy saves your life. It was followed by three other themes: (1) Drug therapy awareness; (2) Drug therapy in daily life; and (3) Drug therapy as a life partner. Conclusions: Elderly patients undergoing polypharmacological treatment emphasize the key factors for improving medication adherence, highlighting the influence of individual, motivational, and relational aspects. They express a strong desire for information and value the support of family doctors and nurses in managing therapy. Patient interviews indicate general support among elderly patients for using mobile health in pharmacological treatment, recognizing its potential and limitations.

Background: Demographic, social, and familial changes have led to an increase in the lack of family and support systems, which is particularly relevant for older adults who may be at risk for low medication adherence. This study examines the relationship between social isolation and/or loneliness and medication adherence in older adults, also identifying the measurement tools used to explore this relationship. Methods: We conducted a systematic review according to PRISMA guidelines, searching databases including PubMed, CINAHL, PsycINFO, and EBSCO. The quality of evidence was assessed following the GRADE approach, integrated with the JBI Critical Appraisal Tools, NOS for cohort studies and AXIS tools. Results: In the final synthesis, we included five articles. According to the findings of the study, social isolation and loneliness may negatively affect medication adherence in older adults. Loneliness and social support may have a mediating role in the relationship between social isolation and medication adherence. Conclusions: Loneliness and social isolation could influence medication adherence in older patients, especially in managing chronic conditions, but more robust research is needed to confirm the associations between social isolation, loneliness, and medication adherence. However, addressing loneliness and social isolation may be critical to improving medication management among older adults.