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患者术前睡眠状况调查及影响因素
高晗夏天娇顾小萍饶丽华高翔
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摘要:
目的 分析影响患者术前睡眠质量的因素。方法 采用分层随机抽样方法,抽取2017年 6 月1 日—2017 年10 月1 日拟行择期手术患者886 例。收集患者一般情况,并于术前一日对患者进行 问卷调查,包括医学结局研究睡眠量表(MOS-SS)、自拟睡眠影响因素调查表、视觉模拟评分(VAS 评分)、 医院焦虑抑郁量表(HADS)。结果 术前1 个月睡眠障碍指数为35.8(28.3,45.3),睡眠不良发生率为 63.1%(559/886),术前1 周为37.7(30.2,47.2),67.7%(600/886),两次比较差异均有统计学意义(Z=-5.367, χ2=60.749;P< 0.01)。自拟睡眠影响因素调查表显示自诉噪音、睡眠环境改变、疾病带来的不适、邻床 患者中重度影响睡眠的患者分别占34.1%、25.4%、23.8%、14.7%。对多因素Logistic回归分析显示,职业、 宗教、焦虑、抑郁影响患者术前1 个月的睡眠质量;性别、活动时疼痛水平、焦虑、抑郁、手术科室影响患 者术前1 周的睡眠质量。结论 手术患者术前睡眠障碍发生率很高,与多种因素有关。
关键词:  睡眠障碍  手术  疼痛  焦虑  抑郁
DOI:10.3969/j.issn.1009-6574.2018.06.006
基金项目:国家自然科学基金项目(81371207)
Research on sleep quality of preoperative patients and its influencing factors
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Abstract:
Objective To investigate the influencing factors of patients' sleep quality before operation. Methods A total of 886 patients scheduled for elective surgery from June 1, 2017 to October 1, 2017 were selected by stratified random sampling method. The general data of the patients was collected and a questionnaire survey was conducted on the day before operation, including the Medical Outcomes Study Sleep Scale( MOS-SS), the self-designed sleep-related factors questionnaire, Visual Analogue Scale( VAS), Hospital Anxiety and Depression Scale( HADS). Results The sleep problems index( SPI) and the incidence of sleep disorder one month before operation were 35.8( 28.3, 45.3) and 63.1%( 559/886) respectively. Those indicators one week before operation were 37.7( 30.2,47.2) and 67.7%( 600/886) respectively. The differences were statistically significant( Z=-5.367,χ2=60.749; P < 0.01). It is indicated in the self-designed sleeprelated factors questionnaire that the factors of noise, the sleep environment changes, the discomfort caused by illness and the roommates influencing sleep quality comprised 34.1%, 25.4%, 23.8% and 14.7% respectively. Multivariate Logistic regression analysis showed that occupation, religion, anxiety and depression affected the quality of sleep in one month before surgery, and gender, pain level during activity, anxiety, depression and the department of surgery affected the quality of sleep in one week before surgery. Conclusions Preoperative sleep disorder is very prevalent and related to multiple factors.
Key words:  Sleep disorder  Operation  Pain  Anxiety  Depression

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