摘要
目的调查维持性血液透析患者睡眠质量、焦虑和抑郁情况，探讨认知行为护理干预措施的效果。方法采用匹兹堡睡眠指数量表（PSQI）、抑郁自评量表、焦虑自评量表，对77例维持性血液透析患者进行问卷调查，对52例睡眠障碍患者给予认知行为干预和渐进性肌肉放松训练，比较干预前后睡眠质量、焦虑抑郁情况。结果本组77例维持性血液透析患者中发生睡眠质量差（PSQI〉5分），中至重度焦虑（SAS〉60分），中至重度抑郁（SDS〉60分）者共52例，总发生率67．5％。干预前PSQI总分为（8．60±2．69）分，干预后为（5．08±1．95）分，干预前后比较差异有统计学意义（t=7．643，P〈0．01），焦虑评分、抑郁评分在护理干预后均有改善，与干预前比较差异有统计学意义（t分别为9．732，8．977；P〈0．01）；匹兹堡睡眠指数量表7个因子中主观睡眠质量、睡眠潜伏期、睡眠持续性、习惯睡眠效率、使用睡眠药物、白天功能紊乱6个因子在护理干预前后差异有统计学意义（t分别为2．127，3．371i5．674，6．399，2．255，2．039；P〈0．05或P〈0．01）。结论认知行为干预方法结合渐进性肌肉放松训练能降低维持性血液透析患者焦虑、抑郁水平，提高睡眠质量。
Objective To explore the effects of cognitive behavior intervention on status of the sleep quality, anxiety and depression of the patients who received maintenance hemodialysis. Methods By questionnaire survey, 77 maintenance hemodialysis patients were investigated with Pittsburgh Sleep Quality Index （PSQI）, Self-Rating Depression Scale （SDS） and Self-Rating Anxiety Scale （SAS）. Among them, 52 with sleep disorders were given cognitive behavioral intervention and progressive muscle relaxation （PMR） training by one to one guidance. Results Of the 77 patients, 52 （67.5%） showed low sleep quality （ PSQI 〉 5 ）, moderate to severe anxiety （ SAS 〉 60） and moderate to severe depression （ SDS 〉 60）. PSQI score before and after the intervention was （ 8.60 ± 2.69 ）, （5.08 ± 1.95 ）, respectively. The difference was statistically significant （t =7. 643,P 〈0. 01 ）. SDS and SAS also improved after the intervention, and the difference was statistically significant （ t = 9. 732,8. 977 ; P 〈 0. 01 ）. The scores of the six dimensions of PSQI showed significant difference （ t = 2. 127,3. 371,5. 674,6. 399,2. 255,2. 039 ; P 〈 0. 05 or P 〈 0. 01 ） after the intervention as compared to before the intervention, regarding subjective sleep quality, sleep latency, sleep continuity, habits of sleep efficiency, sleep disorders and day function. Conclusions The cognitive behavioral intervention and progressive muscle relaxation （PMR） could decrease level of anxiety and depression and improve sleep quality of patients who received maintenance hemodialysis.
出处
《中华现代护理杂志》
2011年第22期2630-2632,共3页
Chinese Journal of Modern Nursing
基金
深圳市科技计划项目（200903260）
关键词
睡眠障碍
护理干预
维持性血液透析
Sleep disorders
Nursing intervention
Maintenance hemodialysis
