脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性的关系

目的评估脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性状况,探索脑卒中偏瘫患者照顾者心理弹性在照顾负担和睡眠质量间的中介和调节作用。方法采用匹兹堡睡眠质量指数、照顾负担量表、Connor-Davidson心理弹性量表对306名脑卒中偏瘫患者照顾者进行测评。结果照顾者睡眠质量总分为9.3±3.7,睡眠障碍检出率为57.8%;照顾负担总分为35.9±11.2,心理弹性总分为55.0±16.1。照顾负担得分与心理弹性得分呈负相关,与睡眠质量得分呈正相关;心理弹性得分与睡眠质量得分呈负相关(均P0.01)。心理弹性在照顾负担和睡眠质量间起到部分中介和调节作用。结论增强脑卒中偏瘫患者主要照顾者的心理弹性水平,有利于减轻其照顾负担,改善其睡眠质量。     

健康赋权在老年2型糖尿病患者述情障碍和自我管理的中介作用

目的 探讨老年2型糖尿病患者述情障碍和自我管理的相关性及健康赋权在两者间的中介作用.方法 采用多伦多述情障碍量表、老年慢性病患者健康赋权量表以及糖尿病自我管理行为量表,对3所三甲医院的210例老年2型糖尿病患者进行问卷调查.结果 老年2型糖尿病患者自我管理得分为(87.18±11.07)分,述情障碍得分为(57.53±10.09)分,健康赋权得分为(91.69±10.67)分;述情障碍与健康赋权、自我管理呈显著负相关(均P＜0.01),健康赋权与 自我管理呈正相关(P＜0.01).健康赋权在述情障碍与 自我管理间起部分中介作用,中介效应占总效应的41.52％.结论 老年2型糖尿病患者述情障碍、健康赋权和自我管理关系密切,述情障碍可通过健康赋权间接影响自我管理.护理人员可通过降低老年2型糖尿病患者的述情障碍程度,提升健康赋权水平,以增强自我管理能力.     

肿瘤患者PICC留置期健康促进行为与心理一致感及抑郁的关系

目的了解肿瘤患者PICC留置期间健康促进行为情况,探讨其健康促进行为与心理一致感、抑郁的关系。方法采用健康促进生活方式量表、心理一致感量表、抑郁自评量表对130例留置PICC肿瘤患者进行调查。结果肿瘤患者PICC留置期间健康促进行为得分为135.7±15.7;健康促进行为总分与心理一致感总分呈正相关,与抑郁呈负相关(均P0.01)。结论肿瘤患者PICC留置期间健康促进行为处于中等水平,健康促进行为与心理一致感和抑郁密切相关。医护人员应帮助肿瘤患者获得有效的社会支持,提高患者心理一致感水平,同时密切关注患者情绪变化,以改善和提高肿瘤患者PICC留置期间健康促进行为水平。     

维持性血液透析患者家庭照顾者心理一致感现状及影响因素

目的 探讨维持性血液透析患者家庭照顾者心理一致感现状及影响因素,为制订有效的护理干预方案提供指导.方法 便利抽样选取武汉市2所三甲医院维持性血液透析患者家庭照顾者237名,采用一般资料问卷、心理一致感量表、照顾准备度量表及积极感受量表进行调查.结果 维持性血液透析患者家庭照顾者心理一致感得分为(56.37±11.77)分.家庭照顾者心理一致感与照顾准备度、积极感受呈正相关(均P＜0.01).多元线性回归分析显示,照顾准备度及积极感受是家庭照顾者心理一致感的主要影响因素(均P＜0.01),共可解释其38.0％的总变异量.结论 维持性血液透析患者家庭照顾者心理一致感处于较低水平.医护人员需针对影响因素给予指导干预,提高其心理一致感,促进心理健康.     

精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系

目的探讨精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系,以及自我效能和心理弹性在病耻感与情绪行为问题关系中的中介效应。方法选取山东省某精神卫生中心前来门诊就诊及住院的精神疾病患者未成年子女104人作为研究对象,采用Link贬低-歧视感知量表、一般自我效能量表(GSES)、心理弹性量表(RS)、长处和困难问卷(SDQ)进行调查。结果精神疾病患者未成年一级亲属的情绪行为问题分别在性别、居住地、就读学校和是否独生子女上存在显著差异性(P0.05,P0.01);精神疾病患者未成年一级亲属SDQ总分与病耻感呈显著正相关(P0.01),与自我效能和心理弹性均呈显著负相关(均P0.01);病耻感分别与心理弹性和自我效能均呈显著负相关(均P0.01);心理弹性与自我效能呈显著正相关(P0.01);自我效能和心理弹性在病耻感与情绪行为问题之间起到完全中介作用(P0.05,P0.01)。结论感知到病耻感的精神疾病患者未成年一级亲属存在情绪行为问题,而自我效能和心理弹性在病耻感与精神疾病患者未成年一级亲属情绪行为问题关系中起完全中介作用。     

肺癌患者创伤后应激障碍及睡眠状况对心理健康的影响

目的调查首诊肺癌患者创伤后应激障碍、睡眠状况及其对患者心理健康状况的影响。方法采用事件冲击量表(IES)、睡眠状况自评量表(SRSS)及症状自评量表(SCL-90)对117例首诊肺癌患者进行调查。结果患者创伤后应激障碍总均分2.46±0.33,睡眠状态总均分2.41±0.68,心理健康状态总均分1.82±0.32;创伤后应激障碍、睡眠状况与心理健康状况呈正相关(均P0.01);创伤后应激障碍、睡眠状况、患者文化程度、家庭人均收入、医疗支付方式、肿瘤分期及是否转移是肺癌患者心理健康状况的主要影响因素(均P0.01)。结论肺癌患者创伤后应激障碍、睡眠状况影响其心理健康状况,需采取针对性干预降低患者创伤后应激障碍,提高睡眠质量,改善患者的心理健康状况。     

老年腹膜透析患者睡眠质量及生活质量的研究

目的了解老年腹膜透析患者睡眠质量,分析睡眠质量与生活质量之间的关系。方法采用匹兹堡睡眠指数量表(Pittsburgh Sleep Quality Index,PSQI)和简明健康调查量表(Medical Outcomes Study Health Status Short Form,SF-36)对75例老年腹膜透析患者的睡眠质量和生活质量进行测评。结果本组患者的PSQI总分为7.89±4.36,高于正常老年组(P0.05),33例(44.0%)患者睡眠质量差。睡眠质量好的患者除社会功能外SF-36各维度评分显著高于睡眠质量差者(P0.05,P0.01);生理健康、心理健康与PSQI总分呈负相关(均P0.01);多元回归分析显示影响生活质量的主要影响因素有PSQI总分、主观睡眠质量、入睡时间、睡眠效率、睡眠障碍、日间功能障碍。结论本组老年腹膜透析患者睡眠质量较差,睡眠质量影响其生活质量,建议采用非药物干预措施改善患者的睡眠质量,以利于生活质量的提高。     

包容型领导对护士心理授权及建言行为的影响

目的探讨包容型领导对护士建言行为的影响,并检验心理授权的中介作用。方法采用包容型领导量表、心理授权量表、建言行为量表对2所大型公立医院251名护士进行调查。采用Pearson相关性分析及多元阶层线性回归分析法检验变量之间的关系及中介效应。结果包容型领导均值为(5.28±1.18)分,心理授权和建言行为得分分别为(5.28±1.09)分和(5.53±1.14)分。包容型领导与护士心理授权(r=0.766,P0.01)、建言行为(r=0.643,P0.01)呈显著正向相关性。心理授权和建言行为呈显著正向相关性(r=0.724,P0.01)。包容型领导对护士心理授权(β=0.749,P0.01)和建言行为(β=0.635,P0.01)具有积极显著的正向预测,心理授权在二者之间起部分中介作用(中介效应=0.537,P0.01)。结论包容型护士长可以有效促进下属护士心理授权感知,进而利于护士积极地向组织建言献策。护理管理者应适当地接纳护士的建议,在必要时给予下属支持与帮助,从而激励下属积极地为护理工作与组织建设贡献自己的智慧与力量。     

老年乳腺癌患者掌控感现状的调查分析

目的探讨老年乳腺癌患者掌控感现状及其与焦虑、抑郁情绪的关系,为临床心理护理提供参考。方法采用一般资料调查问卷、生活掌控感量表、医院焦虑抑郁量表对123例老年乳腺癌患者进行问卷调查。结果老年乳腺癌患者掌控感总分(15.11±3.78)分,均分(2.16±0.54)分;家庭关系、文化程度、疾病认知是老年乳腺癌患者掌控感的影响因素;掌控感与焦虑、抑郁情绪呈负相关(均P0.01)。结论老年乳腺癌患者掌控感水平偏低,临床护理人员应多种举措并举促进其掌控感的发展。     

维持性血液透析患者睡眠障碍、相关因素及对生活质量的影响

目的:评估维持性血液透析(MHD)患者中睡眠障碍的患病率、相关因素及对生活质量的影响,为改善患者的睡眠障碍及提高生活质量提供理论依据。方法:采用横断面调查的方法,连续纳入2015年10月~2016年3月间在本院血液透析中心接受MHD的患者。采用匹兹堡睡眠质量指数量表(PSQI)评定睡眠质量,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者的焦虑、抑郁状况,分析引起睡眠障碍的相关因素。采用SF-36量表评定患者健康相关生活质量,研究睡眠障碍对患者生活质量的影响。结果:共纳入58例MHD患者,男29例(50.0%),年龄18岁~85岁,平均(55.4±15.5)岁。共有69.0%(40/58)的患者PSQI总分大于5分。调整了可能的混杂因素后,SDS标准分与PSQI总分相关(OR1.200,95%CI1.086~1.327)。单因素分析显示,除情感职能外,睡眠障碍组SF-36各维度得分及总分均显著低于无睡眠障碍组。多元逐步线性回归分析显示,PSQI得分和SAS标准分与生活质量生理健康和生活质量心理健康得分均呈负相关。结论:MHD患者睡眠障碍的患病率很高,抑郁症状是影响患者睡眠质量的主要因素,且睡眠障碍显著影响患者的生活质量,应采取相应的干预措施和心理护理。     

轻度认知障碍并发失眠症老年患者的抚触保健操干预

目的探讨抚触保健操对轻度认知障碍并发失眠症老年患者的干预效果。方法对34例轻度认知障碍并发失眠症老年患者在常规护理基础上行抚触保健操干预,每周3次,每次30min,连续8周。干预前后使用匹兹堡睡眠指数量表(PSQI)、睡眠日志(SD)、Epworth嗜睡量表(ESS)进行疗效评价。结果干预后PSQI总分及各成分评分显著降低,SD总睡眠时间、睡眠效率、入睡时间得到改善,ESS总分降低,与干预前比较差异有统计学意义(均P0.01)。结论抚触保健操干预可改善轻度认知障碍伴失眠症老年患者的睡眠状况和日间功能障碍。     

农村老年人运动功能与睡眠质量现状及相关性研究

目的 探讨农村老年人运动功能和睡眠质量现况及其相互关系。 方法 采用整群抽样方法,使用老年人运动功能量表（GLFS-25）和匹兹堡睡眠质量指数量表（PSQI）对493名老年人进行调查。 结果 老年人运动功能障碍综合征发生率为30.22%,性别、年龄、BMI、睡眠障碍是老年人运动功能障碍综合征的危险因素;睡眠障碍发生率为37.32%,性别、运动功能障碍综合征是老年人睡眠障碍的危险因素。 结论 农村老年人运动功能与睡眠质量较差,二者呈正相关,互为影响因素。护理人员在关注老年人运动功能的同时,也应关注老年人的睡眠质量,以改善其生活质量。     

Quality of sleep and health-related quality of life in haemodialysis patients.

BACKGROUND: Sleep complaints are common in haemodialysis patients. In the general population, insomnia impacts negatively on health-related quality of life (HRQoL). The objective of this study was to examine the association between quality of sleep and HRQoL in haemodialysis patients independent of known predictors of HRQoL. METHODS: Quality of sleep was measured using the Pittsburgh Sleep Quality Index (PSQI) and HRQoL was measured using the Medical Outcomes Study 36-item Short Form (SF-36) in 89 haemodialysis patients. RESULTS: Sixty-three (71%) subjects were 'poor sleepers' (global PSQI >5). The SF-36 mental component summary (MCS) and physical component summary (PCS) correlated inversely with the global PSQI score (MCS, r = -0.28, P < 0.01; PCS, r = -0.45, P < 0.01). The PCS score also correlated with age (r = -0.24, P = 0.02), haemoglobin (r = 0.21, P = 0.048) and comorbidity (r = -0.40, P < 0.01), and mean PCS was lower in depressed subjects (26.2 vs 35.9, P = 0.02). Subjects with global PSQI >5 had a higher prevalence of depression, lower haemoglobin and lower HRQoL in all SF-36 domains. The global PSQI score was a significant independent predictor of the MCS and PCS after controlling for age, sex, haemoglobin, serum albumin, comorbidity and depression in multivariate analysis. CONCLUSIONS: Poor sleep is common in dialysis patients and is associated with lower HRQoL. We hypothesize that end-stage renal disease directly influences quality of sleep, which in turn impacts on HRQoL.     

Higher plasma interleukin-18 levels associated with poor quality of sleep in peritoneal dialysis patients.

BACKGROUND: Sleep disorders are prevalent in patients with end-stage renal disease. Increasing evidence suggests that cytokines are involved in the regulation of sleep and wakefulness. The purpose of this study was to examine the relationship between quality of sleep and plasma interleukin-18 levels in peritoneal dialysis patients. METHODS: Plasma interleukin-18 levels were determined by the enzyme-linked immunosorbent assay (ELISA) methodology in 57 peritoneal dialysis patients. Quality of sleep was measured using the Pittsburgh Sleep Quality Index. Demographic and routine laboratory data were recorded. RESULTS: In our cohort, the poor sleepers had higher plasma interleukin-18 levels (559.16 +/- 261.22 pg/ml vs 397.49 +/- 191.81 pg/ml, P = 0.01). The plasma interleukin-18 level was positively correlated with the Pittsburgh Sleep Quality Index score (r = 0.286, P = 0.031), that is, there was a positive association between higher plasma interleukin-18 levels and poorer quality of sleep. CONCLUSION: This study demonstrates that interleukin-18 may be involved in sleep disorders in end-stage renal disease patients. Higher plasma interleukin-18 levels are associated with poorer quality of sleep in peritoneal dialysis patients. Whether a cause-and-effect relationship exists between interleukin-18 and quality of sleep deserves further study.     

The investigation of sleep quality and the quality of life in end-stage renal disease patients

Objective To evaluate the sleep quality as well as the quality of life in end-stage renal disease (ESRD) patients, analyze the relationships between them and explore the influence factors. Methods A total of 141 ESRD patients from three hospitals were enrolled. The patients' general information including age, gender, degree of education, income, primary disease and years on dialysis were collected. Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality of the patients, and the life quality was assessed by using Kidney Disease Quality of Life-short form (KDQOL-SF). Results The incidence of sleep disorder was 56% in these 141 ESRD patients. The patients who suffered from sleep disorder had a higher sleep index score in all aspects of PSQI except in usage of sleep medications (P＜0.05). On the aspect of life-quality-associated factors, dialysis-related symptoms (OR=0.944, P=0.026), and change of health status (OR=1.024, P=1.024) were independent risk factors for sleep disorders. As for family-social factors, sleep quality was closely associated with dialysis (r=-0.252, P=0.003), family support (r=-0.174, P=0.040), and BMI (r=-0.189, P=0.025). Further regression analysis found that hemodialysis or peritoneal dialysis (OR= 0.544, P=0.011), poor family support (OR=0.686, P=0.030) were independently risk factors of sleep disorders. Conclusions Poor sleep quality is common in ESRD patients and it is associated with lower quality of life. More attention should be paid on assessment and management of sleep disorder in ESRD patients in order to improve their quality of life.     

精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系

目的 探讨精神疾病患者未成年一级亲属病耻感与情绪行为问题的关系,以及自我效能和心理弹性在病耻感与情绪行为问题关系中的中介效应.方法 选取山东省某精神卫生中心前来门诊就诊及住院的精神疾病患者未成年子女104人作为研究对象,采用Link贬低-歧视感知量表、一般自我效能量表（GSES）、心理弹性量表（RS）、长处和困难问卷（SDQ）进行调查.结果 精神疾病患者未成年一级亲属的情绪行为问题分别在性别、居住地、就读学校和是否独生子女上存在显著差异性（P＜0.05,P＜0.01）;精神疾病患者未成年一级亲属SDQ总分与病耻感呈显著正相关（P＜0.01）,与自我效能和心理弹性均呈显著负相关（均P＜0.01）;病耻感分别与心理弹性和自我效能均呈显著负相关（均P＜0.01）;心理弹性与自我效能呈显著正相关（P＜0.01）;自我效能和心理弹性在病耻感与情绪行为问题之间起到完全中介作用（P＜0.05,P＜0.01）.结论 感知到病耻感的精神疾病患者未成年一级亲属存在情绪行为问题,而自我效能和心理弹性在病耻感与精神疾病患者未成年一级亲属情绪行为问题关系中起完全中介作用.     

Association between personal basic information,sleep quality,mental disorders and erectile function: a cross‐sectional study among 334 Chinese outpatients

Male erectile dysfunction (ED) may cause anxiety and depression, while mental disorders and sleep disturbances may also be closely related to ED. However, the exact nature of their relationship remains unclear, and whether personal basic background data affect erectile function is unknown. We conducted a cross‐sectional study among Chinese outpatients with ED from January 2012 to December 2014. All the men answered a questionnaire collecting information about mental health status, sleep disturbances and personal data, underwent a physical examination and had a blood sample drawn. Sleep disturbances were assessed on the basis of a 19‐item version of the Pittsburgh Sleep Quality Index, which includes questions on sleep patterns during the past month. Among the 462 patients, 128 patients with alcohol abuse, diabetes, hypertension, hyperlipidaemia, psychiatric drugs, neurologic injury or abnormal hormones were excluded from the study; 86.27% and 68.66% of the patients suffered from anxiety and depression respectively. Sleep quality and anxiety symptoms significantly affected erectile function, whereas personal income and education level had no significant effects. Our study suggested that it is necessary to pay attention to the psychological status of patients with ED, especially anxiety disorder. Sleep quality may be an important factor affecting erectile function according to the personal data.     

外科重症监护室老年患者的多导睡眠图分析

目的 评估外科重症监护室(surgical intensive care unit,SICU)非机械通气老年患者术后的睡眠质量和睡眠结构. 方法 采用澳大利亚生产的Compumedics Siesta多导睡眠图(polysomnography,PSG)监测系统,分析50例SICU术后当晚的非机械通气老年患者(病例组)和40例非手术的老年体检者(对照组)的PSG. 结果 与对照组比较,病例组的术后睡眠总时间减少[289.5 min(147.5～398.8 min)比218.4 min(125.3～345.7 min)] (P＜0.05),睡眠效率低[48.2％ (24.6％～66.5％)比36.3％(20.8％～57.6％)](P＜0.05);病例组术后睡眠以1期睡眠为主[67.3％(21.6％～78.3％)],对照组睡眠以2期睡眠为主[59.6％(18.2％～73.2％)];与对照组比较,病例组术后深睡眠显著减少[18.3％(4.1％～20.9％)比7.9％(0～11.4％)](P＜0.05),所有患者缺乏快速眼动睡眠(rapid eye movement,REM),72％(36例)患者缺乏慢波睡眠(slow wave sleep,sws),对照组只有6例缺乏REM,5例缺乏SWS.与对照组比较,病例组的术后睡眠更破碎,夜间睡眠觉醒更频繁[9.1次/h(4.8～24.3次/h)比20.5次/h(8.8～32.2次/h)](P＜0.01). 结论 术后老年患者容易出现睡眠障碍和睡眠剥夺,表现为睡眠总时间不足、深睡眠缺乏、睡眠破碎、频繁觉醒.