65～80岁老年患者睡眠质量与心理状况的相关性研究

目的 调查老年住院患者心理健康状况和睡眠质量情况,分析二者的相瓦关系.方法 纳入2005年10月-2007年10月在哈尔滨医科大学附属第四医院老年住院患者300例.采用匹兹堡睡眠质量评价老年住院患者的睡眠质量,以匹兹堡睡眠质量指数>8分作为睡眠障碍的标准,将300例患者按匹兹堡睡眠质量指数<5分,5～8分,>8分为3组.分别为70例、84例、146例;采用心理卫生自评量表(90项症状自评量表)评价患者心理状况.测试前向患者说明调查目的及意义,要求患者在1～2 h内独立完成答卷,各组间心理卫生自评量表得分比较采用方差分析,匹兹堡睡眠质量指数和心理卫生自评量表得分的相关性分析采用Spearman等级相关分析.结果 按意向处理分析,300例患者全部进入结果分析.(1)匹兹堡睡眠质量指数>8分的患者症状自评量表中躯体化、强迫、抑郁、焦虑、精神病性5个因子及总均分显著高于5～8分和<5分的患者,且匹兹堡睡眠质量指数得分越高,症状自评量表各因子及总得分越高.(2)症状自评量表躯体化、强迫、抑郁、焦虑、精神病性5个因子及总分与睡眠质昔呈显著正相关,其中其他、躯体化、强迫、3个因子与睡眠质量、入睡时间、睡眠时间、睡眠效率呈现非常显著正相关,郁抑郁、焦虑、和症状自评量表与睡眠效率呈显著正相关.结论 老年住院患者睡眠质量越差.焦虑分和抑郁分就愈高,呈显著正相关,并且促使焦虑,抑郁等多种情绪障碍的发生.说明住院老年人失眠不单单是一个睡眠生理紊乱,同时还有一个心理紊乱过程.

Relativity study on sleep quality and mental status for 65 to 80 years old people

Objective To investigate the mental health status and sleep quality in elderly inpatients, and probe into the relationship between them. Methods A total of 300 elderly inpatients were selected from the Fourth Affiliated Hospital of Harbin Medical University from October 2005 to October 2007. Pittsburgh sleep quality index (PSQI) was used to assess the sleep quality, and Pittsburgh sleep quality index more than 8 was used as the judging standard of sleep disorder. The 300 patients were divided into the group of PSQI less than 5 (n = 70), the group of PSQI from 5 to 8 (n = 80), and the group of PSQI more than 8 (n = 146) according to their PSQI index. The symptom checklist 90 (SCL-90) was used to assess the influence of mental status. The objective and significance were explained to the patients before the test. The patients were asked to finish the questionnaires within 1 to 2 hours independently. The analysis of variance (ANOVA) was made to compare the means of scores for SCL-90, and correlation analysis based on Spearman was used to make the correlation test between the mental health status and sleep quality. Results According to the intention, all the 300 patients were analyzed in the result.① The scores of somatization, compulsion, depression, anxiety and psychoticism and the total score in the group of PSQI more than 8 were significantly higher than those in the groups of PSQI from 5 to 8 and less than 4. The higher the score of PSQI was, the higher the score of factors and the total score of SCL-90 were. ② The scores of somatization, compulsion, depression, anxiety and psychoticism and the total score were in a highly positive correlation with the sleep quality, wherein the scores of others, somatization and compulsion were in a significantly positive correlation with the scores of sleep, time for falling asleep, time of sleep and efficiency of sleep. The scores of depression and anxiety and the total score of SCL-90 were in a highly positive correlation with the score of efficiency of sleep. Conclusions The poorer the sleep quality in eider inpatients is, the higher the scores of depression and anxiety are, so they axe in a remarkable positive correlation. The poor sleep quality causes the emotional disorder such as depression and anxiety. Our results indicate that sleeplessness is not only a kind of physical order, but also a kind of mental order.