目的 探讨原发性失眠患者日间功能损害及其影响因素。 方法 选取2010年3月－12月符合美国《精神障碍诊断与统计手册》第4版诊断标准的原发性失眠者62例，另选择性别、年龄匹配的健康睡眠者53例。失眠组和对照组均采用匹茨堡睡眠质量指数量表（PSQI）评估1个月的主观睡眠质量，多导睡眠监测（PSG）评估客观睡眠质量，并通过“主观睡眠时间/客观睡眠时间×100%”计算睡眠知觉，PSG监测后受试者完成一系列日间功能评定，包括Epworth嗜睡量表（ESS）评价嗜睡程度、Flinders疲劳量表（FFS）评价疲劳程度、贝克抑郁量表（BDI）和状态-特质焦虑量表（STAI）评估情绪状态。 结果 ① 与对照组相比，失眠组主客观睡眠质量均较差；PSQI分数更高[（14.37 ± 2.44）、（2.74 ± 1.79）分，P＜0.001）]；睡眠知觉差[（49.76 ± 33.29）、（99.36 ± 12.79）分，P＜0.001）]。② 失眠组FSS、BDI、SAI、TAI分数明显高于对照组，ESS分数低于对照组（P值均＜0.05）。③ PSQI总分与ESS呈负相关（r=−0.17，P＜0.01），与FSS、BDI、SAI、TAI分数呈正相关（r=0.54，r=0.66，r=0.70，r=0.87）（P值均＜0.01）。客观睡眠时间与ESS（r=−0.01，P=0.138）、FSS（r=−0.02，P=0.019）、BDI（r=−0.03，P=0.022）、SAI（r=−0.03，P=0.086）、TAI（r=−0.04，P=0.015）分数均无明显相关性。 结论 原发性失眠者主观睡眠质量与多项日间功能损害相关，这为有效的治疗失眠和改善日间症状提供理论依据。
目的 了解老年患者住院期间睡眠影响因素及质量。 方法 对2009年7月－12月入住老年科的108例患者运用匹兹保睡眠质量指数（PSQI）和自编影响睡眠因素调查表进行调查分析。 结果 92.6%的老年患者有睡眠质量问题，病情不稳定患者比病情稳定者睡眠障碍发生率高，病房温湿度、气味、夜间光线、夜间查房等环境因素和担心家事、家人朋友不关心等社会因素，夜间喝浓茶、咖啡的不良习惯对睡眠质量的影响差异有统计学意义（P＜0.05）。 结论 多数老年患者住院期间睡眠质量差，医护人员应对此予以高度重视，针对性地采取有效治疗、护理措施及健康指导方式，改善老年患者睡眠质量。
Objective To compare the effect of different doses of compound betamethasone intradermal block on post-herpetic neuralgia (PHN) in elderly patients. Methods Between June 2013 and December 2014, 96 elderly patients who matched the criteria of PHN were chosen and randomly divided into saline control group (group C), compound betamethasone 0.5 mL group (group B0.5) and compound betamethasone 1.0 mL group (group B1.0). For the control group, 20 mL analgesic saline liquid including 5 mL of 2% lidocaine was used. And 0.5 and 1.0 mL compound betamethasone was added into the solution of group C to get the solution for group B0.5 and group B1.0, respectively. The patients got intracutaneous injection once in the affected area on the day 1, 8, and 15 respectively, and patients in the same group were injected the same solution of analgesic liquid. All the patients took the same medicine during treatment. Their visual analog scale (VAS) scores, quality of sleep (QS) scores and adverse events before treatment (T0), at discharging from the hospital (T1), and three months after discharging (T2) were carefully noted and analyzed. Results The VAS and QS scores of the three groups at T1 and T2 improved significantly compared with those at T0 (P < 0.05). The VAS and QS scores of group B0.5 and group B1.0 improved significantly more compared with group C (P < 0.05), and the difference of VAS and QS scores between group B0.5 and group B1.0 was not statistically insignificant (P > 0.05). Conclusions Adding 0.5 mL or 1 mL of compound betamethasone to the 20 mL analgesic liquid for intradermal block treatment on PHN can obviously release patients’ pain and improve their sleep quality. Compared with 1 mL, adding 0.5 mL compound betamethasone to the 20 mL analgesic liquid for intradermal block treatment on PHN is a more ideal dose.
ObjectiveTo observes the postoperative transformation of subjective and objective sleep quality and related influencing factors in patients with rheumatic valvular heart disease (RVHD) who were found with central sleep apnea (CSA) after cardiac valve replacement.MethodsA total of 262 patients undergoing cardiac valve replacement were screened for CSA by overnight polysomnography and 21 patients with CSA were enrolled and followed up successfully in the 3th, 6th and 12th month of postoperation from April 2010 to January 2013. The Pittsburgh Sleep Quality Index, Epworth Sleepiness, polysomnography and cardiac function were evaluated in preoperation and postoperation (in the 3th, 6th and 12th month).ResultsNew York Heart Association class ［preoperation and postoperation: (3.7±0.5), (2.3±0.6), (1.7±0.6), (1.6±0.7), F=81.124, P<0.05］ continuously decreased, left ventricular ejection fraction ［preoperation and postoperation: (58.5±6.8)%, (60.0±7.4)%, (60.9±5.6)%, (64.4±4.0)%, F=7.182, P<0.05］ steadily increased, six-minute walk distance ［preoperation and postoperation: (271.5±76.6), (422.1±71.9), (445.1±56.2), (454.5± 63.5) m, F=67.134, P<0.05］ constantly increased. During postoperative follow-up, sleep apnea-hypopnea index ［preoperation and postoperation: (26.2±13.4), (12.0±11.5), (8.6±7.5), (7.4±5.5)/h, F=20.548, P<0.05, central sleep apnea index ［preoperation and postoperation: (19.6±10.3), (0.5±1.5), (0.3±1.3), (0.2±0.7)/h, F=72.926, P<0.05］ and oxygen desaturation index ［preoperation and postoperation: (20.1±16.6), (10.8±9.5), (8.5±7.2), (6.1±5.1)/h, F=9.646, P<0.05］ sustained improved. Aroual index ［preoperation and postoperation: (23.1±12.1), (2.7±3.8), (3.5±4.8), (2.2±2.1)/h, F=58.370, P<0.05］ presented overall downward trend. Pittsburgh Sleep Quality Index scale ［preoperation and postoperation: (11.1±3.2), (8.2±3.3), (6.0±3.8), (4.4±2.5), F=27.670, P<0.05］ were constantly improved. Epworth Sleepiness scale ［preoperation and postoperation: (13.3±5.7), (6.9±4.5), (8.2±4.8), (6.1±3.7), F=15.994, P<0.05］ showed overall reduction.ConclusionThe sleep quality of patients with RVHD and CSA is improved after cardiac valve replacement, of which the trend is in keep with postoperative recovery of cardiac function.
ObjectivesTo assess the efficacy of non-drug interventions on improving sleep quality in ICU patients by network meta-analysis.MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect randomized controlled trials (RCTs) on non-drug interventions on improving sleep quality in ICU patients from inception to December, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, network meta-analysis was performed by using the Stata 13.0 software.ResultsA total of 12 RCTs, involving 1 223 patients and 9 non-pharmacological interventions (music therapy, comprehensive nursing intervention, TCM emotions, music therapy+TCM emotions, Chinese medicine pillow therapy, ear acupressure, eye mask+earplugs+music, eye mask+earplugs, regular care) were included. The results of Pittsburgh sleep quality index (PSQI) showed that eye mask+earplugs, eye masks, and comprehensive nursing interventions were superior to conventional care in improving sleep quality in ICU patients, and the rankings were: eye mask+earplugs>eye mask>comprehensive nursing intervention, music therapy+TCM emotional>Chinese medicine emotional>music therapy>general care. The results of Richards-Campbell sleep scale (RCSQ) showed that eye mask+earplugs+music, Chinese medicine pillow therapy, and auricular pressure beans were superior to conventional care, and the rankings were: eye mask+earplugs+music>Chinese medicine pillow therapy>music therapy>ear acupressure beans>general care.ConclusionsThe evidence shows that in improving the sleep quality of ICU patients, eye mask + earplug, eye mask, comprehensive nursing intervention, music therapy + TCM emotional characteristics may all be effective intervention methods. It is suggested that more non-drug interventions should be carried out in the future for enhancing the sleep quality of ICU patients.
ObjectiveTo systematically review the correlation between sleep quality and social support of the elderly.MethodsDatabases including PubMed, MEDLINE, The Cochrane Library, Springerlink, ProQuest, CMB, CNKI, VIP, and WanFang Data were searched to collect studies on the correlation between sleep quality and social support of the elderly from January 1996 to January 2020. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 9 studies involving 2 427 elderly people were included. The meta-analysis showed that the combined correlation coefficient between sleep quality and social support was -0.40 (95%CI −0.54 to −0.26). The correlation between sleep quality and social support of the elderly varied with the year of publication and sample size, however without regular change. The correlation coefficient of the elderly from institutions (hospital or pension institutions) was higher than that of the community (−0.33 vs. −0.26); the correlation coefficient of the elderly with health problems was higher than those without health problems (−0.32 vs. −0.25); the results measured by non-random sampling method were higher than those measured by random sampling (−0.37 vs. −0.23); and the results measured by Pittsburgh sleep quality index (PSQI) and social support rating scale (SSRS) were higher than those measured by PSQI and perceived social support scale (PSSS) (−0.30 vs. −0.13).ConclusionsThe higher the level of social support of the elderly in China, the lower the score of PSQI, and the better the sleep quality, in which there are differences in different sample sources and physical conditions.
Objective To explore the influencing factors of sleep quality of the elderly in Chengdu community and put forward corresponding nursing strategies. Methods The elderly in four communities in Chengdu were selected by convenient sampling method from January to June 2021. The elderly in the community were investigated and analyzed by general information questionnaire, Interpersonal Relationship Integrative Diagnostic Scale (IRIDS) and Pittsburgh Sleep Quality Index (PSQI). Multiple linear stepwise regression was used to analyze the factors affecting the sleep quality of the elderly. Results A total of 232 elderly were investigated and 211 were finally included. The total score of PSQI in the elderly was positively correlated with the score of interpersonal conversation disturbance (r=0.297, P<0.05) and the score of treating people disturbance (r=0.208, P<0.05). The results of multiple linear stepwise regression analysis showed that physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were the main influencing factors of sleep quality in the elderly. Conclusions The community elderly in this study had better sleep quality. Physical exercise, monthly amount of money, education and four dimensions of interpersonal troubles were all important factors affecting the sleep quality of the elderly. Community nursing staff should pay more attention to the sleep quality of the elderly, put forward measures to improve the related factors leading to sleep disorders, encourage the elderly to take physical exercise. They should also provide psychological counseling and interpersonal communication skills for the elderly with interpersonal troubles and help expand the communication platform to improve sleep quality of the elderly in the community.
Objective To understand the incidence of frailty in maintenance hemodialysis (MHD) patients, and to explore the correlation and influencing factors of frailty in MHD patients, so as to provide some basis for the intervention of frailty in MHD patients. Methods Patients who underwent MHD in the Department of Nephrology of West China Hospital of Sichuan University from January to March 2021 were selected. Frail scale and Pittsburgh Sleep Quality Index (PSQI) were used for evaluation, and the influencing factors of frail in patients with MHD and its correlation with frail were analyzed. Results A total of 141 patients with MHD were included, including 57 cases without frailty (40.43%), 71 cases in early frailty (50.35%), and 13 cases in frailty (9.22%). 54 cases (38.30%) had very good sleep quality, 56 cases (39.72%) had good sleep quality, 24 cases (17.02%) had average sleep quality, and 7 cases (4.96%) had very poor sleep quality. The frailty of MHD patients was positively correlated with age (rs=0.265, P=0.002), PSQI (rs=0.235, P=0.005) and magnesium (rs=0.280, P=0.001). Logistic regression analysis showed that the influencing factors of MHD patients’ frailty were gender [odds ratio (OR) =4.321, 95%confidence interval (CI) (1.525, 12.243), P=0.006], PSQI [OR=1.110, 95%CI (1.009, 1.222), P=0.032], magnesium [OR=122.072, 95%CI (4.752, 3 135.528), P=0.004], hypertension [OR=0.112, 95%CI (0.023, 0.545), P=0.007] and other diseases [OR=0.102, 95%CI (0.019, 0.552), P=0.008]. Conclusions The incidence of frailty in MHD patients is high. Gender, PSQI, magnesium, hypertension and other diseases are the influencing factors of frailty in MHD patients, and there is a correlation between frailty and sleep. It is suggested that renal medical staff should pay more attention to the assessment of MHD frailty and sleep, and carry out multi-disciplinary personalized intervention to improve the quality of life of MHD patients.