老年晚期肺癌化学治疗患者睡眠质量的影响因素研究  

Study on influencing factors of sleep quality in elderly patients with advanced lung cancer undergoing chemotherapy

作　　者：樊盼玉 李玉梅[1] 杨磊[2] 樊嘉欣 Fan Panyu;Li Yumei;Yang Lei;Fan Jiaxin(Department of Nursing,Shanghai Pulmonary Hospital,Shanghai 200433,China;Department of Internal Medical Nursing,Xinxiang Medical College,Xinxiang 453000,China;Medical College of Tongji University,Shanghai 200433,China)

机构地区：[1]同济大学附属上海市肺科医院护理部,上海200433 [2]新乡医学院内科护理教研室,新乡453000 [3]同济大学医学院,上海200433

出　　处：《结核与肺部疾病杂志》2023年第3期210-215,共6页Journal of Tuberculosis and Lung Disease

基　　金：同济大学护理学院(筹)学科建设三年行动计划临床研究项目(JS2210319);同济大学教学改革研究与建设项目(JS20221212)。

摘　　要：目的:探讨影响老年晚期肺癌化学治疗(简称“化疗”)患者睡眠质量的因素,为临床实施精准化护理提供参考。方法:采用患者一般资料调查表、匹兹堡睡眠质量指数(pittsburgh sleep quality index,PSQI)量表、酒精使用障碍筛查量表(alcohol use disorder idenitification test,AUDIT),横断面调查2022年10月至2023年1月上海市肺科医院肿瘤科收治的住院老年晚期肺癌化疗患者145例。以PSQI≥8为睡眠障碍切点,分析睡眠质量状况及其影响因素。结果:老年晚期肺癌化疗患者的平均PSQI得分为(8.41±3.96)分,睡眠障碍发生率为51.03%(74/145)。其中女性的PSQI总分(x±s)、主观睡眠质量(x±s)、入睡时间[M(Q_(1),Q_(3))]、睡眠时间[M(Q_(1),Q_(3))]、催眠药物使用[M(Q_(1),Q_(3))]的得分分别为(10.78±3.11)、(1.65±0.48)、1.87(1.47,2,29)、1.78(1.31,2.28)、1.09(0.83,1.39)分,明显高于男性[(7.96±2.33)(1.13±0.33)、1.30(1.26,1.33)、1.22(0.89,1.52)、0.19(0.16,0.29)分],差异均有统计学意义(t=2.673、2.555;U=2.421、2.667、2.924;P=0.013、0.012,0.022、0.013、0.007)。有吸烟史者在睡眠时间(x±s)、催眠药物使用(x±s)2个维度得分分别为(1.67±0.48)(0.93±0.29)分,明显高于无吸烟史者[(1.22±0.39)(0.17±0.05)分],差异均有统计学意义(t=2.700、2.914;P=0.008、0.006)。有酒精依赖史者催眠药物使用维度得分[M(Q_(1),Q_(3))]为0.10(0.06,0.12)分,低于无酒精依赖史者[0.39(0.35,0.50)分],差异有统计学意义(U=2.616,P=0.010)。白细胞计数异常的患者在PSQI总分[M(Q_(1),Q_(3))]和入睡时间(x±s)、睡眠障碍[M(Q_(1),Q_(3))]得分分别为8.60(4.36,8.73)、(1.45±0.43)、1.30(0.65,1.40)分,高于白细胞计数正常的患者[6.88(3.56,7.12)、(0.94±0.28)、1.01(0.68,1.36)分],差异均有统计学意义(U=2.267,t=2.137,U=3.531;P=0.032、0.034、0.001)。血红蛋白异常、红细胞计数异常者日间功能障碍维度得分(x±s)分别为(1.25±0.36)(1.12±0.28)分)均高于正常者[(0.67±0.15)(0.76�Objective:To explore the influencing factors of sleep quality in elderly patients with advanced lung cancer undergoing chemotherapy,and to provide references for accurate nursing.Methods:A cross-sectional survey was conducted on 145 elderly patients with advanced lung cancer undergoing chemotherapy admitted to the Oncology Department of Shanghai Pulmonary Hospital from October 2022 to January 2023,using a patient general information questionnaire and the Pittsburgh sleep quality index(PSQI)scale and the Alcohol Use Disorder Identification Test(AUIDT)scale.PSQI≥8 was defined as the cutoff point for sleep disorders,the status of sleep quality and its influencing factors were analyze.Results:The average PSQI score of elderly patients with advanced lung cancer undergoing chemotherapy was(8.41±3.96),and the incidence of sleep disorders was 51.03%(74/145).The total PSQI score(x±s)of female was(10.78±3.11),and the scores of subjective sleep quality(x±s),time to sleep(M(Q_(1),Q_(3))),sleep duration(M(Q_(1),Q_(3))),and usage of hypnotic drugwere(M(Q_(1),Q_(3)))were(1.65±0.48),(1.87(1.47,2.29),(1.78(1.31,2.28)),and(1.09(0.83,1.39)),respectively,which were significantly higher than those of men((7.96±2.33),(1.13±0.33),(1.30(1.26,1,33)),(1.22(0.89,1.52)),and(0.19(0.16,0.29)),respectively),the differences were statistically significant(t=2.673,2.555,2.421,U=2.667,and 2.924;P=0.013,0.012,0.022,0.013,and 0.007,respectively).The scores of sleeping time(x±s)and hypnotic drug usage(x±s)in smokers were(1.67±0.48)and(0.93±0.29),respectively,which were significantly higher than those in non-smokers((1.22±0.39)and(0.17±0.05),respectively),the differences were statistically significant(t=2.700 and 2.914;P=0.008 and 0.006,respectively).The score of hypnotic drug use(M(Q_(1),Q_(3)))dimension of those who with alcohol dependence history was(0.10(0.06,0.12),which was significantly lower than that of those who without alcohol dependence history(0.39(0.35,0.50)),(U=2.616,P=0.010).Patients with abnormal white blood cell counts

关 键 词：入睡和睡眠障碍 肺肿瘤 因素分析 统计学 

分 类 号：R473.73[医药卫生—护理学]