社会支持程度对腹膜透析置管后患者睡眠障碍发展轨迹的预测作用  

Predictive effect of social support degree on the development trajectory of sleep disorders in patients with peritoneal dialysis after catheterization

作　　者：张彩凤 杨玉霞 侯秀珍 方晓霞 Zhang Caifeng;Yang Yuxia;Hou Xiuzhen;Fang Xiaoxia(Department of Nephrology,Fourth Clinical College,Xinxiang Medical College,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Reproductive Medicine,Fourth Clinical College,Xinxiang Medical College,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Nursing,Fourth Clinical College,Xinxiang Medical College,Xinxiang Central Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院新乡医学院第四临床学院肾内科,新乡453000 [2]新乡市中心医院新乡医学院第四临床学院生殖医学科,新乡453000 [3]新乡市中心医院新乡医学院第四临床学院护理部,新乡453000

出　　处：《中华现代护理杂志》2023年第30期4133-4137,共5页Chinese Journal of Modern Nursing

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20191316)。

摘　　要：目的探讨社会支持程度对腹膜透析置管后患者睡眠障碍发展轨迹的预测作用。方法采用便利抽样法选取2021年5月—2022年10月在新乡市中心医院行腹膜透析置管术患者281例。在所有患者入组时(T0),腹膜置管术后第3天(D3)、第7天(D7)、第14天(D14)、第21天(D21)和第28天(D28)采用匹兹堡睡眠质量指数(PSQI)分别对患者进行睡眠质量评估后,采用潜类别增长模型分析患者睡眠障碍发展轨迹,采用领悟社会支持量表评估后将患者分为低社会支持组和高社会支持组,比较两组患者睡眠障碍发展轨迹分布差异。结果低社会支持组患者134例(47.69%),高社会支持组患者147例(52.31%);识别出3个潜在类别睡眠障碍发展轨迹:无睡眠障碍78例(27.76%)、睡眠障碍改善79例(28.11%)、睡眠障碍持续124例(44.13%),且轨迹显示PSQI得分在D3时最低,其次是D7和T0;低社会支持组中无睡眠障碍30例(22.39%)、睡眠障碍改善34例(25.37%)、睡眠障碍持续70例(52.24%),高社会支持组中无睡眠障碍48例(32.65%)、睡眠障碍改善45例(30.61%)、睡眠障碍持续54例(36.73%),两组患者睡眠障碍轨迹分布差异有统计学意义(P<0.05)。结论置管后腹膜透析患者睡眠障碍普遍存在,发生率为72.24%,在术后1周内较为明显。低社会支持度患者整体睡眠质量偏低,且更容易出现睡眠持续障碍。Objective To explore the predictive effect of social support degree on the development trajectory of sleep disorder in patients with peritoneal dialysis after catheterization.Methods A total of 281 patients who received peritoneal catheterization in Xinxiang Central Hospital from May 2021 to October 2022 were selected by the convenient sampling method.Sleep quality(PSQI)was assessed by using Pittsburgh Sleep Quality Index(PSQI)at the time of enrollment(T0)and on day 3(D3),day 7(D7),day 14(D14),day 21(D21)and day 28(D28)after peritoneal catheterization,and then the development trajectory of sleep disorders was analyzed by the latent class growth model.After assessed by Perceived Social Support Scale(PSSS),patients were divided into low social support group and high social support group,and the differences in the development trajectory distribution of sleep disorders of patients were compared between two groups.Results There were 134 patients(47.69%)in the low social support group and 147 patients(52.31%)in the high social support group.Three potential categories of sleep disorder development trajectories were identified,including 78 cases without sleep disorder(27.76%),79 cases with improved sleep disorder(28.11%)and 124 cases with persistent sleep disorder(44.13%).The trajectories showed the lowest PSQI score at D3,followed by D7 and T0.In the low social support group,there were 30 cases without sleep disorders(22.39%),34 cases with improved sleep disorders(25.37%)and 70 cases with persistent sleep disorders(52.24%).In the high social support group,there were 48 cases without sleep disorders(32.65%),45 cases with improved sleep disorders(30.61%)and 54 cases with persistent sleep disorders(36.73%).There was a statistically significant difference in the distribution of sleep disorder trajectories between the two groups of patients(P<0.05).Conclusions Sleep disorders are common in patients undergoing peritoneal dialysis after catheterization,with an incidence rate of 72.24%,which is more obvious within one week afte

关 键 词：透析 腹膜透析 睡眠障碍 社会支持 潜类别增长模型 

分 类 号：R473.5[医药卫生—护理学]