医务人员倒班相关睡眠障碍情况及其影响因素分析  

Analysis of shift work disorder and its influencing factors in medical staff

作　　者：王沁 郑彦晴 郭娜[1] 邢纪斌[1] 周少丽[1] WANG Qin;ZHENG Yanqing;GUO Na;XING Jibin;ZHOU Shaoli(Department of Anesthesiology,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Anesthesiology,the 74th Army Group Hospital of the PLA,Guangzhou 524400,China)

机构地区：[1]中山大学附属第三医院麻醉科,广东广州510630 [2]中国人民解放军陆军第74集团军医院麻醉科,广东广州524400

出　　处：《新医学》2025年第3期289-300,共12页Journal of New Medicine

基　　金：广东省基础与应用基础研究基金企业联合基金(2021A1515220061);广东省医学会偏向性激动剂-新型阿片类镇痛药物医学研究项目专项资金(GDMA202498002);中山大学附属第三医院临床研究专项基金(YHJH202307和QHJH201902)。

摘　　要：目的 通过问卷调查了解医务人员倒班相关睡眠障碍(SWD)情况及其影响因素,以改进医务人员睡眠认知及个人睡眠行为,提高其倒班工作睡眠质量,从而优化医疗服务体系,造福病患群体。方法 采用随机抽样的方法,选取500名医务人员进行上夜班期间因早醒而无法再入睡困难程度、上夜班期间醒着时自我感觉舒适度、上夜班期间打瞌睡的可能性、休息至少2 d后开车时打瞌睡或睡着等4个维度SWD问卷调查,采用单因素分析及多因素二元Logistic回归分析这4个维度SWD的影响因素。结果 500名调查对象中,在过去的一个月里上全夜班时遇到过早醒而无法再次入睡者占88.2%、醒着时自我感觉舒适度下降者占88.0%、上全夜班期间有可能打瞌睡者占85.2%,在至少休息2 d后开车时有可能打瞌睡或睡着者占56.0%。根据每个人的SWD风险计算可知,有72%参与者为SWD高风险人群,其余28%参与者为SWD低风险人群。多因素二元Logistic回归分析显示,婚烟状况(总体检验P=0.011,以未婚为参照,已婚OR=2.322、95%CI 1.328~4.058、P=0.003)、非夜班期间有服用助眠药等(OR=5.678,95%CI 1.350~23.872,P=0.018)均为夜班期间早醒而不能入睡的影响因素;压力情况(OR=3.732,95%CI1.072~12.996,P=0.039)和非夜班期间服用助眠药物等(OR=5.731,95%CI 1.367~24.031,P=0.017)是夜班期间醒着自觉舒适度下降的影响因素;运动情况(OR=0.540,95%CI 0.325~0.895,P=0.017)和压力情况(OR=5.246,95%CI 1.616~17.025,P=0.006)是夜班期间打瞌睡的影响因素;婚姻情况(总体检验P=0.043,以未婚为参照,已婚OR=1.509、95%CI 1.024~2.224、P=0.037)、光暴露时间(总体检验P=0.003,以光暴露时间<1 h为参照,光暴露时间3~<6 h OR=0.410、95%CI 0.208~0.825、P=0.012)和夜班期间小睡(OR=0.640,95%CI0.422~0.972,P=0.036)是“休息至少2 d后开车时打瞌睡”的保护因素。结论 医务人员中SWD较为常见,尤其已婚者及非夜班期间服用助眠药�Objective To investigate the status of shift work disorder(SWD)and influencing factors in medical staff,aiming to improve individual sleep cognition and sleep behavior of medical staffs and enhance the quality of shift work sleep,thereby optimizing medical service system and benefiting the patients.Methods Five hundred medical staff were selected by random sampling method to conduct a questionnaire survey of SWD in four dimensions including the situation of waking up early and unable to fall back to sleep,the perceived comfort of waking up during night shift,the possibility of dozing off during night shift,and the situation of dozing off or falling asleep while driving after at least 2 days rest during night shift.Influencing factors of SWD were analyzed from these four dimensions by using univariate and multivariate binary Logistic regression analyses.Results Among 500 respondents,88.2%of them experienced the situation of waking up early and unable to fall back to sleep during night shift in the past month,88.0%for those with decreased perceived comfort of waking up during night shift in the past month,85.2%with the possibility of dozing off during night shift in the past month and 56.0%with the situation of dozing off or falling asleep while driving after at least 2 days rest during night shift in the past month,respectively.According to the risk of SWD in all respondents,72%of them had high-risk SWD and the remaining 28%had low-risk SWD.Multivariate binary Logistic regression analysis showed that martial status(P=0.011 for overall test;OR=2.322,95%CI:1.328-4.058,P=0.003 for married versus single),and intake of hypnotics during non-night shift(OR=5.678,95%CI:1.350-23.872,P=0.018)were both influencing factors of waking up early and unable to fall back to sleep during night shift.Stress(OR=3.732,95%CI:1.072-12.996,P=0.039)and intake of hypnotics during non-night shift(OR=5.731,95%CI:1.367-24.031,P=0.017)were influencing factors of decreased perceived comfort of waking up during night shift.Exercise(OR=0.540,9

关 键 词：倒班相关睡眠障碍 倒班综合征 问卷调查 影响因素 医务人员 

分 类 号：R47[医药卫生—护理学]