住院老年糖尿病睡眠障碍患者睡眠护理干预的研究

发布时间：2018-04-02 04:01

本文选题：糖尿病　切入点：睡眠障碍　出处：《天津医科大学》2017年硕士论文

【摘要】：目的1调查影响住院老年糖尿病睡眠障碍患者睡眠影响因素;2探讨对住院老年糖尿病睡眠障碍患者给予“生理-行为”睡眠护理干预后的睡眠效果。方法本研究采用随机对照试验方法,按照纳入排除标准,选择2015年9月~2016年5月天津医科大学代谢病医院内在住院期间发生睡眠障碍的老年糖尿病患者作为研究对象。通过随机数字表法将住院老年糖尿病患者分为试验组和对照组。采用询问及患者自评相结合的调查方式,由经过统一培训的调查人员根据调查表的内容询问研究对象后填写。调查问卷的内容包括研究对象人口学相关资料、生活习惯、疾病状况以及相关临床生化指标等,再通过匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index,PSQI)对住院老年糖尿病患者进行睡眠质量的测量评价。对于试验组患者,本研究在常规睡眠护理干预的基础上提供给患者“生理-行为”睡眠护理干预措施;对照组患者,本研究仅接受常规睡眠护理干预。睡眠护理干预时间为7天;给予睡眠护理干预7天后再次对研究对象进行匹兹堡睡眠质量指数量表测量,了解睡眠护理干预后研究对象的睡眠质量,同时通过病历收集研究对象血糖的相关生化指标,利用Epidata3.0软件进行数据录入,统计分析数据则使用SPSS21.0软件。通过方差分析、t检验、多元线性回归分析、Pearson积距相关分析及协方差分析对量表测评结果进行分析。结果1调查分析结果1.1根据纳入排除标准,本研究实际共纳入研究对象120例,其中男性52例(43.3%),女性68例(56.7%);60~70岁组的人数最多占55%,70~75岁组次之,80以上岁人群最少。1.2通过对住院老年2型糖尿病患者的睡眠影响因素进行单因素分析、Pearson相关分析以及多因素分析,结果显示高龄、高身体质量指数、糖化血红蛋白(hemoglobin Alc,Hb Alc)值高、合并有心脑血管疾病的2型糖尿病患者睡眠质量差,而规律运动是睡眠障碍的保护因素。1.3本研究将住院老年2型糖尿病患者匹兹堡睡眠质量指数量表总分及各项目得分与全国常模进行比较,其中主观睡眠质量(1.50±0.76)、睡眠潜伏期(1.55±0.93)、睡眠时间(1.85±0.56)、睡眠效率(1.88±0.43)、睡眠障碍(1.37±0.52)5个因子得分均高于比国内常模,差异均具有统计学意义(P0.05),住院老年2型糖尿病患者睡眠质量比国内一般人群差。2干预结果本研究对试验组研究对象进行干预后,即在常规睡眠护理基础上给予“生理-行为”睡眠护理干预的患者其主观睡眠质量、睡眠潜伏期、睡眠时间、睡眠效率、睡眠障碍5个因子得分和匹兹堡睡眠质量指数量表总分明显降低,试验组干预前后的5个因子得分及匹兹堡睡眠质量指数量表总分差异具有统计学意义,而仅给予常规睡眠护理干预的对照组患者在干预前后测量其匹兹堡睡眠质量指数量表总分数值及各因子得分差异不具有统计学意义。结论1住院老年2型糖尿病患者普遍存在睡眠问题,睡眠质量比国内一般人群差,睡眠障碍发生率远高于正常人群,影响了老年糖尿病患者的生活质量和康复效果。同时本研究发现年龄、身体质量指数四个方面是住院老年2型糖尿病患者睡眠障碍的危险因素。2本研究提出的“生理-行为”睡眠敢于措施对住院老年2型糖尿病患者睡眠质量的改善有明显效果。
[Abstract]:The factors of sleep sleep disorders affect the hospitalized elderly patients with diabetes to 1 Investigation on 2; senile patients with diabetes for sleep disorders "physiology" sleep sleep effect after nursing intervention. Methods the method of randomized controlled trials, according to the inclusion and exclusion criterion, sleep disorder occurred September 2015 ~2016 year in May the metabolic disease Hospital of Medical University Of Tianjin the hospitalization of elderly patients with diabetes as the research object. The hospitalized elderly patients with diabetes were divided into experimental group and control group by random number table method. Self evaluation methods of combining and by asking the patient by investigators trained according to the content of the questionnaire about the research object. After completing the questionnaire including study on demographic information, lifestyle, disease status and clinical biochemical indicators, recanalization Pittsburgh sleep quality index scale (Pittsburgh Sleep Quality Index, PSQI) on the measurement and evaluation of sleep quality in elderly patients with diabetes. For patients in the experimental group, based on routine nursing intervention on sleep provides "physiological behavior" sleep in patients with nursing intervention; patients in the control group, this study received only routine sleep sleep nursing. Nursing intervention for 7 days; give again to study on Pittsburgh sleep quality index scale sleep nursing intervention for 7 days, the object of study about sleep after nursing intervention on sleep quality and related biochemical indicators through medical records collected blood glucose, input the data by using Epidata3.0 software, statistical analysis of data use the SPSS21.0 software. Through variance analysis, t test, multiple linear regression analysis, correlation analysis and covariance from the Pearson product division Analysis of the scale evaluation results were analyzed. Results of the 1 survey results of 1.1 according to the exclusion criteria, this study included 120 subjects, including 52 cases of male (43.3%), 68 cases were female (56.7%); 60~70 age group accounted for 55%, 70~75 years old group, 80 years old to the crowd at least.1.2 through single factor analysis of influencing factors of sleep in hospitalized elderly patients with type 2 diabetes, Pearson correlation analysis and multivariate analysis, results showed that older age, higher body mass index, glycosylated hemoglobin (hemoglobin Alc, Hb Alc) with high value of sleep in patients with type 2 diabetes quality and cardiovascular disease, and regular exercise is.1.3 protective factors of sleep disorders in this study of hospitalized elderly type 2 diabetic patients in Pittsburgh sleep quality index score and each item score compared with the national norm, the subjective quality of sleep among them (1.50 + 0.76), Sleep latency (1.55 + 0.93), sleep time (1.85 + 0.56), sleep efficiency (1.88 + 0.43), sleep disorders (1.37 + 0.52) 5 factor scores were higher than the national norm, the difference was statistically significant (P0.05), the quality of sleep in patients with type 2 diabetes than in the general population of domestic.2 intervention the results of test group of subjects intervention in hospitalized elderly, namely "physiological behavior" sleep nursing intervention in routine care on the basis of sleep in patients with subjective sleep quality, sleep latency, sleep time, sleep efficiency, sleep disorders 5 factor scores and Pittsburgh sleep quality index score decreased significantly. The experimental group before and after the intervention of the 5 sleep factor score and the Pittsburgh quality index scores the difference was statistically significant, but only routine sleep nursing intervention for patients in the control group before and after intervention to measure the sleep quality in Pittsburgh Volume index scale scores and each factor score difference was not statistically significant. Conclusion 1 hospitalized elderly patients with type 2 diabetes are common sleep problems, sleep quality than the general population in China, the incidence of sleep disorder is far higher than the normal population, affecting the quality of life and rehabilitation effect of elderly patients with diabetes. The study found that age, four aspects of body mass index is the physiological behavior of.2 risk factors in hospitalized elderly patients with type 2 diabetes mellitus patients with sleep disorders in this study proposes to improve sleep of elderly type 2 to measure the quality of sleep in patients with diabetes mellitus have obvious effect.

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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