摘要
目的探讨血液透析患者不同睡眠模式与焦虑抑郁的关联,为改善其心理及睡眠状况提供依据。方法采用横断面调查方法,以便利抽样法选取2023年5月至2024年5月惠州市第六人民医院血液净化中心的264例患者为研究对象,使用一般资料调查表、匹兹堡睡眠质量指数(PSQI)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行调查,采用Mplus8.3进行潜在剖面分析,并用混合效应Logistic回归探讨睡眠模式类别与焦虑抑郁的关联。结果共收回有效问卷264份,其中男142例,女122例,年龄(56.61±12.69)岁。患者PSQI总分10.00(7.00,13.00)分,SAS总分45.00(40.00,49.00)分,SDS总分51.00(49.00,60.00)分。血液透析患者睡眠模式分为整体睡眠良好组(31.4%,83/264)、未使用催眠药物的睡眠困难组(55.7%,147/264)、使用催眠药物的睡眠障碍组(12.9%,34/264)3个类别;不同睡眠潜在类别在年龄、文化程度、焦虑、抑郁分布上差异均有统计学意义(χ^(2)值为9.75~25.72,均P<0.05);与整体睡眠良好组相比,未使用催眠药物的睡眠困难组发生焦虑的风险更高(OR=5.409,P<0.05),使用催眠药物的睡眠障碍组发生焦虑、抑郁(0R=5.010、6.488,均P<0.05)的风险更高。与未使用催眠药物的睡眠困难组患者相比,使用催眠药物的睡眠障碍组发生抑郁的风险更高(0R=6.501,P<0.05)。结论血液透析患者睡眠模式存在3个潜在类别,且与焦虑、抑郁之间显著相关,临床需实施精准筛查与个体化干预,以改善患者的生命质量。
Objective To investigate the association between different sleep patterns and anxiety and depression in hemodialysis patients,thereby providing a reference for improving their psychological and sleep conditions.Methods This study was a cross-sectional survey.A convenience sampling method was used to select patients undergoing regular dialysis at a hemodialysis centre in the Sixth People's Hospital of Huizhou from May 2023 to May 2024.Sleep quality,anxiety and depression symptoms were assessed using the Pittsburgh Sleep Quality Index(PSQI),Self-rating Anxiety Scale for(SAS)and Selfrating Depression Scale(SDS).Potential profiles were analyzed using Mplus 8.3 and mixed-effects Logistic regression was used to explore the association between sleep pattern category and anxiety-depression.Results A total of 264 valid questionnaires were returned,of which 142 were males and 122 were females,aged(56.61±12.69)years old.The sleep patterns of hemodialysis patients were divided into three potential categories:patients with overall better sleep quality31.4%(83/264),patients with poor sleep using hypnotic medication12.9%(34/264),and patients with poor sleep without hypnotic medication 55.7%(147/264).Significant differences were found in age,education,anxiety and depression across different sleep categories(χ^(2) values were 9.75-25.72,all P<0.05).Compared with the group with overall better sleep quality,the risk of anxiety was higher in the group with sleep difficulties without hypnotic medication(OR=5.409,P<0.05),and the risk of anxiety and depression(OR=5.010,6.488,both P<0.05)was higher in the group with sleep disorders using hypnotic medication.Compared with patients with poor sleep without hypnotic medication,patients with poor sleep using hypnotic medication had a higher risk of depression(OR=6.501,P<0.05).Conclusions There are three potential categories of sleep patterns in hemodialysis patients and significant correlations between them and anxiety and depression,and precise screening and individualized interventions need to be implemented in the clinic to improve patients'quality of life.
作者
锁丹
由天辉
卢慧懿
黄家莲
王月洪
郑晶
Suo Dan;You Tianhui;Lu Huiyi;Huang Jialian;Wang Yuehong;Zheng Jing(School of Nursing,Guangdong Pharmaceutical University,Guangzhou 510310,China;School of Continuing Education,Guangdong Pharmaceutical University,Guangzhou 510224,China;Division of Nephrology,the Sixth People's Hospital of Huizhou,Huizhou 516211,China;Division of Nephrology,the First Hospital of Guangdong Pharmaceutical University,Guangzhou 510062,China)
出处
《中国实用护理杂志》
2025年第30期2380-2385,共6页
Chinese Journal of Practical Nursing
基金
广东省中医药局中医药科研项目(20222111)
惠州市科技计划项目(221015196943666)。
关键词
血液透析
睡眠
焦虑
抑郁
潜剖面分析
Hemodialysis
Sleep
Anxiety
Depression
Latent profile analysis
